Racial segregation and genomics-related knowledge, self-efficacy, perceived importance, and communication among medically underserved patients

Purpose: There is limited research on the relationship between structural environmental factors and genomics-related knowledge, self-efficacy, perceived importance, and communication. We examined the potential impact of racial segregation on these genomics-related outcomes among medically underserved patients. Methods: We analyzed data from a sample of 546 patients recruited from a primary care clinic in St. Louis, Missouri. Multivariable models were used to examine associations between racial composition of social environments across the life course and genomics-related knowledge, self-efficacy, perceived importance, and communication. Results: Non-Hispanic White patients reporting multiple past White social environments had higher genetic knowledge than non-Hispanic White patients reporting one or no past White social environments (P = .021), Black patients reporting 1 or no past White social environments (P = .002), and Black patients reporting multiple past White social environments (P < .001). We also found that among those reporting multiple current White social environments, Black patients were more likely than non-Hispanic White patients to frequently communicate about family history with family (P = .003). Conclusion: These findings indicate that structural factors may affect understanding of genetic information and communication about family history among medically underserved patients. Targeted interventions may increase the use of genetic services among this population and reduce health inequities.