One size does not fit all: an historian's perspective on precision diabetes medicine

Abstract

This article offers an historical approach to exploring precision medicine's potential for reducing health disparities in diabetes. It examines case studies from the twentieth-century USA, from early twentieth-century beliefs that Jews were most at risk of developing diabetes to claims in the 1980s that Native Americans, African Americans, Hispanic Americans and Asian Americans had the greatest likelihood of developing the disease. These case studies reveal that attempts to understand perceived health disparities have long tended to focus on the biology and behaviours of the unwell, while paying less attention to food security, workplace hazards, access to quality healthcare and other social determinants of health. The precision medicine initiative, I argue, has an opportunity to right this imbalance by leveraging the tools of big data to learn more not only about biomarkers but also about the social and physical environments in which people live and work.

Keywords: Anti-racism; Diabetes; Health disparities; History; Personalised medicine; Precision medicine; Race; Review; Social determinants of health; USA.