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It’s In Your Genes. Know Your Family’s Medical History.
Everyone says you got your brains from Mom, and your curly hair is just like Grandpa’s. But what about the high cholesterol and heart disease on Dad’s side of the family? How can you know whether you inherited those too?
Taking a family health history will make it easier to sort out your genetic heritage, and what you learn will benefit other relatives and your doctors too. By sharing the data with health providers, you help them determine what tests you need, what risk factors to keep an eye on, and what guidance to give to reduce your odds of getting sick.
With a thorough knowledge of your family background, your physician gains valuable clues to a possible diagnosis of health problems and can sometimes even calculate your risk of developing a given disease.
Fully 97 percent of people surveyed in 2004 by the Centers for Disease Control thought that knowing their family health history was important. But just 30 percent had actually begun the task of gathering any information.
Putting together a family health history can even be fun, giving you the opportunity to learn more about your parents, grandparents, aunts and uncles, and other relatives. This article explains how to do it and why it’s worth the effort.
How Family History Could Save Your Life
Doctors say that most common health problems are caused by a combination of genetic, behavioral and environmental factors (e.g., smoking or exposure to radon or asbestos). A good family medical history is “one of the best predictors we have of a person’s future risk of disease,” writes Howard Levy, M.D., an assistant professor of medicine at Johns Hopkins University.
A 2001 study published in the American Journal of Cardiology reported that more than 70 percent of all “early coronary artery disease events” occurred in the 14 percent of families with a history of heart disease. More than 85 percent of early strokes took place in the 11 percent of families with a history of stroke.
If you knew you were among those families, wouldn’t you want your doctor to know? Wouldn’t you take your health much more seriously?
You’ll have to invest some time in a family history, but it’s a cheap and effective screening test. Once you and your doctor have the history in hand, she will be able to recommend specific additional tests and behavioral modifications.
If your father developed colon cancer at age 50, for example, your physician will recommend you have a first colonoscopy—normally recommended at age 50—at 40 or even sooner. She may also talk with you about good nutrition and regular physical activity. What’s called “aggressive risk factor modification” could reduce your chances of getting colon cancer.
Which Common Diseases Can Be Inherited?
Among the nation’s top health problems, the following have strong genetic components: Certain cancers (especially colorectal, breast and ovarian)
- High blood pressure
- Stroke
- Coronary artery disease
- High cholesterol
- Alzheimer’s disease
- Gout
- Diabetes
- Osteoporosis
- Glaucoma
- Depression
- Alcoholism
- Various forms of arthritis
A poor genetic inheritance confers a tendency toward these diseases. But good nutrition, physical fitness, frequent check-ups, medication and early screenings can provide powerful protection.
As the American Medical Association puts it, early identification of increased disease risk “can often improve, delay, or even prevent adverse health outcomes.”
How To Collect Family Medical Information
To encourage families to share and document their medical histories, the U.S. Surgeon General has designated Thanksgiving as National Family History Day.
Of course, any other family get-together offers the same opportunity: religious and civic holidays, weddings, reunions and the like.
Before you start surveying the family, explain why you want the data and how it will be useful for everyone. Once you start asking questions, be sensitive to any reluctance you encounter. If family members aren’t comfortable disclosing all the information you want, respect their desire for privacy. You may be able to learn more in the future or from other relatives.
The goal is to write down as much medical history as possible for yourself and then first-degree relations such as brothers and sisters, children and parents. Genetically speaking, you are 50 percent identical to them.
Second-degree relatives—with whom you share 25 percent identical genes—are aunts and uncles, nieces and nephews, and grandparents. If you can branch out further, that’s great, but the most relevant information will come from first- and second-degree relatives.
You want to know the date of birth or person’s age, date of death and age at death, and cause of death. And you’ll need to indicate medical issues such as:
- Cancer (and where in the body it originated)
- Heart disease
- Diabetes
- Asthma
- Mental problems (e.g., depression, schizophrenia, bipolar disorder)
- Birth defects
- High blood pressure or stroke
- Alcoholism or drug addiction
- Kidney disease
- Hearing or vision loss
- And so on
If you can learn at what age a person was diagnosed, indicate that. A disease with an earlier-than-usual onset is significant, especially if you see it in more than one family member.
Also note mitigating lifestyle factors such as whether your relative who had an early heart attack was also obese, sedentary and a heavy smoker.
Record instances of infertility or any miscarriages or stillbirths. If there are twins in the family, indicate whether they are identical or fraternal. Jot down whether relatives are half-brothers or half-sisters. Also note family members’ dominant racial and ethnic background.
If you were adopted, ask whether your adoptive parents are aware of any health history in your birth family. Adoption-agency records might also offer some clues.
For instructions on drawing a visual family tree (or “pedigree”) by hand, visit the National Society of Genetic Counselors’ Web site at www.nsgc.org/consumer/familytree.
How To Organize And Share Health Information
Keeping track of health information for yourself and your family the old-fashioned way, with paper and pencil, is still viable. But there are good reasons to consider using an online service to organize everyone’s health details.
Medical offices and hospitals are increasingly turning to electronic health records, and the Obama administration has encouraged the practice with funds from the stimulus package. One of the chief arguments for electronic record keeping is that it can prevent mistakes that could harm your health. And if you start maintaining your own health facts online, you can share them more easily with your doctor.
The following services can help you organize your medical information on the Web:
This free service allows users to securely organize health information; obtain medical records from doctors, pharmacies, and other entities; and share information with family members, care givers, or medical professionals.
Through partnerships with various companies, Google Health enables users to import, for instance, data on prescription medicines they take. Other partners, such as the American Heart Association, offer tools like a 10-year risk calculator for heart attack. Additional services allow you to export your records easily to provide them to doctors and hospitals. Detailed information on disease and health is offered by the Cleveland Clinic’s MyConsult.
Also free, HealthVault launched before Google Health and offers a more elegant interface and arguably a broader range of information. Users can input all manner of basic health data, partner with numerous other organizations (including the Mayo Clinic), and even track the measurements taken by devices such as OneTouch’s blood-glucose meter and the HoMedics blood-pressure monitor.
HealthVault includes a rudimentary family medical history feature that allows you to export and print the data.
This free government-sponsored tool was specifically created to track family medical history. It lacks bells and whistles but does an excellent job of helping you create a family history and generate a “family tree” to communicate the information in the manner health professionals use.
Another benefit of this tool is that your data are not stored online. Thus, there’s no danger of someone’s hacking in to the Web site and violating your privacy. After you add details, you save and download the report to your own computer. Next time you want to add, you upload the file and proceed.
Be Proactive About Health Care
Some experts recommend taking your family health history to every doctor visit. That might be overkill, but it is wise to take a copy of the document to your next appointment, then to submit a new version every year or whenever you add significant details.
Ask your doctor to go over the document and to comment on any specific areas of concern. Before your visit, make a list of any questions you have about needed tests, behavior changes or other details.
Don’t assume that a genetic risk means you’ll definitely succumb to a disease. Instead, use the knowledge to take charge of your health. Knowing your vulnerabilities can spur you to work more closely with your physician and to take more responsibility for lifestyle factors under your control.
If you have employees, what you’ve learned can help them too:
- Encourage staffers to gather family history during holiday periods.
- Invite a local genetic counselor to give a lunchtime presentation on inherited disorders and how they can be prevented. You can find counselors in your area by visiting the National Society of Genetic Counselors, www.nsgc.org.
- Print and distribute copies of online documents that explain the importance of a family medical history.
For More Information
Visit these Web sites to learn more gathering and using a family medical history.
The Surgeon General’s Family Health History Initiative
www.hhs.gov/familyhistory
The Genetic Alliance, with booklets on family health history, genetics, and health
www.geneticalliance.org (click “programs,” then “family health history”)
The Genetic Alliance’s Does It Run in the Family online tool
www.doesitruninthefamily.org