On Thanksgiving Day, the US Surgeon General is encouraging families to take the time to discuss health issues that affect them specifically. We know that family health history is an important part of routine medical care, and Thanksgiving has been National Family History Day since 2004. It was created as part of the Family History Public Health Initiative, which was launched in 2002 by the Office of Public Health Genomics.

The aim of the Initiative was "to increase awareness of family health history as an important risk factor for common chronic diseases such as cancer, heart disease, and diabetes, and to promote its use in programs aimed at reducing the burden of these diseases in the US population".

Its four main activities are research on family health history in populations and individuals, developing tools for collecting family health history, testing whether family health history-based strategies work, and promoting the application of family health history to health professionals and the public.

Learning about and documenting family health history can benefit someone's health in many ways, as many common conditions including arthritis, diabetes mellitus, heart disease, osteoporosis, stroke, and some cancers have a genetic component.

If an individual is aware of which conditions his or her parents and grandparents had, he or she can take steps to help avoid developing the same condition. Genetics cannot be changed, but lifestyle changes involving diet, exercise, not smoking, and regular medical check-ups can reduce the risk.

Risk of a disease may be particularly high if there are certain combinations of diseases within a family or diseases that occur at an earlier than expected age. In addition, if a disease occurs in more than one close relative, the individual may need to be aware.

Family Medical History

Good questions to ask close relatives include the presence of any birth defects, childhood health problems, and the age and cause of death for deceased relatives. Also, a person should be aware if there are common adult diseases (diabetes mellitus, heart disease, stroke, cancer, arthritis) that run in the family, and at what age family members were affected.

A person's health may be influenced by his or her blood relatives, including parents, grandparents, siblings, and aunts and uncles. Family gatherings such as Thanksgiving may present a useful opportunity to gather and share this information.

Certain medical facts are particularly relevant for specific groups of people and times of life. For example, before and during pregnancy it is useful to know if there is a family health history of a birth defect or genetic disorder like sickle cell disease. Knowing about a history of a genetic condition in the family can help recognize disorders in children, so they can be treated early.

For young adults with a family health history of chronic diseases such as diabetes mellitus or heart disease, screening tests can be initiated earlier. In a similar way, adults who have a close relative affected by, for example, breast cancer before age 50 could choose to have genetic counseling.

A computerized tool called "My Family Health Portrait" has been created on behalf of the Surgeon General. This is a free Web-based tool that can help families collect and organize health history information and share it with their physicians. Users complete a form that remains private and is not stored on the website. Only the owner can download and share it if he or she chooses and can update it over time.

Another Web-based tool for collecting information on family history and lifestyle factors is available. Called "Your Health Snapshot" it was developed at Washington University in St. Louis, MO, to obtain any history of cancer, as well as lifestyle information, in order to estimate risk of cancer and other chronic diseases. It has been adapted to incorporate more detailed information on family history and to send this information to the patient's electronic health record. The tool produces a summary report, or risk assessment, that the patient can take into the primary care appointment to discuss possible areas of raised risk.

Keeping and safely storing a record is sensible, whether written or electronic. Ideally the record would cover health information on three generations of close relatives. This will aid physicians when determining which tests, screenings, and lifestyle changes to recommend.

References:

US Department of Health & Human Services. Surgeon General's Family Health History Initiative.
http://www.hhs.gov/familyhistory/. Accessed November 2, 2015.

My Family Health Portrait: A tool from the Surgeon General.
https://familyhistory.hhs.gov/. Accessed November 2, 2015.

Washington University in St. Louis. Your Health Snapshot
https://yourhealthsnapshot.wustl.edu/. Accessed November 2, 2015.

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