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How internal medicine is impacted by the overrepresentation of Nigeria in African North American ancestral genetic databases

Fatimah LC Jackson

The genetics of African North Americans are complex amalgamations of various West and Central African peoples with modest gene flow from specific European and Amerindian peoples. The recently reported overrepresentation of Nigerian lineages in African North Americans reflects pronounced limitations in the African genomic database, the artificiality of the colonial maps of Africa, the contributions of multiple African empires and kingdoms into the transatlantic trade in enslaved Africans, and the overrepresentation of Yoruba peoples in the existing limited representation of West Africans in public genomic databases. For internal medicine, this overrepresentation reinforces the use of long held cultural stereotypes in clinical and didactic presentations. It encourages “short cut” assumptions that may not be biologically or sociologically sound. Additionally, this overrepresentation supports existing unconscious biases that harm holders and recipients of the biases and increases the magnitude of unintentional harm done to Legacy African North American patients

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