importance of family history in health

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The Importance of Family Health History

Your Patients’ and Your Own

  1. JoAnn Grif Alspach , RN, MSN, EdD, Editor

As much as we might anticipate that the most cutting-edge scientific approaches to health assessment would afford the most
reliable indicators for guiding health care decisions, that isn’t always the case. Researchers at the Genomic Medicine Institute’s
Center for Personalized Genetic Healthcare at the Cleveland Clinic recently reported that when an assessment of family health
history was compared to evaluations from commercially available personal genome screening test kits, family health history
consistently served as the superior tool for predicting an individual’s risk of developing certain diseases. 1 , 2 More specifically, this study of 22 women with breast cancer and 22 men with prostate cancer was designed to determine the
accuracy and concordance of risk assessment for 3 common forms of cancer (breast, prostate, colon) when risk was predicted
by family history versus by the genomic screening kits marketed by one vendor (Navigenics, Foster City, California). Each
assessment method was used to sort patients into one of 3 risk categories: general population, moderate risk, or high risk.
Some of the more notable findings from this research include the following 2 :

  • For all 3 types of cancer, family history and genetic testing risk assessments agreed on the subjects’ risk categories an
    average of only 40% of the time. 1

  • Overall concordance between the 2 methods of risk assessment was low (K<0.15) for all 3 types of cancer. Concordance between
    these methods of risk appraisal varied from 59% for breast cancer to 41% for prostate cancer and only 39% for colon cancer.

  • Of the 22 women with breast cancer, 10 had high hereditary breast cancer risk based on family history, yet genetic screening
    only identified 1 as high risk (K=0.12). Similarly for colon cancer, none of the 9 individuals with high hereditary risk identified
    via family history were categorized as high risk by genomic screening. Likewise for prostate cancer, none of the 3 subjects
    with high hereditary risk based on family history were designated as high risk by personal genomic screening. Overall, of
    the 22 patients with high hereditary risk as determined by family history, their personal genetic screening tests identified
    only 1 subject as high risk. 2 If commercially prepared genetic screening kits marketed directly to the public neglect to identify hereditary risks, individuals
    may be erroneously reassured by false negative results and conclude that they have no reason to seek further health care screening
    or follow-up. 3

  • Conversely, genomic testing classified 8 men at a moderate/high risk for prostate cancer, while their family history categorized
    them with risk no higher than the general population, suggesting that false positives may also be a concern with genomic screening. 2 , 3 The researchers’ explanation for this finding is that the genomic screening products marketed to consumers typically examine
    a wide array of DNA variants, including some not universally recognized, yet may not include genetic mutations associated
    with specific disorders. 3

The researchers concluded that a family history and personalized genomic screening may one day become complementary tools
for gauging cancer risk, 2 but at least for now, family health history remains “the gold standard in personal disease risk assessment.” 1 (page 2) That conclusion is important for both critical care nurses’ assessments and counseling of critically ill patients as well
as for monitoring our own personal and family health risks.

 

Next Section

Definition of Family Health History

As Critical Care Nurse readers know, a family health history (also referred to as a family medical history, a family history, or medical family
tree) is a compilation of relevant information about medical conditions affecting a patient and his/her close family members. 4 , 5 It represents an essential component of a patient’s medical history, typically obtained at the time of admission to a health
care facility as one component of a comprehensive patient assessment. Two features that distinguishes a family health history
from a patient’s medical history are that a family history extends beyond enumeration of the patient’s major health problems
to identify those experienced by each member of that patient’s immediate family and its indication of the nature of the relationships
among family members. 6

Previous Section Next Section

Relevance

Critical care physicians, nurses, and many other health care professionals routinely record patients’ family medical history
to obtain a more inclusive depiction of who the patient is and the health issues most likely to affect him/her owing to genetic
or familial influences. Because family members share not only patients’ genetic material but often their environment, habits,
and lifestyle choices, recording a family history may facilitate identification of patients at heightened risk for certain
disorders because it reflects both that person’s genes and other shared risk factors. 4 Following decades of public health education regarding the risk factors for a number of common chronic diseases, even school
children now know that family history is one of the most important risk factors in the development of health problems such
as heart disease and cancer. When research reveals that a family health history is more effective than genetic testing in
predicting a patient’s risk for a number of these disorders, then the relative value of this traditional mode of patient assessment
needs to be illuminated: “Family history risk assessment has been shown to be one of the most effective tools for predicting
what diseases an individual may be at risk for developing.” 2 (page 1)

Previous Section Next Section

Advantages

In addition to its value as an effective and accurate marker of risk for developing a number of chronic health disorders,
a family health history offers a number of other practical advantages for patients, family members, and their health care
providers: the assessment device is simple to construct, easy to gather and update information for, inexpensive to prepare,
readily accessible, immediately useful to family and care providers, and clinically applicable in actual patient care settings. 1

Previous Section Next Section

Who to Include as “Family”

Although the term family may be narrowly or broadly interpreted with or without contemporary notions of what constitutes a family, within the context
of a family health history, the scope of family members typically embraces 3 generations of relatives by birth 7 : you, your children, your siblings, your parents, your maternal and paternal grandparents, and your maternal and paternal
aunts and uncles.

Previous Section Next Section

Information to Record

The information sought for inclusion in a family health history primarily relates to major medical disorders, diseases, and/or
conditions associated with an hereditary or familial component and the person’s age when the disorder was first diagnosed. 5 , 7 Examples of these disorders are listed in Table 1 .

View this table:

  • In this window
  • In a new window

Table 1

Major medical diseases, disorders or conditions usually included in family health history 5 , 7

Other environmental and lifestyle factors in a person’s history such as alcohol addiction, drug addiction, smoking, diet,
exercise, and weight problems may also affect inherited risks. 3 The National Society of Genetic Counselors 8 also lists birth defects, learning problems, mental retardation, and vision or hearing losses at a young age as relevant
data. For some families, intermixing of different racial or ethnic backgrounds may be pertinent as well as living in or travelling
to foreign countries. For every family member who is deceased, important data points are their age at the time of death, the
cause(s) of death, and, when known, the person’s age at the onset of that cause. 7

It is extremely important that these data be gathered from both sides of the family. In a recent study by Rubinstein et al, 9 2500 healthy women indicated they knew much less about the health history of their paternal family and that they tended to
discount the risk of breast cancer when its family history existed on their paternal versus maternal side. For unexplained
reasons, it appeared as though these women perceived that their maternal health history was more relevant to their risk than
their paternal pedigree.

Previous Section Next Section

How Information Is Used

Health care professionals may apply the information contained in a family health history in a number of important ways ( Table 2 ). Charis Eng, MD, PhD, Founding Director and geneticist at the Genomic Medicine Institute’s Center for Personalized Healthcare,
relates that there are 3 red flags when reviewing a family health history 10 :

View this table:

  • In this window
  • In a new window

Table 2

Applications of family health history information 5 , 7

  • Determining whether more than one family member has developed the same condition or disorder over the years

  • Identifying how closely the affected individuals are related to each other

  • Identifying the ages of onset when that disorder or condition arose in each affected individual

When a pattern in this information is evidenced, it may be time to speak with one’s physician and, if warranted, to a genetic
counselor. Relevant patterns might include early age for onset of cancer or heart disease (eg, an acute myocardial infarction
in a 32-year-old), several generations of family members affected by the same disorder, or multiple primary cancers in the
same individual versus a single primary site with metastasis. 4

Findings from Rubinstein et al’s 9 report suggest that another potential use for family history data is that it affords an opportunity for health care professionals
to clarify or correct erroneous interpretations of risk related to family history. Study results found that beyond their parents,
significantly more women reported cancer in their maternal relatives compared to their paternal lineage and that a family
history of cancer on the paternal side was associated with a lower perceived risk for breast cancer than when the cancer history
existed on the maternal side. Findings suggest these women may have a limited awareness and/or understanding that their paternal
family history is equally relevant as their maternal side. In addition, this sample of women perceived the influence of age
and parenthood in directions opposite to scientific evidence—eg, perceiving that risk of cancer decreases (rather than increases)
with age. 9

Other patterns that may suggest heightened risk for developing related disorders include diseases that do not usually affect
persons of that gender (eg, a male who develops breast cancer) and specific combinations of disorders within the family (eg,
diabetes and peripheral arterial disease or breast and ovarian cancers). 6 In families that demonstrate these patterns, family health history represents a significant risk factor for development of
these conditions.

Previous Section Next Section

Approaches to Gather Information

The approaches most frequently suggested for soliciting family medical history information are by asking questions and talking
with family members at natural family gatherings such as holidays, reunions, or even funerals. 7 Many families are fortunate to have members who enjoy tracking and researching family genealogy, who may have some of the
demographic data already organized. Other families may include one or more members who assume the role of family historian
and could serve as valuable resources for locating this information. Public records such as death certificates may also be
used for this purpose.

Although some families may welcome the opportunity to participate in developing its medical history, others may not. In addition,
individual family members’ interest or willingness to contribute to this effort may vary. Attempts at gathering this information,
then, may be met with enthusiasm, indifference, reluctance, or even outright refusal to discuss this information. Some family
members may not see the value of this endeavor, others may consider these issues as highly private, and for yet others, discussions
related to deceased family members may precipitate a cascade of sorrowful, painful memories laden with guilt, regret, shame,
anger, or other emotions they would prefer remain in the past. Given these possibilities, some strategies recommended for
soliciting this information are listed in Table 3 .

View this table:

  • In this window
  • In a new window

Table 3

Strategies for soliciting family medical history 5

Previous Section Next Section

Documenting Family History

Documentation of a family health history is important for establishing, updating, correcting, maintaining, accessing, and
sharing this information among and between family members as well as with various health care professionals. Another form
of documentation can be a family medical tree, drawn to visually summarize these findings in graphic form. 10 The US Surgeon General’s “My Family Health Portrait” is an online tool developed specifically for these purposes; it is available
at http://familyhistory.hhs.gov . 7 An alternate Web site ( www.hhs.gov/familyhistory ) provides background information on this tool. Free print versions are also available by calling the Health Resources and
Services Administration Information Center at (888) ASK-HRSA. 7

In a recent study 11 of 35 veterans (71% male, 78% older than 50 years), investigators assessed satisfaction with using this tool and found that
all participants rated the tool as very useful and that most (88%) viewed its functionality, look, navigation, and performance
favorably. The total time that participants needed to complete the tool averaged 25 minutes. The study also identified several
barriers to use this tool: lack of knowledge regarding the importance of familial risks in developing chronic diseases and
privacy and confidentiality concerns related to entering personal data into an online database. In addition to the Surgeon
General’s online tool, a number of other resources are available to assist in preparing and maintaining a family health history.
Some of these resources are identified in Table 4 .

View this table:

  • In this window
  • In a new window

Table 4

Family health history resources

Previous Section Next Section

Closure

As health care increasingly progresses toward personalized approaches to detect and treat health problems, the American Society
of Human Genetics characterizes a family health history as “the most important genetic test of all.” 12 Amid the myriad technological advances for monitoring, diagnosing, and screening of our current health status and likely
health challenges in decades ahead, it is important for critical care nurses to keep in mind that—at least for the present—the
family medical history remains the most reliable and valid tool we currently have available to make these patient assessments
and provide guidance to our patients.

Creating, updating, and sharing a family health history can empower individuals to be more proactive in their personal health
and lifestyle surveillance, make more timely and informed health-related decisions, improve their own health outcomes, minimize
development of serious complications, and offer peace of mind in place of anxiety or fear of the unknown. 4 Learning about and acting upon one’s family’s health history may help to ensure a longer, healthier future together with
fewer family funerals and many more joyous family reunions to celebrate those years.

  • ©2011 American Association of Critical-Care Nurses
Previous Section

 

References

  1. American Society of Human Genetics. New research validates clinical use of family health history as the ‘gold standard’ for assessing personal disease risk. Press release October 22, 2010. http://www.ashg.org/pdf/PR_FamilyHealthHistory_110510.pdf . Accessed November 11, 2010.

    1. Leach B,
    2. Eng C

    . Comparison of family health history to personal genomic screening for risk assessment of breast, colon and prostate cancer. Abstract presented at American Society of Human Genetics 60th Annual Meeting; November 2–6, 2010; Washington, DC. http://ashg.org/cgi-bin/2010/showdetail.pl?absno=20199 . Accessed November 11, 2010.

    1. Neergaard L

    . Family health history: ‘Best kept secret’ in care. Associated Press, Medical News, 2010. http://news.yahoo.com/s/ap/us_med_healthbeat_family_health . Accessed November 11, 2010.

  2. Cleveland Clinic Genomic Medicine, Patient Resources-Family History. http://my.clevelandclinic.org/genomics-genetics/patient-resources/family-history.aspx . Accessed November 12, 2010.

  3. Mayo Foundation for Medical Education and Research. Mayo Clinic. Medical History: Compiling Your Family Medical History. http://www.mayoclinic.com/health/medical-history/HQ01707 . Accessed November 12, 2010.

  4. US Department of Health & Human Services. Surgeon General’s Family History Initiative: Resource Packet for Health Professionals. Frequently Asked Questions About Family Health History. http://www.hhs.gov/familyhistory/respachealth.html . Accessed November 12, 2010.

  5. US Department of Health & Human Services. Surgeon General’s Family History Initiative: Resource Packet for Health Professionals. Fact Sheet. http://www.hhs.gov/familyhistory/respachealth.html . Accessed November 12, 2010.

  6. National Society of Genetic Counselors. Your Family History. http://www.nsgc.org/About/FamilyHistoryTool/tabid/226/Default.aspx . Accessed November 12, 2010.

    1. Rubinstein WS,
    2. O’Neill SM,
    3. Rothrock N,
    4. et al

    . Components of family history associated with women’s disease perceptions for cancer: a report from the Family Healthware Impact
    Trial (FHITr)
    . Abstract presented at American Society of Human Genetics 60th Annual Meeting; November 2–6, 2010; Washington, DC. http://www.ashg.org/cgi-bin/2010/showdetail.pl?absno=20467.pdf . Accessed November 11, 2010.

    1. Grendzynski D

    . Talking Family History at Thanksgiving. Cleveland Clinic—About Us. http://myclevelandclinic.org/news_service/family_history.aspx . Accessed November 12, 2010.

    1. Arar N

    . Veterans’ Response to the Use of Family Health History Online Tool. Department of Medicine, Division of Nephrology, University of Texas Health Science Center, San Antonio, TX. Abstract presented at American Society of Human Genetics 60th Annual Meeting; November 2–6, 2010; Washington, DC. http://ashg.org/cgi-bin/2010/showdetail.pl?absno=21223.pdf . Accessed November 11, 2010.

  7. American Society of Human Genetics. Know Your Family Health History: Information for Healthcare Providers. http://www.talkhealthhistory.org/healthcare/index.shtml . Accessed November 11, 2010.

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    Crit Care Nurse

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  1. Top
  2. Definition of Family Health History
  3. Relevance
  4. Advantages
  5. Who to Include as “Family”
  6. Information to Record
  7. How Information Is Used
  8. Approaches to Gather Information
  9. Documenting Family History
  10. Closure
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The Importance of Family Health History

Your Patients’ and Your Own

  1. JoAnn Grif Alspach , RN, MSN, EdD, Editor

As much as we might anticipate that the most cutting-edge scientific approaches to health assessment would afford the most
reliable indicators for guiding health care decisions, that isn’t always the case. Researchers at the Genomic Medicine Institute’s
Center for Personalized Genetic Healthcare at the Cleveland Clinic recently reported that when an assessment of family health
history was compared to evaluations from commercially available personal genome screening test kits, family health history
consistently served as the superior tool for predicting an individual’s risk of developing certain diseases. 1 , 2 More specifically, this study of 22 women with breast cancer and 22 men with prostate cancer was designed to determine the
accuracy and concordance of risk assessment for 3 common forms of cancer (breast, prostate, colon) when risk was predicted
by family history versus by the genomic screening kits marketed by one vendor (Navigenics, Foster City, California). Each
assessment method was used to sort patients into one of 3 risk categories: general population, moderate risk, or high risk.
Some of the more notable findings from this research include the following 2 :

  • For all 3 types of cancer, family history and genetic testing risk assessments agreed on the subjects’ risk categories an
    average of only 40% of the time. 1

  • Overall concordance between the 2 methods of risk assessment was low (K<0.15) for all 3 types of cancer. Concordance between
    these methods of risk appraisal varied from 59% for breast cancer to 41% for prostate cancer and only 39% for colon cancer.

  • Of the 22 women with breast cancer, 10 had high hereditary breast cancer risk based on family history, yet genetic screening
    only identified 1 as high risk (K=0.12). Similarly for colon cancer, none of the 9 individuals with high hereditary risk identified
    via family history were categorized as high risk by genomic screening. Likewise for prostate cancer, none of the 3 subjects
    with high hereditary risk based on family history were designated as high risk by personal genomic screening. Overall, of
    the 22 patients with high hereditary risk as determined by family history, their personal genetic screening tests identified
    only 1 subject as high risk. 2 If commercially prepared genetic screening kits marketed directly to the public neglect to identify hereditary risks, individuals
    may be erroneously reassured by false negative results and conclude that they have no reason to seek further health care screening
    or follow-up. 3

  • Conversely, genomic testing classified 8 men at a moderate/high risk for prostate cancer, while their family history categorized
    them with risk no higher than the general population, suggesting that false positives may also be a concern with genomic screening. 2 , 3 The researchers’ explanation for this finding is that the genomic screening products marketed to consumers typically examine
    a wide array of DNA variants, including some not universally recognized, yet may not include genetic mutations associated
    with specific disorders. 3

The researchers concluded that a family history and personalized genomic screening may one day become complementary tools
for gauging cancer risk, 2 but at least for now, family health history remains “the gold standard in personal disease risk assessment.” 1 (page 2) That conclusion is important for both critical care nurses’ assessments and counseling of critically ill patients as well
as for monitoring our own personal and family health risks.

 

Next Section

Definition of Family Health History

As Critical Care Nurse readers know, a family health history (also referred to as a family medical history, a family history, or medical family
tree) is a compilation of relevant information about medical conditions affecting a patient and his/her close family members. 4 , 5 It represents an essential component of a patient’s medical history, typically obtained at the time of admission to a health
care facility as one component of a comprehensive patient assessment. Two features that distinguishes a family health history
from a patient’s medical history are that a family history extends beyond enumeration of the patient’s major health problems
to identify those experienced by each member of that patient’s immediate family and its indication of the nature of the relationships
among family members. 6

Previous Section Next Section

Relevance

Critical care physicians, nurses, and many other health care professionals routinely record patients’ family medical history
to obtain a more inclusive depiction of who the patient is and the health issues most likely to affect him/her owing to genetic
or familial influences. Because family members share not only patients’ genetic material but often their environment, habits,
and lifestyle choices, recording a family history may facilitate identification of patients at heightened risk for certain
disorders because it reflects both that person’s genes and other shared risk factors. 4 Following decades of public health education regarding the risk factors for a number of common chronic diseases, even school
children now know that family history is one of the most important risk factors in the development of health problems such
as heart disease and cancer. When research reveals that a family health history is more effective than genetic testing in
predicting a patient’s risk for a number of these disorders, then the relative value of this traditional mode of patient assessment
needs to be illuminated: “Family history risk assessment has been shown to be one of the most effective tools for predicting
what diseases an individual may be at risk for developing.” 2 (page 1)

Previous Section Next Section

Advantages

In addition to its value as an effective and accurate marker of risk for developing a number of chronic health disorders,
a family health history offers a number of other practical advantages for patients, family members, and their health care
providers: the assessment device is simple to construct, easy to gather and update information for, inexpensive to prepare,
readily accessible, immediately useful to family and care providers, and clinically applicable in actual patient care settings. 1

Previous Section Next Section

Who to Include as “Family”

Although the term family may be narrowly or broadly interpreted with or without contemporary notions of what constitutes a family, within the context
of a family health history, the scope of family members typically embraces 3 generations of relatives by birth 7 : you, your children, your siblings, your parents, your maternal and paternal grandparents, and your maternal and paternal
aunts and uncles.

Previous Section Next Section

Information to Record

The information sought for inclusion in a family health history primarily relates to major medical disorders, diseases, and/or
conditions associated with an hereditary or familial component and the person’s age when the disorder was first diagnosed. 5 , 7 Examples of these disorders are listed in Table 1 .

View this table:

  • In this window
  • In a new window

Table 1

Major medical diseases, disorders or conditions usually included in family health history 5 , 7

Other environmental and lifestyle factors in a person’s history such as alcohol addiction, drug addiction, smoking, diet,
exercise, and weight problems may also affect inherited risks. 3 The National Society of Genetic Counselors 8 also lists birth defects, learning problems, mental retardation, and vision or hearing losses at a young age as relevant
data. For some families, intermixing of different racial or ethnic backgrounds may be pertinent as well as living in or travelling
to foreign countries. For every family member who is deceased, important data points are their age at the time of death, the
cause(s) of death, and, when known, the person’s age at the onset of that cause. 7

It is extremely important that these data be gathered from both sides of the family. In a recent study by Rubinstein et al, 9 2500 healthy women indicated they knew much less about the health history of their paternal family and that they tended to
discount the risk of breast cancer when its family history existed on their paternal versus maternal side. For unexplained
reasons, it appeared as though these women perceived that their maternal health history was more relevant to their risk than
their paternal pedigree.

Previous Section Next Section

How Information Is Used

Health care professionals may apply the information contained in a family health history in a number of important ways ( Table 2 ). Charis Eng, MD, PhD, Founding Director and geneticist at the Genomic Medicine Institute’s Center for Personalized Healthcare,
relates that there are 3 red flags when reviewing a family health history 10 :

View this table:

  • In this window
  • In a new window

Table 2

Applications of family health history information 5 , 7

  • Determining whether more than one family member has developed the same condition or disorder over the years

  • Identifying how closely the affected individuals are related to each other

  • Identifying the ages of onset when that disorder or condition arose in each affected individual

When a pattern in this information is evidenced, it may be time to speak with one’s physician and, if warranted, to a genetic
counselor. Relevant patterns might include early age for onset of cancer or heart disease (eg, an acute myocardial infarction
in a 32-year-old), several generations of family members affected by the same disorder, or multiple primary cancers in the
same individual versus a single primary site with metastasis. 4

Findings from Rubinstein et al’s 9 report suggest that another potential use for family history data is that it affords an opportunity for health care professionals
to clarify or correct erroneous interpretations of risk related to family history. Study results found that beyond their parents,
significantly more women reported cancer in their maternal relatives compared to their paternal lineage and that a family
history of cancer on the paternal side was associated with a lower perceived risk for breast cancer than when the cancer history
existed on the maternal side. Findings suggest these women may have a limited awareness and/or understanding that their paternal
family history is equally relevant as their maternal side. In addition, this sample of women perceived the influence of age
and parenthood in directions opposite to scientific evidence—eg, perceiving that risk of cancer decreases (rather than increases)
with age. 9

Other patterns that may suggest heightened risk for developing related disorders include diseases that do not usually affect
persons of that gender (eg, a male who develops breast cancer) and specific combinations of disorders within the family (eg,
diabetes and peripheral arterial disease or breast and ovarian cancers). 6 In families that demonstrate these patterns, family health history represents a significant risk factor for development of
these conditions.

Previous Section Next Section

Approaches to Gather Information

The approaches most frequently suggested for soliciting family medical history information are by asking questions and talking
with family members at natural family gatherings such as holidays, reunions, or even funerals. 7 Many families are fortunate to have members who enjoy tracking and researching family genealogy, who may have some of the
demographic data already organized. Other families may include one or more members who assume the role of family historian
and could serve as valuable resources for locating this information. Public records such as death certificates may also be
used for this purpose.

Although some families may welcome the opportunity to participate in developing its medical history, others may not. In addition,
individual family members’ interest or willingness to contribute to this effort may vary. Attempts at gathering this information,
then, may be met with enthusiasm, indifference, reluctance, or even outright refusal to discuss this information. Some family
members may not see the value of this endeavor, others may consider these issues as highly private, and for yet others, discussions
related to deceased family members may precipitate a cascade of sorrowful, painful memories laden with guilt, regret, shame,
anger, or other emotions they would prefer remain in the past. Given these possibilities, some strategies recommended for
soliciting this information are listed in Table 3 .

View this table:

  • In this window
  • In a new window

Table 3

Strategies for soliciting family medical history 5

Previous Section Next Section

Documenting Family History

Documentation of a family health history is important for establishing, updating, correcting, maintaining, accessing, and
sharing this information among and between family members as well as with various health care professionals. Another form
of documentation can be a family medical tree, drawn to visually summarize these findings in graphic form. 10 The US Surgeon General’s “My Family Health Portrait” is an online tool developed specifically for these purposes; it is available
at http://familyhistory.hhs.gov . 7 An alternate Web site ( www.hhs.gov/familyhistory ) provides background information on this tool. Free print versions are also available by calling the Health Resources and
Services Administration Information Center at (888) ASK-HRSA. 7

In a recent study 11 of 35 veterans (71% male, 78% older than 50 years), investigators assessed satisfaction with using this tool and found that
all participants rated the tool as very useful and that most (88%) viewed its functionality, look, navigation, and performance
favorably. The total time that participants needed to complete the tool averaged 25 minutes. The study also identified several
barriers to use this tool: lack of knowledge regarding the importance of familial risks in developing chronic diseases and
privacy and confidentiality concerns related to entering personal data into an online database. In addition to the Surgeon
General’s online tool, a number of other resources are available to assist in preparing and maintaining a family health history.
Some of these resources are identified in Table 4 .

View this table:

  • In this window
  • In a new window

Table 4

Family health history resources

Previous Section Next Section

Closure

As health care increasingly progresses toward personalized approaches to detect and treat health problems, the American Society
of Human Genetics characterizes a family health history as “the most important genetic test of all.” 12 Amid the myriad technological advances for monitoring, diagnosing, and screening of our current health status and likely
health challenges in decades ahead, it is important for critical care nurses to keep in mind that—at least for the present—the
family medical history remains the most reliable and valid tool we currently have available to make these patient assessments
and provide guidance to our patients.

Creating, updating, and sharing a family health history can empower individuals to be more proactive in their personal health
and lifestyle surveillance, make more timely and informed health-related decisions, improve their own health outcomes, minimize
development of serious complications, and offer peace of mind in place of anxiety or fear of the unknown. 4 Learning about and acting upon one’s family’s health history may help to ensure a longer, healthier future together with
fewer family funerals and many more joyous family reunions to celebrate those years.

  • ©2011 American Association of Critical-Care Nurses
Previous Section

 

References

  1. American Society of Human Genetics. New research validates clinical use of family health history as the ‘gold standard’ for assessing personal disease risk. Press release October 22, 2010. http://www.ashg.org/pdf/PR_FamilyHealthHistory_110510.pdf . Accessed November 11, 2010.

    1. Leach B,
    2. Eng C

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  1. Top
  2. Definition of Family Health History
  3. Relevance
  4. Advantages
  5. Who to Include as “Family”
  6. Information to Record
  7. How Information Is Used
  8. Approaches to Gather Information
  9. Documenting Family History
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Genetics Home Reference, Your Guide to Understanding Genetic Conditions

  1. Home
  2. Help Me Understand Genetics
  3. Inheriting Genetic Conditions
  4. Why is it important to know my family medical history?

Why is it important to know my family medical history?

A family medical history is a record of health information about a person and his or her close relatives. A complete record includes information from three generations of relatives, including children, brothers and sisters, parents, aunts and uncles, nieces and nephews, grandparents, and cousins.

Families have many factors in common, including their genes, environment, and lifestyle. Together, these factors can give clues to medical conditions that may run in a family. By noticing patterns of disorders among relatives, healthcare professionals can determine whether an individual, other family members, or future generations may be at an increased risk of developing a particular condition.

A family medical history can identify people with a higher-than-usual chance of having common disorders, such as heart disease, high blood pressure, stroke, certain cancers, and diabetes. These complex disorders are influenced by a combination of genetic factors, environmental conditions, and lifestyle choices. A family history also can provide information about the risk of rarer conditions caused by mutations in a single gene, such as cystic fibrosis and sickle cell disease .

While a family medical history provides information about the risk of specific health concerns, having relatives with a medical condition does not mean that an individual will definitely develop that condition. On the other hand, a person with no family history of a disorder may still be at risk of developing that disorder.

Knowing one’s family medical history allows a person to take steps to reduce his or her risk. For people at an increased risk of certain cancers, healthcare professionals may recommend more frequent screening (such as mammography or colonoscopy) starting at an earlier age. Healthcare providers may also encourage regular checkups or testing for people with a medical condition that runs in their family. Additionally, lifestyle changes such as adopting a healthier diet, getting regular exercise, and quitting smoking help many people lower their chances of developing heart disease and other common illnesses.

The easiest way to get information about family medical history is to talk to relatives about their health. Have they had any medical problems, and when did they occur? A family gathering could be a good time to discuss these issues. Additionally, obtaining medical records and other documents (such as obituaries and death certificates) can help complete a family medical history. It is important to keep this information up-to-date and to share it with a healthcare professional regularly.

For more information about family medical history:

Educational resources related to family health history are available from GeneEd. Additional information about family history is available from MedlinePlus.

The Centers for Disease Control and Prevention’s (CDC) Office of Public Health Genomics provides information about the importance of family medical history . This resource also includes links to publications, reports, and tools for recording family health information.

The Office of the Surgeon General offers a tool called My Family Health Portrait that allows you to enter, print, and update your family health history.

The American Medical Association provides family history tools , including questionnaires and forms for collecting medical information. The National Institute on Aging provides suggestions on how to obtain a health history form older individuals .

The Genetic Alliance also offers a list of links to family history resources .

Topics in the Inheriting Genetic Conditions chapter

  • What does it mean if a disorder seems to run in my family?
  • Why is it important to know my family medical history?
  • What are the different ways in which a genetic condition can be inherited?
  • If a genetic disorder runs in my family, what are the chances that my children will have the condition?
  • What are reduced penetrance and variable expressivity?
  • What do geneticists mean by anticipation?
  • What are genomic imprinting and uniparental disomy?
  • Are chromosomal disorders inherited?
  • Why are some genetic conditions more common in particular ethnic groups?
  • What is heritability?

Other chapters in Help Me Understand Genetics

Printable Chapter PDF (2MB)

Published : August 14, 2018

The resources on this site should not be used as a substitute for professional medical care or advice. Users with questions about a personal health condition should consult with a qualified healthcare professional .