News — By Dani Kupperman, Genetic Counselor at Danbury Hospital, Jessica Lipschutz, Genetic Counselor at Norwalk Hospital, and Susan Ingram, Genetic Counselor at Norwalk Hospital
Summary:
- Thanksgiving is also National Family Health History Day. Public health organizations and healthcare providers are urging families to use the holiday as an opportunity to start conversations about family health history.
- Knowing your family’s medical history and sharing it with your medical providers can help your healthcare team assess your risk for certain diseases and recommend appropriate healthcare services and testing.
- Although it can sometimes be challenging to find out about or share your health history, overcoming these barriers can provide health benefits for you and your family — and possibly save a life.
As parents, siblings, grandparents, and other relatives gather to celebrate Thanksgiving, the U.S. Centers for Disease Control and Prevention (CDC) recommends that families do more than eat turkey and give thanks. According to the CDC, Thanksgiving — which is also National Family Health History Day — is a perfect time for families to not only enjoy each other’s company, but also to collect information about their family health history.
What is family medical history?
Family medical history is a record of health information about family members that are related to you by blood, including children, parents, siblings, aunts/uncles, nieces/nephews, grandparents, and great grandparents. Because step-relatives, adoptive parents/siblings, and people who married into your family are not blood relatives, they do not need to be included in your family health history.
Family medical history includes information about:
- Major medical issues that can be inherited, such as cancer heart disease, mental health conditions, pregnancy complications, and other genetic conditions
- Age when conditions were diagnosed
- Cause of death
- Age at the time of death
- Ethnic background
- Environment and lifestyle factors
It is not necessary to include information about health problems that are triggered by external factors and cannot be inherited, such as injuries or illnesses caused by viruses.
Why is family medical history important?
Knowing your family health history can provide you with information that you can share with your healthcare providers. Your healthcare providers will use that information to determine your risk for developing certain health conditions, such as cancer, heart disease, or genetic diseases.
Although your family health history can’t predict whether you will develop a disease, it can help your healthcare provider develop a personalized preventive care and treatment plan for you. Based on your family health history, your healthcare provider may recommend:
- Diagnostic tests
- Earlier or increased disease screening
- Medications, treatments, or changes in lifestyle habits to reduce the chances you will develop a specific disease
- Genetic testing for you or your family members
Keep in mind that family medical history is only useful if you act on it — which means that you should not only gather and record the information, but also share it with your healthcare provider and other family members. You should also make sure you update your family health history whenever you receive new information.
Do I need to know my family medical history if I am having genetic testing?
Knowing your family medical history will help genetic counselors determine whether you meet the criteria for genetic testing and what type of genetic testing will be most beneficial. If any of your blood relatives have had genetic testing, having access to their test results can also give genetic counselors a better idea of what tests to perform.
For example, a patient who is newly diagnosed with breast cancer will usually be tested for BRCA gene mutations, which are linked to breast cancer susceptibility. But, if the patient also has a family history of other cancers, a genetic counselor may decide to perform additional genetic tests to provide the patient with more comprehensive results.
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What are the barriers to getting family medical history?
Although getting a family medical history is important, it can sometimes be challenging to gather due to lack of information, as well as cultural, emotional, or generational factors.
In some cultures and families, disease isn’t a topic that is openly discussed. Some family members also may be more private about their medical history than others.
Talking about disease can also bring up strong emotions, especially if someone is distressed about their health condition or the fact that they may have passed a gene mutation to their children. Fear is a significant barrier to discussing family health history — some people don’t want to think about how family health history could affect them, or believe that it could put them or others in a position where they have to make difficult decisions.
Parents may not want their children to worry about them, so they avoid talking about their health and medical history. Older people may also feel uncomfortable talking about cancer or may avoid talking about it in specific terms. Instead, they may use vague terms, such as referring to ovarian, uterine, or cervical cancer as “female” cancer or “cancer down there.”
In some cases, relatives may have passed away or are no longer in contact, and there is no way to obtain their health history information. It can also be challenging for people who were adopted to obtain family medical history due to lack of information about their birth parents.
How can I overcome barriers to getting a family medical history?
In most families, it’s probably not the best idea to start asking relatives direct and personal questions about their health conditions at the Thanksgiving dinner table. However, it is still possible to use the holiday as an opportunity to start conversations about family health history.
Consider engaging family members in more private, one-on-one conversations about health history while doing dishes, cooking, watching a football game, playing catch outside, or enjoying a beverage by the fire. Informal conversations may help family members to feel more comfortable, as well as allow you to more accurately remember and record the information.
For family members who become upset about discussing health information, it may help to tell them that they have no control over what conditions are passed down. Sharing family health history — even though it may feel embarrassing or uncomfortable — can help to change another family member’s destiny by allowing them to understand their risk and get proper preventive care.
You might also want to ask your genetic counselor to help you come up with ideas for how you can collect family health information. If you can’t contact your blood relatives due to death or adoption, or don’t feel comfortable reaching out for any other reason, that’s okay — just let your genetic counselor know. Genetic counselors can now do large panels that test for many more genetic risks at the same time, so you can still receive comprehensive genetic testing even if your family health history is absent or incomplete.
How do I share my health history with my family?
If you have a health condition that could affect others in your family, you might be reluctant to share that information. However, it’s important to remember that letting family members know about your health condition will give them and their healthcare providers the knowledge and tools they need to make the best, personalized healthcare decisions. And, it could even save your loved one’s life.
Your genetic counselor may have a letter that you can mail or email to relatives to inform them of your health condition if you don’t feel comfortable talking to family members in person. And, if a family member is hostile about receiving the information, you can still feel good about doing the right thing and letting them know.
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