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Chunk #21 — How do we even the ledger?

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Clinical use of current polygenic risk scores may exacerbate health disparities.
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Additional leading global efforts also provide easy unified access linking genetic, clinical record, and national registry data in more homogeneous continental ancestries, such as the UK Bio bank, Bio Bank Japan, China Kadoorie Bio bank, and Nordic efforts (e.g. in Danish, Estonian, Finnish, and other integrated bio banks). Notably, some of these bio banks such as UK Bio bank have participants with considerable global genetic diversity that enables multi-ethnic comparisons; although minorities from this cohort provide the largest deeply phenotyped GWAS cohorts for several ancestries, these individuals are often excluded in current statistical analyses in favor of single ancestries, large sample sizes, and the simplicity afforded by genetic homogeneity. These considerations notwithstanding, there are critical needs and challenges for expanding the scale of genetic studies of heritable traits in diverse populations; this is especially apparent in Africa where humans originated and retain the most genetic diversity, as Africans are understudied but disproportionately informative for genetic analyses and evolutionary history27,73. The most notable investment here comes from the Human Heredity and Health in Africa (H3Africa) Initiative, increasing genomics research capacity in