Social factors more important than genetics

While many people, especially in the US, have become focused on the genetics of health, many times that number have their health determined almost solely by social factors. You have to have food and water long before you are rich enough to worry about inheritance as a factor in your health.

An article in the Australian News today puts the issue into clearer focus with its title, "Being poor kills":

For instance, a boy living in the Glasgow suburb of Calton is expected to live to 54 - 28 years less than a boy born in affluent Lenzie nearby. 

That same child from Calton will typically have a shorted life than a child born in India, where life expectancy is 62.

Author David Rose continues:

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The World Health Organisation (WHO) has carried out a three-year analysis of the social determinants of health, concluding that social factors - rather than genetics - are responsible for huge variations in ill health and life expectancy around the world. Government policies that contribute to the gap between rich and poor, and wider social injustice, are "killing people on a grand scale", its authors add.

The report, drawn up by an eminent panel of experts forming the WHO's Commission on the Social Determinants of Health, found that in almost all countries, poor socio-economic circumstances equated to poor health.

The researchers found that a girl born in the African country of Lesotho was, on average, likely to live to 42, but this is less than half the expected lifespan of a girl in Japan (86). In Sweden, the risk of a woman dying during pregnancy and childbirth is one in 17,400, but in Afghanistan the odds are one in eight. The differences were so marked that genetics and biology could not explain them, the authors write: "(The) toxic combination of bad policies, economics and politics is, in large measure, responsible for the fact that a majority of people in the world do not enjoy the good health that is biologically possible."

The report calls for governments to consider how all their policies - including taxes, housing and transport - affect health. It says that it is entirely possible to reduce health inequality within a relatively short period of time. But it gives warning that, without action, injustice and inequality will only increase. The report says that governments should ensure a living wage for workers, together with working conditions that reduce work-related stress and ensure a healthy work-life balance.

I think it's time we consider how lucky most of us are to even consider genetic testing as part of our health care. As we look at the wonderful information now available to us because of genomic science, how do we offer this valuable resource to people who are not rich and not Caucasian? How do we bridge the divide?

Marie Godfrey, PhD

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