Objectives: To understand public perceptions and opinions of three options for prescribing medicine: individualized genetic testing, race-based prescription, and traditional prescription. Methods: Focus groups in urban, suburban, and rural communities over-sampled for minority groups conducted from February through April, 2001 in Georgia.

There is growing concern in the medical community about potential genetic determinism in the patient population. Limited information about the public understanding of genetic factors in disease formation is available. To access public perceptions of potentially deterministic phrasing of genetic risk factors, we sought to establish interpretations of the phrase, "a gene for heart disease." Focus groups in urban, suburban, and rural communities were conducted from July through October, 2001 in Georgia. A total of 108 participants were recruited. Participants were recruited to balance sex and racial representation. We used three outcome measures for participants understandings of the phrase: (1) participants' statements of the meaning of the phrase; (2) the level of determinism assigned to genetic factors by participants; and (3) participant reports of the health consequences of having "a gene for heart disease." Participants did not report a single interpretation of the phrase. There were dominant participant interpretations under each outcome measure: (1) "a gene for heart disease" was interpreted as meaning genetic and environmental factors both played roles in disease formation; (2) genetic predisposition was perceived as heightened, not absolute, risk; (3) the perceived health impact was a greater risk of becoming sick. Minority interpretations were found under each measure. Overall, naming "a gene for heart disease" does not appear to have a deterministic impact on a plurality of participants' perceptions of risks associated with genetic factors. Genetic fatalism in patient populations may be confined to a sizable minority. Important considerations for provider intervention and patient education are indicated.

A quantitative examination of a representative sample of popular discourse about genetics and heredity from U.S. mass magazines between 1919 and 1996 indicates that the term mutation has become increasingly negative in its connotations through time. Although it has been used more frequently than alternative terms such as variation and alteration, it is more likely to bear negative connotations than these alternatives. Increases in the negative contextualization of mutation were initially associated with reports of genetic damage to humans from nuclear radiation after 1956. Later increases in negative connotations appear to arise from more diffuse sources. These results are contextualized by comparison to other research on meanings of mutation and an observational sample of scientific discourse. Hum Mutat 19:6975, 2002.

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