There are major challenges facing the countries in the Pacific Basin. These include issues of hazardous waste management and the consequent adverse effects of hazardous wastes on human health, the potential disruption of our whole way of life as a consequence of global climate change, and the increasing problem on human health of air pollution and the effects of breathing polluted air. These issues and others were the focus of the 12th meeting of the Pacific Basin Consortium for Environment and Health Sciences, held in Beijing in late 2007. This volume is a collection of papers presented at that meeting, and this introductory chapter provides some perspective on three of the major issues that are of concern in all of the countries in this region. This meeting provided an opportunity for Chinese scientists and those from other countries in the Pacific Basin to share perspectives and possible solutions with others from the international community, and these various approaches are reflected in these proceedings.

Public health genomics prioritizes effective and ethical translation of genomic science into population health precision medicine. With the rapid development of cost-effective, next-generation genome sequencing, calls are growing for greater inclusion of Black people in genomic research, policy, and practice. Genetic testing is often the first step in precision medicine. This study explores racial differences in patient concerns about genetic testing for hereditary breast cancer. Employing a community-based participatory mixed methods research design, we developed a semi-structured survey that was shared broadly. There were 81 survey respondents, of which, forty-nine (60%) self-identified as Black, twenty-six (32%) indicated they had a history of a breast cancer diagnosis, or had received BRCA genetic testing. Black participants who expressed concerns about genetic testing were fairly equally distributed between concerns that could be addressed with genetic counseling (24%) and concerns about the subsequent use of their genetic data (27%). The concerns expressed by the participants in our study underscore a need for transparent disclosures and assurances regarding the use and handling of genetic data. These findings should be viewed in context with patient-led efforts to overcome systemic inequities in cancer care, as Black cancer patients have joined forces with advocates and researchers to develop protective health data initiatives and to improve their representation in genomic datasets. Future research should prioritize the information needs and concerns of Black cancer patients. Interventions should be developed to support their hidden work as a means to reduce barriers and improve representation in precision medicine.

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