New York City’s genetic diversity makes it a great place to tailor healthcare to the individual.
The genetic makeup of New York City is a vast web of stories and relationships—migrations, couplings, clusterings, undetected syndromes, and bodily boons. That’s what makes the city an incredible laboratory for the next frontier of healthcare: medicine tailored to you and your genes.
So says Eimear Kenny, professor and genetic researcher at the Icahn School of Medicine at Mount Sinai. Kenny and PhD candidate Gillian Belbin study neighborhood-level human movement patterns across New York City, using, among other things, the genetic samples of 32,000 New Yorkers.
These Big Apple residents all volunteered their anonymized genetic information and health records to the ISMMS’s BioMe Bank. Close to 35 percent of them were born outside the U.S., from roughly 130 different countries. Individuals self-described their ancestry, ethnicity, and gave their current zip code for the bank’s records, too.
Within all this data, Kenny and Belbin look for (and map) distinct patterns in the genes: Who settled in what neighborhood? Whose relative moved where? Whose parents come from different ethnicities?
“New York City is a melting pot: We have a treasure trove of diversity in our bank,”says Kenny. “As geneticists, it gives us a nice opportunity to test whether people who were born in U.S. might be similar to groups born outside.”
Within the BioMe sample, Kenny and Belbin have defined 10 distinct ancestral “groups,” where members are more related to one another than to other New Yorkers. Kenny compares them to “cities within the city,” since in many cases, they clump within particular neighborhoods in New York City. Individuals of Puerto Rican descent, for example, cluster in East Harlem and South Bronx.
“You don’t need genetic data to know this, but it helps us confirm that these communities capture populations that are similar,” says Kenny.
That’s especially helpful when it comes to defining genes that pose risks. Individuals in the Puerto Rican group, for example, were found to be more likely than others to have Steel syndrome, a musculoskeletal condition that often goes undiagnosed. Kenny and Belbin isolated the gene that causes the syndrome—a specific variant for Puerto Ricans.
“If we’d lumped everyone together into ‘Hispanic,’ we probably wouldn’t have been able to see this,” says Kenny.
High-resolution genetic analysis of this kind can lead to better outcomes at the doctor’s office. Patients of particular ancestries, and particular communities, can get screened for conditions for which they may be at risk. That could lead to more effective treatment than if they were retroactively diagnosed.
It’s all a way of tailoring health care to the individual, or what’s called “precision medicine,” which President Obama has called a chance for huge breakthroughs in the quest for healthier lives.
“If we’re born with a particular disease, or a particular genetic makeup that makes us more vulnerable to something, that’s not our destiny, that’s not our fate,” he said at an event marking the announcement of a major precision medicine funding initiative in January. “We can remake it.”
According to Kenny and Belbin, who presented their findings at the American Society of Human Genetics Annual Meeting this month, the range and depth of genetic compositions within cities make them the ideal place for researchers and doctors to start fine-tuning their care.
”If you think forward to the next 20 or 40 years, our urban centers are going to grow more and more, and become even more diverse,” Kenny says. “More cities will look like New York City going forward.”