Racial Differences in Beliefs about Genetic Screening among Patients at Inner-City Neighborhood Health Centers. RESULTS

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Demographics

Fifty percent of the respondents were African-American and 50% Caucasian. Distributions for sex, marital status, level of education, household income, self-rated health, likelihood of having a physical examination within the last year, religion and religious influence differed significantly between races (Table 1). Interestingly, a higher percentage of African Americans thought God’s Word was the most important source for moral decisions than did Caucasians (79% vs. 56%, PO.001).

Table 1. Patient characteristics

Variable	Overall* (n=314) %	Caucasians (n=157) %	African Americans (n=157) %	P Value
Age (%)
50-64	52	52	52
65+	48	48	48	1.00
Female (%)	72	63	80	O.001
Marital Status (%)
Married	30	41	20
Widowed	30	27	32
Never married	11	11	10
Separated/divorced	30	21	38	O.001
Level of Education (%)
Some college education or more	40	48	33
<High school/vocational school	60	52	67	0.007
Household Income (%)
<$ 10,000	29	25	33
$10,000-$19,999	32	26	37
$20,000-$39,999	20	22	18
$40,000+	20	27	11	0.002
Self-Rated Health (%)
Excellent/very good	32	44	20
Good	36	35	38
Fair/poor	32	21	42	<0.001
Complete physical within the last year (%)	80	75	85	0.020
Religion (%)
Christian, Catholic/Orthodox	16	32	3
Christian, Protestant	68	58	86
Other	16	10	11	<0.001
God’s Word is most important source for moral
decisions (%)	68	56	79	O.001
Influence of Religion (%)
Quite a lot	76	69	83
Some	13	18	8
Not much	11	13	8	0.008
* May not add up to 100% due to rounding

Causes of Diseases

For seven diseases, respondents were asked to identify if they believed that the disease was caused by genetics, environment, both or neither. Most respondents thought that sickle cell disease, cystic fibrosis and diabetes were primarily genetic. Most thought that influenza was environmental, whereas a plurality thought that cancer, obesity and alcoholism had both genetic and environmental causes (Table 2). Racial differences in the perceived causes were found for four of these diseases: cystic fibrosis, cancer, obesity and diabetes (Table 2). Source your medication needs online. Cialis professional canada home delivered

Table 2. Percent of respondents who attribute disease to genes, the environment neither or both, by race

			African
	Overall*	Caucasians	Americans
Disease	(n=314)	(n=157)	(n=157)	P Value*
Sickle Cell Anemia
Genes	88	88	88
Environment	1	1	1
Both	4	4	5
Neither	6	7	5	0.859
Cystic Fibrosis
Genes	75	80	70
Environment	4	2	8
Both	22	12	10
Neither	9	7	13	0.044
Cancer
Genes	32	26	39
Environment	9	9	10
Both	46	58	34
Neither	12	8	17	O.001
Obesity
Genes	31	25	37
Environment	14	14	14
Both	43	52	35
Neither	11	9	13	0.023
Diabetes
Genes	61	51	71
Environment	6	5	6
Both	26	36	17
Neither	7	7	6	O.001
Alcoholism
Genes	27	23	32
Environment	20	18	22
Both	40	48	33
Neither	12	11	13	0.079
The Flu
Genes	со	со	3
Environment	69	64	74
Both	12	17	8
Neither	16	16	16	0.121
* May not add up to 100% due to rounding; | P value by Fisher’s exact test

Attitudes about Genetic Testing

Most (>90%) respondents thought that genetic testing is a good idea and that research on genetics would bring cures for many diseases (Table 3), while few believed that genetic testing results should be made available to employers, used for gender selection of a baby or as a basis for abortion. Buy flomax

Table 3. Attitudes* on genetic testing by race

Attitudes on Genetic Testing (%)	Overall (n=314)	Caucasians (n=157}	African Americans (n=157)	P Value*
Genetic testing to check tor risk ot getting a disease is a good idea	90	90	90	0.865
Employers should be able to see the results of genetic testing before hiring workers	29	26	30	0.358
Genetic testing will lead to racial discrimination	47	34	58	O.001
Genetic testing will lead to discrimination against the handicapped	55	47	64	0.003
Research on genetics will bring cures for many diseases	94	93	95	0.637
Research on genetics is tampering with nature and unethical	25	17	31	0.003
All pregnant women should have tests to look for genetic problems in the baby	70	58	79	O.001
Only pregnant women who want to should have tests to look for genetic problems in the baby	81	81	79	0.709
A pregnant woman whose baby has an abnormal genetic test should have an abortion                                                  23		20	24	0.378
People should be able to use genetic testing to select the sex of their children                                                             17           17 * Includes only patients who gave “agree” and “neutral” responses; f P value by Chi-squared test			14	0.517

Multivariate Models

After controlling for age, gender, educational level, marital status, self-rated health, time since last physical exam, and the influence of religion on major decisions, African Americans were more likely than Caucasians to agree that genetic testing led to racial discrimination (Table 4). Similarly, African Americans were more likely to agree that research on genetic testing was tampering with nature and thereby unethical, and more likely to agree that all pregnant women should have genetic tests. Although African Americans were less likely to identify themselves as Christian/Catholic/Orthodox, African Americans remained more likely to believe that God’s Word was their most important source for moral decisions.

Table 4. Demographics, health and attitudes about predictive genetic testing among African Americans compared with Caucasians

African Americans vs. Caucasians
Variable	Odds Ratio	95% Confidence Interval	P Value
Age 50-64 years (ref., 65+ years)	1.78	0.57-2.43	0.657
Female (ref., male)	1.30	0.59-2.82	0.515
Some college education or more (ref., <high-school diploma) 1.28		0.59-2.76	0.532
Marital Status (ref., Separated/Divorced) Married Widowed Never married	0.19 0.37 0.56	0.08-0.47 0.14-0.97 0.17-1.91	O.001 0.042 0.358
Self-Rated Health (ref., Fair/Poor) Excellent/very good Good	0.16 0.53	0.06-0.40 0.22-1.27	O.001 0.156
Complete physical within the last year	2.04	0.87-4.77	0.102
Genetic testing will lead to racial discrimination	3.02	1.51-6.05	0.002
Research on genetics is tampering with nature and is unethical	2.29	0.96-5.43	0.061
All pregnant women should have genetic tests	3.85	1.73-8.61	0.001
God’s Word is the most important source for moral decisions	3.61	1.50-8.72	0.004
Religion (ref., Other) Christian, Catholic/Orthodox Christian, Protestant	0.07 1.63	0.02-0.34 0.62-4.30	0.001 0.323
Influence of Religion on Decisions (ref., Not Much) Quite a lot Some	1.46 1.33	0.37-5.73 0.26-6.81	0.584 0.733