Why One-Size-Fits-All Genomics Fails: The Urgent Need for Ancestry-Aware Precision Medicine

We are not all the same in how we look, act, or need healthcare. So, let's make sure health systems are using genetic databases that are not designed to be "one size fits all."

The Problem: A Standard Genome Does Not Represent Us All

Walk into any hospital or research lab, and there is a good chance the tools used to interpret genetic data are built on a single, standard reference: the GRCh38 human genome. That reference, and the databases built around it (gnomAD, 1000 Genomes, ExAC), have powered incredible medical advances, but they were not built for everyone. And for too many people, especially in marginalized communities, that means medicine can misfire in ways that are invisible to the institutions meant to serve them.

The prevailing assumption is simple: if a genetic variant is “rare” or “benign” in the reference, which must hold true for everyone. But this belief, while convenient, is deeply flawed. In fact, the standard genome is overwhelmingly weighted toward European ancestry, leaving major gaps in how we interpret risk, disease, and health for African American, Latino, Indigenous, and other historically excluded populations.

What’s Getting Missed, and Who’s Paying the Price

Real-World Harm: Misdiagnosis and Missed Opportunities

Studies show that patients from underrepresented ancestries are up to twice as likely to receive a “Variant of Uncertain Significance (VUS),” which is a vague label that often leads to no action, or worse, unnecessary tests and anxiety. For patients at Federally Qualified Health Centers (FQHCs), and for students and faculty at Minority-Serving Institutions (MSIs), this is more than a data quality issue; it is a life-altering blind spot.

Imagine being told you might carry a dangerous mutation, when in fact, that variant is benign in your ancestral population. Or imagine having a serious mutation missed entirely because the reference dataset does not reflect your genetic background. These are not hypotheticals; they are realities for thousands of Black, Indigenous, and Latino patients across the U.S.

Research Gaps Become Care Gaps

When researchers rely solely on the global reference genome without accounting for ancestry, they not only risk clinical errors; they limit scientific progress. Potential breakthroughs specific to marginalized populations are delayed or dismissed because the tools are not calibrated to see them.

The Truth: Variant Interpretation Must Be Ancestry-Aware

Precision medicine demands more than sequencing data; it demands precision thinking. That means acknowledging that no reference is truly “universal.” To serve all patients equitably, genomics must be:

• Ancestry-aware: Incorporating allele frequencies from diverse and localized populations.

• Functionally informed: Accounting for how gene expression and epigenetics vary across environments and populations.

• Continuously curated: With reference panels updated as new populations and variants are studied.

This is not about political correctness; it is about scientific rigor. Without it, precision medicine becomes privileged medicine: accurate for some, flawed for others.

The Phronetik Solution: Equity Starts with the Right Lens

At Phronetik, we are intentionally designing our platform for communities that have been historically excluded, not after the fact, but from the very beginning.

Population-Specific Reference Panels

Our in-house bioinformatics team works with MSIs, FQHCs, and local partners to build and continuously refine ancestry-aware reference panels. These datasets reflect the real genomic diversity of African American, Caribbean, Latino, and Indigenous communities, correcting for blind spots baked into mainstream tools.

Localized Genomic Intelligence

From our precision health models in the U.S. Virgin Islands to agricultural genomics pilots in the Caribbean and southern U.S., we are deploying NGS-based services that return accurate, community-specific insights. Whether the application is human health or food security, our models are built for real-world equity.

Empowerment Through Partnership

Phronetik does not just bring the tools; we bring a framework for community-led genomic intelligence. We co-author grants, support capacity-building, and empower institutions to run their own labs, interpret their own data, and shape the future of research and care in their regions.

Why Ancestry Aware in Precision Medicine Matters, And What You Can Do

As family trees can effectively capture the past, genomic references must also.

Every flawed variant interpretation is a missed opportunity to intervene, to understand, to heal. When we assume the reference genome fits everyone, we erase the unique biological narratives of entire communities.

But this is not a problem without a solution. The good news is that we can fix this.

By supporting ancestry-aware precision medicine, we can close knowledge gaps, correct diagnostic errors, and deliver real equity in care. This is the work Phronetik is doing every day. And we invite researchers, funders, clinicians, and community members to join us.

Join the Movement for Genomic Equity

• Are you an MSI or FQHC looking to build your own reference datasets?

• Are you a researcher who wants to partner on ancestry-aware projects?

• Are you a policymaker or funder ready to make genomics equitable for all?

Partner with Phronetik and help us rewrite the genomic future so that no one is invisible, and no community is left behind.

Call to Action

The global reference genome was never designed to represent all of us equally, and the consequences are real: misdiagnoses, overlooked risks, and persistent inequities in care. At Phronetik, we are changing that by building ancestry-aware genomic tools that reflect the true diversity of the communities we serve. Our commitment to equity goes beyond the lab; it is embedded in every partnership, every dataset, and every patient story we touch.

Join us. If you are a researcher, clinician, institution, or advocate who believes health equity begins with data that sees everyone, partner with Phronetik. Together, we can make precision medicine truly precise, and truly for all.

Stay tuned for our next post, “Sequencing My Genome Is a Privacy Nightmare—My Data Will Be Sold or Used Against Me.” Please join the conversation. Follow us on LinkedIn & Facebook, and subscribe to our Newsletter for updates on how we’re transforming healthcare for all.

Passion + Perseverance = Phronetik Progress. 

We ARE Precision Medicine