Week 4: Health Disparities, part 1

In honor of Martin Luther King, this week I’m reading through some articles on health disparities: how they still persist, and how they can maybe be improved.

#10: Health-related disparities: influence of environmental factors

The first author of this article was the director of the National Institute of Environmental Health Sciences when this article was published in 2005, so programs funded by NIEHS feature pretty prominently. The article gives five potential explanations for health disparities: genetic predisposition to various diseases; disproportionate exposure to environmental toxins; social, behavioral and cultural risk factors; reduced access to health care services; and stress or other factors associated with race or minority status. It then goes into the first two in depth. It’s another review, so here are some highlights:

  • The activity of enzymes like the cytochrome P450 system can have a 10,000 fold variation in activity depending on which allele you have. This obviously impacts how your body is able to handle drugs and environmental toxins.
  • How toxic an exposure is depends on your underlying genetics; most people don’t get most diseases they are at risk for by environmental factors
  • Examples of increased susceptibility due to genetics: organophosphate pesticide toxicity/paraoxonase enzyme; bladder cancer in smokers/N-acetyl-transferase; berylliosis (97% of affected workers have the marker)
  • African-American women are more likely to carry variants that upregulate proinflammatory cytokines
  • Differences in DNA repair genes may underlie individual predisposition for cancer: people with less risky variants had more well-protected DNA
  • Living and working in poor neighborhoods is a predictor for coronary heart disease even after controlling for income and education
  • 61% of asthma cases in kids happen in those who live in areas that don’t meet air quality standards

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This got me started browsing all the resources that are available on the NIEHS website. And rethinking the wisdom of my decision to live next to a freeway. (But it’s so convenient in the mornings!) And once again resolving to eat more fruits and vegetables to help anti-oxidize my DNA…

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