Gregory L. Hall, MD is the author of Precision Medicine for African Americans: A Concise, Evidence-Based Guide to Important Differences and Better Outcomes (Springer Nature, 2nd edition, 2025), which covers the diagnosis, treatment and prevention of disease in African American patients.
What is precision medicine for African Americans?
Precision medicine means fitting care to the person: their genes, biology, environment, and life experience. For African Americans, that means knowing where the evidence shows that the best approach is different. Examples include medication choice, how lab results are read, when screening should start, and how trust is built in the exam room.
This isn’t about treating people differently because of skin color. It’s about applying what the research shows so Black patients get the same good outcomes everyone deserves. “One size fits all” medicine has not delivered that.
The precision medicine approach, condition by condition
Each section below follows a chapter of the book and links to plain-language articles and videos on the topic.
Trust and communication
Good outcomes start with trust. Distrust of medicine has historical roots, and it affects whether patients fill prescriptions, come back for follow-up, and agree to screening. Representation matters too: Black physicians are more likely to choose primary care, and Black patients who see them tend to live longer.
Black Doctors and Longer Lives
Black physicians choose primary care more often, and their Black patients tend to live longer.
Fear of Medication Side Effects
Why worry about side effects keeps some patients from taking needed medicine.
More on trust: The Tuskegee syphilis study · Historical reasons for distrust · How bias affects care
Heart disease and high blood pressure
High blood pressure tends to start earlier and hit harder in Black adults. Salt sensitivity is more common, and the evidence supports particular first-line medicines. Lipoprotein(a), an inherited heart risk factor, also tends to run higher.
The Right Blood Pressure Medicine
Which first-line medicines the evidence favors for Black women and men.
More on heart health: Heart disease · Heart failure · Atrial fibrillation · Stroke · Statin intolerance · Peripheral vascular disease
Kidney disease and the APOL1 gene
APOL1 gene variants, found almost entirely in people of recent African ancestry, raise the risk of kidney disease. Kidney function equations have also changed in recent years, which affects how results are read.
Diabetes and obesity
Diabetes and obesity are more common, and complications happen at higher rates. The right approach looks at screening, how lab markers like A1c are interpreted (and could be inaccurate), medication choice, and culturally relevant nutrition. Ketosis-prone (Flatbush) diabetes, seen more often in Black communities, doesn’t fit neatly into type 1 or type 2 and is easy to miss.
More on diabetes: Metformin intolerance · Smoking and diabetes
Cancer
Black Americans die of several common cancers at higher rates, including breast, prostate and colorectal cancer. Earlier, consistent screening and clearing up myths save lives. Prostate cancer is the most common cancer in Black men, and the screening conversation should start earlier.
More on cancer: The “air hits the cancer” myth · Blood clots after a cancer diagnosis · Lung cancer screening · Calcium and prostate cancer · Smoking after cancer
Lab results and blood disorders
Some “abnormal” lab results are normal variation in people of African ancestry, such as a lower white blood cell count. Others, like sickle cell disease and sickle cell trait, need specific attention.
More on lab results: Low potassium
Lung, rheumatic, digestive and liver disease
Asthma, lupus, sarcoidosis, and several digestive and liver conditions look different in African American patients: how common they are, how they show up, and how they respond to treatment. In the gut, most African Americans lose some ability to digest lactose after childhood, yet many tolerate small servings of dairy, yogurt or aged cheese, so cutting dairy entirely can shortchange calcium and vitamin D. H. pylori infection and stomach cancer are more common, colorectal cancer tends to appear at younger ages (screening should start by 45), and fatty liver disease, while less frequent than in some groups, still tracks closely with diabetes. The gut microbiome, shaped by diet and environment, is an emerging part of the picture.
Stress, mental health, sleep and pain
Chronic stress affects the body, depression often goes undiagnosed, and pain is often undertreated. Each calls for a deliberate, bias-aware approach. African Americans report lower rates of depression and anxiety than white Americans, yet face worse outcomes when these conditions take hold.
More on mental health and sleep: Sleep apnea
Women’s health
Black women in the U.S. die during pregnancy or soon after at about three times the rate of white women, a gap that has held for decades. Uterine fibroids are also far more common: by age 50, an estimated 80% of Black women will have had them.
Nutrition and supplements
Nutritional needs differ too. Low vitamin D is a common example. Supplement advice that works for one group may not fit another.
More on nutrition: Is the blood type diet “precision nutrition”? · Magnesium deficiency · Vitamin C deficiency · Diet differences
“If race is a social construct, why does it matter?”
This is the question asked most often. Ancestry, genetics, environment and lived experience all shape health, and ignoring real differences in outcomes doesn’t make them go away. Inherited risk isn’t destiny; it’s a target for prevention. And grouping all “minorities” together hides the fact that Black Americans live about four years less than white Americans, while Asian and Hispanic Americans live longer.
More on race and ancestry: Genetic clues many doctors ignore
The book
Precision Medicine for African Americans: A Concise, Evidence-Based Guide to Important Differences and Better Outcomes, 2nd edition (Springer Nature, 2025). Sixteen chapters for physicians, nurses, pharmacists and students, covering cardiovascular, diabetes and obesity, cancer, renal, rheumatic, pulmonary, hematologic, GI and hepatic care, mental health, pain, nutrition, emotional intelligence, and professional responsibility.
Softcover ISBN 978-3-031-95773-4 · eBook ISBN 978-3-031-95774-1
Get it from Springer · Get it on Amazon · All books by Gregory L. Hall, MD
About the author
Gregory L. Hall, MD is an internal medicine physician with more than 30 years in clinical practice and public health. He is President of the Cuyahoga County Board of Health, Founder of the National Institute for African American Health (NIAAH), Associate Clinical Professor at Case Western Reserve University School of Medicine, Pri-Med faculty, a 2025 Library of Congress HistoryMakers inductee, and host of Better Black Health TV.
Watch on YouTube · Press & speaking inquiries
