You’ve likely filled out many forms asking for family health history details. At wellness visits and checkups, your provider has probably asked you detailed questions about this history.
But what is your family health history? What counts?
Do you mention the cousin with the vision issue you heard was genetic? The grandfather who died young from issues related to high blood pressure? The half-sibling who was just diagnosed with type 2 diabetes?
When it comes to health issues that run in families, more information is always better than less. But certain information is more important than other information.
Let’s dig into what information you should try to collect — and from which family members.
What Is Your Family Health History?
Your family health history is a record of the diseases and conditions different members of your family have. This includes family members both living and deceased.
Providers ask about this history because family members share genes. Genes are responsible for everything from your eye color to the length of your toes. Genes are also linked to health — in both specific and general ways.
Some genes directly connect to certain diseases, like cystic fibrosis. Other genes play contributing roles, meaning we don’t always know how likely you are to develop a condition. This is true for many chronic issues, such as anxiety, high blood pressure, and heart disease.
You can’t change your genes. But when you have information, you can make choices and take action. In fact, you can prevent, delay, or change the course of certain diseases if you know you’re at risk.
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What Are First-Degree and Second-Degree Relatives?
Providers often use the term “first-degree” relative when asking about family health history. A first-degree relative is a family member who shares about half of their genes with you. This includes parents, siblings, and children.
A second-degree relative shares about 25% of their genes with you. There is a first-degree relative between you and a second-degree relative on your family tree. This includes grandparents, half-siblings, aunts and uncles, and nieces and nephews.
Knowing about medical conditions among second-degree relatives helps you get a fuller picture of your family health history.
Third-degree relatives are people like first cousins or great-grandparents. This is good information to have, but it’s not as essential. Start with parents and siblings, then move to half-siblings, aunts/uncles, cousins, and grandparents.
What Genetic Health Issues Should Concern Me?
Families that carry known genes for specific inherited disorders, including rare ones, often work directly with genetic counselors. Understanding your risk for these conditions usually requires genetic testing.
But chronic health conditions function a bit differently. Most people have some family history with at least one chronic disease, such as heart disease, diabetes, or cancer. Though your provider may ask you about a range of conditions, the most common ones include:
- Breast and ovarian cancer: Having a parent, sibling, or child with breast or ovarian cancer puts you at higher risk for developing it. Knowing this history can help you and your doctor decide when you should get your first mammogram. You can also take genetic tests to identify certain genes linked to these cancers.
- Colon cancer: If you have multiple relatives with colon cancer or have relatives who received a colon cancer diagnosis before 50, your risk is greater. Knowing this information can help you and your doctor start colon cancer screening earlier.
- Diabetes: Having a parent or sibling with diabetes makes you more likely to develop diabetes or prediabetes. (Prediabetes means having blood sugar that is higher than normal but not high enough for a diabetes diagnosis.) But you may be able to prevent or delay diabetes by eating healthier, exercising, and keeping a healthy weight.
- Heart disease: Many people think they only need to worry about heart attacks. But knowing about other conditions — like high blood pressure, high cholesterol, and aortic aneurysm — is also important. Try to find out what heart-related diseases and procedures your relatives have had (and at what ages).
- Behavioral health: Conditions like attention-deficit/hyperactivity disorder (ADHD), anxiety and depression, addiction, and certain learning disorders can run in families. Knowing this history can help you recognize any challenging issues. If you have children, it can help doctors diagnose behavioral health conditions earlier and get help sooner.
- Osteoporosis: If one of your parents has broken a bone, especially a hip, they may have osteoporosis. Osteoporosis weakens bones (mostly in women, though it affects men, too). If you have a family history of it, you’ll want to start getting bone scans earlier.
What’s the Best Way to Collect Family History?
Some of these conversations are already part of what families talk about. But people’s families vary in their willingness to talk about health issues.
Start by gathering what information you already know. This includes birth and death dates, plus stories family members may have passed down about their health conditions. If there is an unofficial family historian, they are likely to be a great resource.
As for asking health questions, if your parents are still living, start with them. If you have adoptive parents, you may learn family medical history through them. You can also ask to see any records from the adoption agency.
Talk to siblings and half-siblings next. Depending on how close-knit your family is, they can fill you in on aunts, uncles, nieces, and nephews.
Aside from asking about diagnosed conditions, you may also find out how old they were when they received their diagnoses. For example, high blood pressure or cancer at 85 is different than high blood pressure or cancer at 35.
Some families struggle to talk about mental health and addiction issues. If this is the case in your family, start by asking for stories.
For example, if you are trying to learn about an aunt who died by suicide, ask the relative who knew her best to simply describe her. You don’t have to come away with a clinical diagnosis. But asking questions can get you closer to seeing the full picture.
The National Human Genome Research Institute and the U.S. Surgeon General created a free tool to help you track family health history. It’s called My Family Health Portrait. Learn more about this web-based tool.
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