Genes and environments: moving toward personalized medicine in the context of health disparities.

Understanding gene-environment interactions that may influence disease is the cornerstone of a personalized medicine approach built on diagnostics, risk assessment/risk modification, pharmacogenetics and biology. Although genetic and personalized medicine can influence clinical decision making, currently most genetic information is based on populations of European ancestry. Additional human genome research must include diverse populations in order to assess the impact DNA sequence variation and environmental influences have on human disease risk. Within this article, we present a brief overview of human genome variation and discuss how epigenomics may influence gene expression. Examples of gene-environment interactions are explored and linked to several health disparities and health outcomes among communities of color. With the Jackson Heart Study poised to take the next steps in examining genes and the environment in ways that other cohorts cannot, we will be closer to a more inclusive personalized medicine goal that transforms medicine from curative to preemptive for all.