Health History - Why is it so Important?
Creating a Family Health History
Why Create a Family Health History?
A Family Tree for Health
A family health history is a written record of a family’s health. The history contains information about a family’s medical conditions, lifestyle habits (for example, whether anyone in the family has smoked), and where and how family members grew up. It’s like a family tree for health.
What a Family Health History May Reveal
You can use a family health history to see if you, your children, or your grandchildren might face an increased risk of developing serious health problems. These health problems might be common ones, such as heart disease, cancer or diabetes. They could also be less common diseases that are passed from one generation to the next, such as hemophilia or sickle cell anemia.
People can’t change the genes they inherit from their parents, but they can change things like diet, physical activity, and medical care to try to prevent diseases that run in the family. This is good news because many diseases result from a combination of a person’s genes, lifestyle, and environment.
Actions That May Reduce Disease Risk
A health care professional can use a family health history to help assess a person’s risk of certain diseases. The professional might recommend actions to lower the chance of getting those diseases.
Actions to reduce the risk of disease may involve:
- Lifestyle changes, such as eating healthier foods or exercising more
- Getting certain medical tests
- Taking medications that are more effected based on your specific genes
For example, a son with a family history of diabetes might be told to lose weight and exercise more. A daughter who is considering having a baby might get tested to see if she carries a gene for a rare condition that runs in the family.
How You and Your Family May Benefit
For older adults, a family health history might help explain why you have developed certain health conditions. But it is important to know that simply getting older increases the risk of many diseases, too.
Creating and sharing your family health history with your health care professional can help you be healthier. But perhaps the biggest benefit is providing information that may help your children and grandchildren live longer, healthier lives.
Family History and Disease Risk
Diseases Can Have Various causes
Many things influence your overall health and likelihood of developing a disease. Sometimes, it’s not clear what causes a disease. Many diseases are thought to be caused by a combination of genetic, lifestyle, and environmental factors. The importance of any particular factor varies from person to person.
If you have a disease, does that mean your children and grandchildren will get it, too? Not necessarily. They may have a greater chance of developing the disease than someone without a similar family history. But they are not certain to get the disease.
Health Problems That May Run in Families
Common health problems that can run in a family include:
- Alzheimer’s disease/dementia
- Blood clots
- Heart disease
- High cholesterol
- High blood pressure
- Pregnancy losses and birth defects
Some diseases are clearly heritable. This means the disease comes from a mutation, or harmful change, in a gene inherited from one or both parents. Genes are small structures in your body’s cells that determine how you look and tell your body how to work. Examples of heritable diseases are Huntington’s disease, cystic fibrosis, and muscular dystrophy.
Role of Lifestyle and Environment
Genes are not the only things that cause disease. Lifestyle habits and environment also play a major part in developing disease. Diet, weight, physical activity, tobacco and alcohol use, occupation, and where you live can each increase or decrease disease risk. For example, smoking increases the chance of developing heart disease and cancer. For common diseases like heart disease and cancer, habits like smoking or drinking too much alcohol may be more important in causing disease than genes.
Sun exposure is the major known environmental factor associated with the development of skin cancer of all types. However, other environmental and genetic factors can also increase a person’s risk. The best defense against skin cancer is to encourage sun-protective behaviors, regular skin examinations, and skin self-awareness in an effort to decrease high-risk behaviors and optimize early detection of problems.
Clues to Your Disease Risk
Creating a family health history helps you know about diseases and disease risks. It can also show the way a disease occurs in a family. For example, you may find that a family member had a certain disease at an earlier age than usual (10 to 20 years before most people get it). That can increase other family members’ risk.
Risk also goes up if a relative has a disease that usually does not affect a certain gender, for example, breast cancer in a man. Certain combinations of diseases within a family – such as breast and ovarian cancer, or heart disease and diabetes – also increase the chance of developing those diseases.
Some Risk Factors Are Not Apparent
Even if they appear healthy, people could be at risk for developing a serious disease that runs in the family. They could have risk factors that they cannot feel, such as high blood pressure. They might not even know the disease runs in their family because they’ve lost touch with family members with the disease or because other family members with the disease have kept the information private. Another possibility is that family members who might have developed the disease died young in accidents or by other means. They might also be adopted and not sure genes with members of their adoptive family.
Getting Professional Advice
Family members who think they might be at risk for a disease based on their family health history can ask their health care professionals for advice. The professional may order a test to see if the person has the disease or a risk factor for the disease. For instance, a mammogram can detect possible breast cancer, and a colonoscopy can find colon cancer. Many diseases are more treatable if they are caught early.
The first step toward better understanding of your family’s health is to learn more about the health of close relatives such as parents, brothers and sisters, and children. Creating a family health history is one way to do that.
How to Create a Family Health History
Talk to Your Blood Relatives
The first step in creating a family health history is to talk to your blood relatives. The most helpful information comes from ‘first-degree’ relatives – parents, brothers and sisters, and children. Information from ‘second-degree’ relatives – nieces, nephews, half-brothers, half-sisters, grandparents, aunts, and uncles – as well as less close blood relatives can also be used.
Questions to Ask
To start, make a list of relatives to contact. See if there are any existing family trees, charts, or baby books. Important questions to ask your blood relatives include the following:
- What is your age or date of birth?
- Do you have any chronic conditions, such as heart disease, diabetes, asthma, or high blood pressure?
- Have you had any other serious illnesses, such as cancer or stroke? (If you know of a specific disease or illnesses in your family, ask about them, too.)
- How old were you when you developed these illnesses?
- Have you or your partner had any problems with pregnancies or childbirth?
Other questions to ask are:
- What countries did our family come from? (Knowing this can help because some heritable diseases occur more often in certain population groups. Also, different diets and living environments can influence the risks of developing certain diseases.)
- Has anyone in the family had birth defects, learning problems, or developmental disabilities, such as Down’s syndrome?
- What illnesses did our late parents or grandparents have? How old were they when they died? What caused their deaths?
Using the ‘My Family Health Portrait’ Tool
Free print and online tools can help you create a family health history. One tool is ‘My Family Health Portrait’ from the U.S. Surgeon General. It helps organize your family health history information. The following instructions describe how to use the print and online versions of this tool.
You can download and print out the print version of ‘My Family Health Portrait’ and use it to record information about your family’s health. Once you fill in the information, you can keep it for your records, share the completed form with your health care professional, or share it with family members. You can also refer to it as you enter information into the online version of ‘My Family Health Portrait.’
The online version of ‘My Family Health Portrait’ will organize your information into a chart that resembles a family health history tree. Information that you submit to the online version of ‘My Family Health Portrait’ stays private. It is not shared with the government or anyone else. It is best to gather information about your family health history beforehand so that you will have it easily available when you need to enter it.
You can also use ‘My Family Health Portrait’ to calculate disease risk based on your family history for certain common disorders like diabetes and colorectal cancer.
You can just use a blank sheet of paper to draw your own family health portrait.
Handling Questions from Relatives
Your relatives will probably want to know why you want information about their health. You can explain that knowing what diseases run in the family can help family members take steps to lower their risk. These steps might include certain lifestyle changes, medical tests, or choices of medicines. Offer to share your health history when it is done. Encourage relatives to create their own health histories. The online version of ‘My Family Health Portrait’ makes sharing family history with relatives easy.
Finding the Right Time to Talk
It’s important to find the right time to talk about family health. Family get-togethers like holidays, vacations, and reunions might be good opportunities. Some people may prefer to share health information privately, in person or by telephone. You can also contact family members by mail or e-mail. Be sure to take notes or record the conversations with a tape recorder or video camera to help you remember.
Dealing with Gaps in Information
Don’t worry if you cannot get complete information on every relative. Some people may not want to talk. Others may be unable to remember information accurately. That’s okay. Whatever information they can provide will be helpful.
To get reliable information about relatives who have died or who have mental health problems, you may have to talk to other family members. Death certificates, obtained from a state or county vital statistics office, can often confirm the cause of death. Funeral homes and online obituaries may also have this information.
If a Family Member is Adopted
What if you adopted a child? A family health history can help adopted children, but the information they can get might be limited. Adoptive parents and adoption agencies may have some health information about birth parents, but many states have laws that protect this information. A local health or social service agency may be able to help.
One alternative for adopted people is to start a brand-new family health history for the benefit of their biological children and grandchildren.
Keep the History Up to Date
As children are born and family members develop illnesses, add that information. It may take a little time and effort, but this lasting legacy can improve the health of your family for generations to come.
Promoting Family Health
Finding Out about Your Disease Risk
A family health history can help you and your family members know if any of you may face an increased risk of disease. Share your family health history with your doctor or other health care professional to find out about your risk of disease.
Your health care professional might ask the following questions.
- Is there a family history of known genetic disease?
- Are many family members affected by the same or related disease?
- Does a family’s ancestry make certain diseases more likely?
- Did any family members develop a disease earlier than expected?
A health care professional can sometimes determine a person’s level of disease risk. The level of risk depends partly on the number and relationship of relatives with the disease as well as how old they were when they got the disease.
What Your Health care Professional May Recommend
If you are at risk of a disease that runs in your family, your doctor may recommend steps to help lower that risk. These steps may include lifestyle changes, such as exercising more or eating a healthier diet. A health care professional might also suggest regular tests to look for signs of disease or medications to help prevent a disease.
How is Genetic Testing Done?
If a doctor sees signs of a disease in your family, he or she may suggest a genetic test. In this type of test, a small sample of blood, saliva, or tissue is taken to examine a person’s genes. A specially trained doctor, counselor, or other healthcare professional can tell if someone has a genetic mutation and what that means.
What Genetic Tests Can Tell You
There are many types of genetic tests. Genetic tests can help to:
- Diagnose disease
- Identify gene changes that are responsible for an already diagnosed disease
- Determine the severity of a disease
- Guide doctors in deciding on the best medicine or treatment to use for certain individuals
- Identify gene changes that may increase the risk to develop a certain disease
- Identify gene changes that could be passed on to children
- Screen newborn babies for certain treatable conditions
Genetic test results can be hard to understand, however specialists like geneticists, genetic counselors, and genetic nurses can help explain what results might mean to you and your family. Because genetic testing tells you information about your DNA, which is shared with other family members, sometimes a genetic test result may have implications for blood relatives of the person who had the testing.
When to Ask About Genetic Testing
You may want to ask your health care professional about genetic testing if you:
- Have a family history of a rare, inherited disease, such as cystic fibrosis or sickle cell anemia
- Have a history of more common diseases, such as cancer or heart disease, that affect many relatives in several generations of your family
- Have more than one relative who developed common diseases earlier than normal
- Come from a population group with a higher risk of a specific inherited disease
Sometimes, genetic testing can detect risk for diseases that may be preventable or treatable. This type of testing is available for hundreds of conditions, including less common types of breast, ovarian, and colon cancer.
Many heritable diseases occur in people born with a mutated gene. If a couple in your family is planning to have a child, you might ask them if they want to know about any heritable diseases that run in the family. Health care professionals often can test for a couple’s risk of having a baby with a genetic disease either before pregnancy or during pregnancy, or shortly after the baby is born.
A Valuable Tool
A family health history is an heirloom. Pass it on to your children. Update it when new health conditions, births, and deaths occur. Find out more about the diseases that run in your family. Creating a family health history can help your loved ones live longer and better lives.