GENETIC ATTRIBUTIONS AND RACIALIZED PERCEPTIONS OF OBESITY

Project Summary. Obesity is widespread in the United States and is a risk factor for chronic illness, impaired quality of life, and mortality. Like many health outcomes in the US, its prevalence and treatment are characterized by stark racial disparities. Black patients experience obesity at significantly higher rates than White patients and are less likely to benefit from leading obesity treatments. While these disparities are most plausibly attributed to social, economic, and environmental inequalities, the misguided suggestion that they might instead reflect genetic differences between members of different racial groups has been made repeatedly. This has occurred in the context of trends in which the conceptualization of obesity as a biomedical disease with a genetic etiology has been increasingly ascendant in recent years. The proposed research will examine the extent to which primary care providers endorse genetic explanations for racial disparities in obesity and whether such beliefs might be related to a dearth of knowledge about genetics (Aim 1). It will also test whether primary care physicians are more likely to attribute obesity to genetic causes when it occurs in a Black (vs. White) patient, and whether such racially disparate endorsement of genetic attributions might lead to differences in attitudes toward patients and in clinical judgments regarding patient care (Aim 2). In addition, the research will examine how American adults with obesity react to genetic explanations for obesity in healthcare, and whether such reactions differ between Black and White individuals (Aim 3). This will be accomplished through an experiment testing how Black and White Americans with obesity respond to a description of a physician who does (vs. does not) endorse genetic explanations (Aim 3a), as well as through focus groups in which Black and White adults with obesity will discuss their views about the use of genetics in obesity-related healthcare (Aim 3b). This research will shed light on ethically significant questions related to how beliefs about the role of genetics in obesity may shape clinical care for obesity and physician-patient relationships in racially disparate ways, potentially contributing to racial health disparities. It will inform future efforts to determine how the genetics of obesity can be taught to clinicians and discussed with patients in culturally sensitive ways, to avoid fueling problematic attitudes and beliefs about racial disparities or harming the important relationship between patients and their healthcare providers.