JAMA : the journal of the American Medical Association
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Alleviating health disparities in the United States is a goal with broad support. Medical research undertaken to achieve this goal typically adopts the well-established perspective that racial discrimination and poverty are the major contributors to unequal health status. ⋯ Overemphasis on genetics as a major explanatory factor in health disparities could lead researchers to miss factors that contribute to disparities more substantially and may also reinforce racial stereotyping, which may contribute to disparities in the first place. Arguments that promote genetics research as a way to help alleviate health disparities are augmented by several factors, including research funding initiatives and the distinct demographic patterns of health disparities in the United States.
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The role of estrogens in ischemic heart disease (IHD) is uncertain. Evidence suggests that genetic variations in the estrogen receptor alpha (ESR1) gene may influence IHD risk, but the role of common sequence variations in the ESR1 gene is unclear. ⋯ In this population-based, prospective cohort study, postmenopausal women who carry ESR1 haplotype 1 (c.454-397 T allele and c.454-351 A allele) have an increased risk of MI and IHD, independent of known cardiovascular risk factors. In men, no association was observed.
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Little is known about how state-level driver licensure laws, such as in-person renewal, vision tests, road tests, and the frequency of license renewal relate to the older driver traffic fatality rate. ⋯ In-person license renewal was related to a significantly lower fatality rate among the oldest old drivers. More stringent state licensure policies such as vision tests, road tests, and more frequent license renewal cycles were not independently associated with additional benefits.