“Grandma, could you please pass the stuffing–and, hey, have you ever been diagnosed with hypertension or high cholesterol?” A family holiday may seem like a strange time to discuss matters of life and death, but the U.S. surgeon general says it’s the ideal time to collect information about the health of
your grandparents, aunts, uncles, and cousins–since they’re all gathered in one place. In fact, Thanksgiving has been officially declared National Family History Day.
Why does the country’s top health official care whether you know what disease your great aunt Flora died of? Why should you? Because it could help you live longer. “Many diseases and conditions are at least partially hereditary,” explains Alan Guttmacher, deputy director of the National Human Genome Research Institute at the National Institutes of Health. You may have inherited more than just your mom’s green eyes and your dad’s brown hair; the chance of developing some health disorders can also be passed down from generation to generation through genes.
For example, if your maternal grandmother has diabetes (a condition that affects the body’s ability to regulate blood sugar), you and your mother have a greater
risk of diabetes. “The upside is that if you know your family health history, you can adopt lifestyle habits that will help you avoid future health problems, and your doctor can take better care of you by ordering certain screening tests to catch any warning signs early, when conditions are most treatable,” says Robin Bennett, a genetic counselor at the University of Washington Medical Center and a former president of the National Society of Genetic Counselors. Genetic counselors are health professionals who educate people about disorders that may run in their families and advise them on ways to lower their risk.
Charting the Past Keeping track of your family health history is easy if you plan ahead. The best way to begin is to download and print out a blank chart to fill in with the information that you collect. There is a great sample chart at www.hhs.gov/familyhistory. Then approach your family. First ask your parents about their health and that of your siblings–the most important relatives in determining your health risks. They may also be able to tell you about their siblings (your aunts and uncles) and their parents (your grandparents). If you were adopted, talk to your adoptive parents about your birth parents’
health information (also see “But I Was Adopted!”).
Next check out the box below, “Conditions That May Run in Families.” Ask your parents whether anyone in your family has been diagnosed with these conditions. Then work your way down the blank chart, asking your family members about health problems they’ve experienced, at what age, and whether the problems were resolved. Also, find out about family members who have died. Ask how those relatives died and how old they were when they died.
“You should also find out the primary ethnicity of your family,” advises Guttmacher, “since certain conditions are more prevalent within specific racial or ethnic groups.” For example, sickle-cell anemia, a hereditary blood disease, is much more common among African Americans. Cystic fibrosis (a disease that
causes breathing and digestive problems) affects mainly Caucasian people of European descent.
In addition to physical ailments, you should also document your family’s mental
health. “Teens should be aware that conditions like depression can be influenced by genetics as well,” says Paula Yoon, an epidemiologist with the Office of Genomics and Disease Prevention at the Centers for Disease Control and Prevention. “Unlike … diseases that aren’t likely to affect people until they’re older, mental health disorders tend to first appear in the mid-teens.” Yoon notes that “there are many effective monitoring and treatment techniques.” If you know you’re at high risk, you can look for warning signs and get help.
Finally, uncover as much as you can about your relatives’ lifestyle habits. “If you find that several of your relatives have had lung cancer [and that] they were all heavy smokers, that tells your doctor that the disease was more likely influenced by lifestyle factors … than by genes,” explains Bennett. Heavy drinking, though, could signal alcohol dependence, which may run in families. If you learn that there is a history of the condition in your family, you’ll need to consider it in making your own decisions about drinking.
Can We Talk? Now that you’ve done the background research, ask your extended relatives to help fill in any holes in your chart. Because health can be a touchy subject, explain why you’re asking so many personal questions. “Tell them you’re not trying to be nosy, but you want to take charge of your health,” suggests Bennett. You don’t want them to feel as if they’re at fault for a condition that runs in the family. Genetic predisposition is passed down through multiple generations, Yoon says.
Bring up the subject gently. Say “Tell me about my great-grandparents” or “What was your family like when you were growing up?” When the conversation is flowing, you can get into the specifics. If you’re still not sure about some things afterward, leave those areas of the chart blank. “If all you know about a certain relative is that [he or she] ‘died of old age,’ don’t guess at a cause,” says Bennett. Misinformation is worse than no information.
What do you do with the data? “Record it, keep it in a safe place, and bring it with you to your next doctor’s appointment,” says Bennett. Your doctor will look at several factors–for example, whether you have multiple relatives with a particular disease and whether they were diagnosed at a young age. “Everyone has something in their family,” adds Bennett. “But we’re more concerned when we see relatives coming down with diseases in their 30s, 40s, and 50s. Most people in their 70s and 80s suffer from one or more health conditions, so that’s
less of a red flag.”
Whatever you uncover, don’t panic. You’re not doomed to develop the conditions your relatives have. “Having a predisposition doesn’t mean you’ll get the
disease; it’s just one potential risk factor among many,” explains Bennett.
Likewise, having no family history of a disease doesn’t mean you’re in the clear. Your health status is influenced by other factors, including environment and lifestyle. “Family history isn’t the whole answer,” says Bennett. “It’s just one important piece of the puzzle.”
Conditions That May Run in Families
Genes may influence your chance of having certain diseases and disorders. Find out whether anyone in your family has or has had the following health conditions.
Acne Alzheimer’s disease Birth defects Cancer Depression/Mental illnesses
Diabetes Eye diseases Heart disease Hearing loss High blood pressure High cholesterol Infertility Migraines Miscarriage or stillbirths Obesity Sickle-cell anemia Stroke Thyroid disease
But I Was Adopted!
Want to chart your family health history but don’t know where to begin? Talk to your adoptive parents. They may either have information on the health histories of your birth parents or they may be able to get it. In nearly every state,
adoptees are allowed by law to have access to basic information about their birth parents.
Medical histories are usually included in adoption records, which an adoptee can request when he or she turns 18. Many states will also release the information to adoptive parents upon written request, for a fee. If your parents are entitled to obtain your adoption records, they’ll need to contact the adoption agency that handled your case. For” details on your state’s regulations, as well as a searchable database of adoption agencies, visit the National Adoption Information Clearinghouse Web site at naic.acf.hhs.gov.
If you cant’ find out much about your birth parents, don’t worry. Family history is just one of many tools that physicians have at their disposal. To make sure you get the best health care, have regular physicals and be sure to tell your doctor that you were adopted.