'New' genetics meets the old underclass: Findings from a study of genetic outreach services in rural Kentucky
'New' genetics meets the old underclass: Findings from a study of genetic outreach services in rural Kentucky
复制标题
“新”遗传学与旧下层阶级的相遇：肯塔基州农村遗传推广服务研究的结果
DOI：
10.1080/09581590210127398
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发表时间：
2002
影响因子：
2.8
通讯作者：
S. Kelly
中科院分区：
文献类型：
--
作者：
S. Kelly
在“新”遗传学和公共卫生的交叉点上出现的最严重但研究最少的问题之一是社会阶层和遗传负担之间的关系。在美国，在伦理，政策和公共话语对遗传医学和阶级结构的关注经常被表达在一个潜在的“遗传下层”的概念。本文探讨了有用的遗传下层阶级的隐喻框架遗传和社会劣势的交叉点。数据来自对患有遗传疾病或遗传疾病的儿童的母亲进行的深入访谈的初步分析，这是对肯塔基州农村地区国家资助的遗传外展计划进行的更广泛研究的一部分。本文的第一部分简要地考虑了遗传下层阶级的概念，因为它已经出现在医学伦理和政策文献。有人认为，遗传下层阶级概念所依附的获取和歧视机制不太可能是新遗传学显著加强或加剧社会不利地位的机制。目前几乎没有直接的证据可以证实基因上无法就业或无法投保的下层阶级的概念。然而，与社会分层文献中出现的下层阶级相关的理论维度确实提出了研究遗传条件和社会劣势动态的方法。在本文的第二部分，从这些方面，并通过案例分析，确定的问题和过程，将是重要的社会劣势和公共卫生遗传学之间的关系的理解。
One of the most serious, but least examined, issues arising at the intersection of the 'new' genetics and public health is the relationship between social class and genetic burden. In the USA, concerns in ethics, policy and public discourses about genetic medicine and class structure have frequently been expressed in the notion of a potential 'genetic underclass'. The paper explores the usefulness of the genetic underclass metaphor for framing intersections of genetics and social disadvantage. Data are drawn from preliminary analysis of in-depth interviews with mothers of children affected with a genetic condition or illness, as part of a broader study of the state-funded Genetic Outreach Program serving rural Kentucky. The first section of the paper briefly considers the notion of the genetic underclass as it has appeared in medical ethics and policy literatures. It is argued that the mechanisms of access and discrimination to which the genetic underclass concept is attached are not likely to be those through which the new genetics significantly reinforces or exacerbates social disadvantage. Little direct evidence currently exists to substantiate the notion of a genetically unemployable or uninsurable underclass. However, theoretical dimensions associated with the underclass as it appears in social stratification literature do suggest ways of examining dynamics of genetic conditions and social disadvantage. In the second section of the paper, drawing from these dimensions and through cases analyses, issues and processes are identified that will be of importance to understanding relationships between social disadvantage and public health genetics.