(This article previously appeared on Grandparents.)
Watching what you eat, exercising to stay fit and getting enough sleep are all important factors in staying healthy. But there are other factors beyond your control that determine if you’ll get sick, and your ethnic background is a big one.
While ethnicity won’t definitively determine whether you get a disease or illness, there are some conditions that pop up with more frequency among certain ethnic groups.
We do know that there are single genes that can cause certain conditions, and we know that people of certain ethnicities carry those genes at a higher rate.
— Rachel Ratner, genetic counselor with the Westmed Medical Group
Who’s at Risk?
If for example, you are of Ashkenazic Jewish descent, you are more likely to have the BRCA I or BRCA II gene which increases the chance that you’ll develop breast or ovarian cancer in your lifetime. The BRCA gene is present in 1/500 people overall. But in Ashkenazic Jews, the rate is 1/40. If you have the BRCA gene, your risk of developing the disease is 87 percent higher than if you don’t have it.
Similarly, people who are African-American have a higher risk of developing sickle cell anemia and cardiovascular disease.
People who are Asian and Hispanic are more likely to develop thalassemia — a disorder in which the blood makes an abnormal amount of hemoglobin.
And Caucasians develop cystic fibrosis at higher rates than other groups.
Other conditions associated with certain ethnic groups:
- Hispanics are more likely to develop diabetes (Native Americans, too.) In fact, Mexican Americans have an 87 percent higher risk and Puerto Ricans a 94 percent higher risk of developing this disease than Caucasians, and Latinos are twice as likely to die from it, according to the Centers for Disease Control.
- Asian-American women develop osteoporosis in greater numbers than other members of the population, and since 90 percent of Asian- Americans are lactose intolerant, many do not get enough bone-protecting calcium.
- African-American men have a gene that makes them more likely to get prostate cancer, according to the Centers for Disease Control, while African-American women seem to have a higher risk for aggressive forms of breast cancer. They also die from that disease more frequently than white women.
Some of these disparities are not related to ethnicity itself but are the result of less vigilant screening among certain populations. Either because of a lack of health care or a fear of the medical system, some people don’t get regular medical checkups.
Still, there may be genes present in your ethnic group that make you more susceptible to certain diseases. And that’s why it’s important to discuss your background with your physician.
“We do know that there are single genes that can cause certain conditions, and we know that people of certain ethnicities carry those genes at a higher rate.” says Rachel Ratner, genetic counselor with the Westmed Medical Group in Rye, N.Y.
Can’t My Doctor Tell By Looking at Me?
It may not be obvious to your doctor what you ethnic background is. After all, we live in a melting pot of mixing cultures. But be sure to share details of your heritage with your physician, because knowing your background can be key in diagnosing diseases, avoiding certain medications and assessing the likelihood that you’ll develop serious health issues.
“Now that we have testing available for genetic syndromes that tend to cluster in ethnic populations, it’s important to know the patient’s background to establish whether a particular person is at risk,” says Dr. Carl Olden, a family physician in Yakima, Wash., and a member of the board of the American Academy of Family Physicians.
Sharing this information with your doctor is not difficult, continues Olden, who views it as a way for patients and doctors to get to know one another better. He suggests using a family photo album as a starting point to talk about your relatives but to also list the diseases and health issues they had. Tuck a list into the back of the book for reference.
Family History and Ethnic Background
Your ethnic background coupled with your family health history provides important clues about your likelihood to develop a particular disease, says Ratner.
“If you tell me that your mother had breast cancer, your grandmother had ovarian cancer and your aunt has breast cancer, then you may want to consider genetic testing for the gene,” Ratner says.
If testing determines you have the gene, you may consider more frequent mammograms or, as some women have done, opting to have your breasts surgically removed to prevent cancer. But you will discuss these options with your doctor and a genetic counselor.
As with many medical facts, this type of information is complicated. Just because you belong to an ethnic group with a genetic predisposition to a disease does not mean you are doomed to have a life with that disease. But it does mean that you might want to be screened more regularly or earlier in your life than other people if you and your doctor are concerned.
Genetic testing is expensive, and not always advised. For example, scientists have identified the gene that causes early onset Alzheimer’s disease, but there is no treatment to prevent it — and it doesn’t seem to be particular to any one population. So knowing that you have it won’t help you combat it—it will probably only worry you.
Your doctor may also be aware that certain ethnic groups should avoid certain medications because they cause side effects in select populations. Carbamazepine, for example, an anticonvulsant drug, is usually not prescribed for people who are Asian because there is a history of severe reactions. Differing doses of Warfarin, an anti-coagulant, must be considered if the patient is African-American, Asian or Caucasian.
“Some populations may not metabolize medications as well,” says Olden. “We are beginning to understand more and more about genes and how they affect the response to medication. We are looking at how we respond to medications and how our body detoxifies them or makes them ineffective.”
Not everyone in a particular ethnic group would react badly to a medication, but knowing your ethnic background would signal your doctor to monitor you closely on a particular drug—or to consider an alternative.
Choices Factor In, Too
“Every condition is a combination of genes and environment,” says Ratner. “There’s the environment inside your body and the one outside your body. You can see two people who have the same gene mutations but have different outcomes. There’s a lot we still don’t know. But one of the reasons I like genetics is that it’s an effort to say that you can change a family history of illness with information that generations before didn’t have. Maybe they could have changed the outcome if they’d had the information that someone today has.”
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