CRISPR in Public Health: The Health Equity Implications and Role of Community in Gene-Editing Research and Applications

Abstract

CRISPR (clustered regularly interspaced short palindromic repeats) is a Nobel Prize–winning technology that holds significant promise for revolutionizing the prevention and treatment of human disease through gene editing. However, CRISPR’s public health implications remain relatively uncertain and underdiscussed because (1) targeting genetic factors alone will have limited influence on population health, and (2) minority populations (racial/ethnic, sexual and gender)—who bear the nation’s greatest health burdens—historically suffer unequal benefits from emerging health care innovations and tools. This article introduces CRISPR and its potential public health benefits (e.g., improving virus surveillance, curing genetic diseases that pose public health problems such as sickle cell anemia) while outlining several major ethical and practical threats to health equity. This includes minorities’ grave underrepresentation in genomics research, which may lead to less effective and accepted CRISPR tools and therapies for these groups, and their anticipated unequal access to these tools and therapies in health care. Informed by the principles of fairness, justice, and equitable access, ensuring gene editing promotes rather than diminishes health equity will require the meaningful centering and engagement of minority patients and populations in gene-editing research using community-based participatory research approaches. (Am J Public Health. 2023;113(8):874–882. https://doi.org/10.2105/AJPH.2023.307315 )