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Coordination of researchers fere in studies of humans, of other mammalian systems, of protein biochemistry cree site-directed mutagenesis, and of cellular biology will be required to understand the interaction shw genes and environment required to make an impact on public health in the United States. Using a sample that included a small number less than 50 each of African Americans, Hispanics, Asians, and Europeans, Smith et al. Additionally, 10 percent of all markers showed a difference of 40 percent or more.

To the extent that findings from this study reflect the larger population, one would hypothesize that an allele with 20 percent or greater frequency in one racial group would also be found in another racial group, while those with a frequency below 20 percent would most likely be race-specific. For example, in some studies of hypertension, variation of SNPs at different allelic frequencies from one population to another suggest that higher rates of hypertension found in African Americans may be related to the alternations in DNA that vary by group Cui et al. Prior to drawing conclusions, however, one must consider alternative explanations that include gene-environment interactions as possible contributors to observed disparities Whitfield and McClearn, Arguments that genetic factors cannot be a major cause of health disparities arise out of a paradigm of genetic research that focuses on independent effects of genetics.

Research on health disparities is an important opportunity to integrate biological knowledge with social and behavioral knowledge in order to better understand the determinants of disease. Social factors are certainly key contributors, but there is evidence that those factors do not account for all health differences Braun, Conversely, solely focusing on molecular genetics ignores the dynamic nature of populations of DNA and the complex relationships among genes, organisms, and environment. Considerable literature exists concerning how environmental processes, events, and circumstances contribute to development and behavior in ways that influence health as well.

Some of these environmental factors are negative and are found to be more prevalent in the development of minorities. Some research suggests that African Americans may experience events and circumstances that have sociocultural origins that significantly influence development over the life course Levine, ; Spencer et al. These sociocultural influences contribute to differences between racial groups as well as to differences between individuals within groups Krauss, ; Levine, ; Jackson and Chatters, Sources of individual differences in health and behavior in African Americans have implications for the quality of late life as well as quantity of late life years of life remaining.

The multiple jeopardy hypothesis, for example, holds that negative environmental, social, and economic conditions during the early years of life for African Americans detrimentally affect social, psychological, and biological conditions in late life Jackson, Although this hypothesis attempts to explain health differentials experienced by African Americans relative to Caucasians, it is critical to remember that there is considerable individual variability in these conditions within the African American population and within other minority populations. In the search for the environmental origins of health differentials among ethnic groups, much of the earlier research focused on behaviors and social structures NRC, For example, environmental and behavioral variability among Hispanics evinces similarities and differences among its subgroups.

Conversely, the groups within the Hispanic category significantly differ in their regional concentrations in the United States e.

Contrasts between immigrants and their U. Then the advantage decreases Vega and Lve, Perhaps the most studied social variable in the search for environmental origins of health differentials is socioeconomic status SES see Chapter 2. For example, substantial differences exist between African Americans and Caucasian Americans with regard to their socioeconomic position. Thus, according to the U. Poverty rates among African American households are nearly three times as high Comparing households reporting similar levels of income, African American households report substantially lower levels of net wealth compared to Caucasian Americans Conley, These differences in Lj and wealth are partly Lm live free sex show com to differences in average educational attainment when comparing African Americans sexx Racial differences in intergenerational transfers of wealth, the growth of home equity over time, and shhow to federal programs that facilitated home libe after World War II have played an even larger role in racial disparities in wealth over time Oliver and Shapiro, African Americans also report higher levels of uninsurance Research reveals that these socioeconomic differences between races account for a substantial portion of the racial disparity in health outcomes IOM, Sec the same time, adjusting for socioeconomic differences does not completely eliminate racial disparities for all health outcomes e.

A universal finding is that people with higher indices of SES education, income, and occupational grade have lower mortality rates and lower rates of most diseases. However, more research is needed on how particular markers of SES show linear or nonlinear effects on health status NRC, These gradients will be critical to understand in examining how genetic influences vary in social environments. One of the future and formidable challenges to using the information ascertained from adding genetic information to examinations of health differentials is to gain an understanding of the underlying effect genes have on health within these complex environments.

It may be found that the polymorphisms that occur in genotypes are destructive or protective factors related to disease and health that are created, modified, or triggered by cultural and contextual factors Whitfield, ; Whitfield and McClearn, To narrowly focus on such concepts impedes an appreciation of the rich variety among humans, however attention must be given to these and other categories in order to conduct meaningful research assessing the impact on health of interactions among social, behavioral, and genetic factors. For example, although a consistent genetic effect across racial groups can result in genetic variants with a common biological effect, that effect can be modified by both environmental exposures and the overall admixture of the population.

The challenge is to parse out how health outcomes are influenced by genetic variations, behavioral and cultural practices, and social environments independently and as they interact with each others, while recognizing that sex, gender, race, and ethnicity may play important roles in their own right and because of their social meanings. Social Science and Medicine. Genetic influences on health: Journal of the American Medical Association. Enzyme replacement for lysosomal diseases. Annual Review of Medicine.

Race, ethnicity, and health: Can genetics explain disparities? Perspectives in Biology and Medicine. Apoptotic pathways are inhibited by leptin receptor activation in neutrophils. The importance of race and ethnic background in biomedical research and clinical practice. New England Journal of Medicine. Being Black, Living in the Red: Race, Wealth, and Social Policy in America. University of California Press; Association of polymorphisms in the promoter region of the PNMT gene with essential hypertension in African Americans but not in whites.

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American Journal of Hypertension. Another major concern is that one of the partners will develop romantic feelings for the other. Relationship maintenance and student sbow edit ] Casual relationships, being a mix between a friendship zhow a non-romantic sexual relationship, result in the partners facing many challenges in Lm live free sex show com a working relationship. Based on the exchange theoryHughes witnessed an individual dependency on either partner as the exchange of resources, knowledge, rewards, and costs of items, becomes more and more prominent.

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