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Boreal Community Media

Topic of the Month: Your Family Health History

Dec 01, 2021 08:26AM ● By Editor
From Cook County Public Health and Human Services and Sawtooth Mountain Clinic - December 1, 2021

Your Family Health History: 
In December's Topic of the Month you'll find:
  • What a Family Health History is
  • How it can protect you (and other family members) in the future
  • Sample questions to get you started
  • Information about increasingly popular at-home genetic tests
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What's Coming Up Behind You?

You may already know that you inherited your father’s chin, your grandmother’s sweet tooth, your uncle’s love of puzzles, or your cousin’s goofy sense of humor.  Gathering up a "Family Health History" can help you to understand if you share their health risks too.  Stories of family members’ past health challenges and causes of death hold important clues about the future health of family members. This history can alert you to dangers that may be coming up behind you, so you can plan ways to reduce, or even eliminate, them.

Biological families share genes, and both biological and adoptive families share behaviors that can impact health, such as levels of physical activity and the kinds of foods they eat.  Families often live in the same area, and so are exposed to the same things in the environment, like levels of air or water pollution.  A Family Health History takes these factors into account because they can all affect your health.

Most families have a history of at least one chronic disease, such as cancer, diabetes, or heart disease.  If you are closely related to a person with one of these types of conditions, you could be at greater risk for developing that disease yourself.   Gather as much information as you can about as many of your close family members as possible:  parents, sisters, brothers, half-sisters, half-brothers, children, grandparents, aunts, uncles, nieces, and nephews.   If you have access to death certificates and medical records, it’s even better.  That way you won’t miss information because of memory lapses or gaps in data.  If your history isn’t 100% complete, that's okay - some information is better than none.
Important data to include:

  • major medical conditions,
  • causes of death,
  • age at disease diagnosis,
  • age at death, and
  • race/ethnic background. 

Keep this information up-to-date and share it with your family and primary care provider.
 
People can’t change the genetic hand that they’re dealt, but they can play their cards well.  When people:

  • choose a nutritious diet,
  • keep physically active,
  • avoid dangerous behaviors such as smoking or drinking, 
  • get appropriate screenings (mammograms, blood sugar and blood pressure tests, colorectal cancer screenings, etc.) they can greatly improve the odds of living a long and healthy life.

In some families, there may be taboos around discussing health struggles, or perhaps extended family members just don’t see each other often enough to be comfortable talking about sensitive topics.  These discussions aren’t always easy, and it may be more comfortable to have them one-on-one instead of as a group.  If approached gently and with compassion, your relatives might be happy to share information.  Consider including children in these discussions.  It shows them that their health matters, and that their family is a source of knowledge and support.
 
Mental health history is just as important as physical health history, because some mental health issues can have a genetic component.  Bringing up a recent news report, or even sharing your own experience, may be the ice-breaker that gets the conversation started.  Give family members different options for how they’d like to share information:  email, video chat, or in person.  Keep questions short, and most importantly—be a good listener:  non-judgmental and without interrupting.

Sample Family Health History Questions 

Questions about childhood

  • Where were you born?
  • Where did you grow up?
  • Did you experience any health problems as a child?
  • Do you have any brothers or sisters?  If so, are they living?  How old are they?
Questions about adulthood
  • What jobs have you had?  Can you tell me about a typical day?
  • What was your work environment like?
  • Do you have children?  If so, what are their names and when were they born?  Do/did they have any health problems?
  • What habits (e.g., sun exposure, physical activity, smoking) have you had that could have affected your health?
  • Did you have any health problems or illnesses as an adult?  If so, at what age?  Did any of these problems require medical treatment or surgery? 
Questions about parents and grandparents
  • When and where were your parents born?  What do you know about them (e.g., their jobs and hobbies)?
  • When and where were your grandparents born?  What do you remember about them?
  • Did your parents or grandparents have any health problems?
  • Do you know if your parents or grandparents took medicine on a regular basis? If so, for what? Did they use home remedies? What kinds and for what? 
Questions about family life
  • Has your family lived anywhere that caused them health problems (e.g., disaster areas, waste sites)?
  • What foods does your family usually eat?  Describe a typical family breakfast or dinner.  Do you eat special foods for special occasions?
  • Does anyone smoke, use drugs, or drink a lot of alcohol?
  • Is anyone overweight or obese?
  • Has anyone had problems in pregnancy or childbirth?  What kinds of problems?
  • Can you describe any behaviors that might suggest mental health issues? For example, someone who suffered from “the blues” may have had depression.
  • Was anyone screened or had genetic testing for a serious disease like cancer?  What was the result?
  • Where did your ancestors come from and what was their religious background?
  • Is there anything else you would like to tell me about your life or health concerns in our family?

For a clear, helpful, and detailed guide to creating your family’s health history, visit: https://bit.ly/310lMNw

    At-Home Genetic Testing?
     
    The promise is that a vial of saliva or a quick swab of the cheek will provide the answers to all your questions about your ancestry,  health, and even your ideal diet.  The reality of the situation is that at-home tests can be inaccurate and potentially even risky.
       
    Manufacturers claim a variety of benefits, and about 1 in 5 Americans have taken one of these tests.  They have the potential to offer genealogical or medical insights, but they can also be misinterpreted or applied incorrectly.  Additionally, they can leave people grappling with information that they may rather not know.
     
    Identifying Ancestry
    This is the most common reason that people take direct-to-consumer genetic tests.  They compare your DNA to the DNA of other people they’ve tested.  The accuracy is limited by both the size of their “reference database,” and the fact that people have moved around a lot over time.  Just because you have matches in an area today, doesn’t mean that’s where your ancestors were a couple of hundred years ago.
     
    Identifying Relatives
    These tests are quite accurate when matching close relatives, such as parents or siblings.  The more distantly people are related, however, the wider the range of possible relationships there are.  For instance, a person could be a cousin or maybe a niece or nephew.  These tests can turn up relatives that people didn’t know existed.  That can be delightful or distressing, if it reveals painful family secrets.
     
    Identifying Ideal Diets
    Some at-home tests claim to be able to make nutrition recommendations based on your DNA.  The thinking is that people with specific genetic variations will respond best to certain diets or exercise programs.  This application of genetic analysis is very new and still incomplete.  Accurate interpretations of results and useful guidance may one day be possible, but not yet.
     
    Identifying Disease
    At-home tests provide an outline of your disease risk that may be less complete than results that you would get as part of medical care.  They may not include testing for important gene variants, and thus, could provide a false sense of security.  On the other hand, clinical tests are chosen by you and your provider working closely together to determine which tests would best serve you, based on your, and your family’s, health history. 
     
    While the results of at-home genetic tests may seem tantalizing, if you’re considering taking one, before you spit or swab, keep in mind their limitations and downsides.