Climbing the Family Tree

Genetics is not always about blood tests and technology,” explains Luba Djurdjinovic, MS, executive director of the Ferre Institute and director of genetic programs for the NYS Teratogen Information Service. “It’s as much about writing down your family’s health history, being aware of past medical patterns and partnering with your physician to look for chronic health issues that might suggest an inherited predisposition. If your physician sees clues that certain illnesses run in your family, technology comes back into the game, with additional care or screenings to minimize, postpone or prevent the onset of certain diseases.”

ALL IN THE FAMILY

Family get-togethers are a great time to ask relatives about your family’s health history. Your physician will be looking for at least two relatives diagnosed before the age of 50 with the same disease. A family health history should include as much of the following information as possible.

• Collect health information for three generations of relatives, including parents, children, siblings, nieces/nephews, aunts/uncles, cousins and grandparents.
• Include all significant medical issues for each relative, such as birth defects, learning problems/delays, intellectual disabilities and chronic medical conditions. Be sure to include diabetes, thyroid disease, heart disease, cancer and Alzheimer’s disease.
• Note the age when first diagnosed. This is essential, since diagnoses at or beyond 50 years of age weaken any link to genetic predisposition and may be due more to the natural aging process.
• Add details about disease type. Try to go beyond recording that a cousin had “breast cancer.” You want to also note if the cancer spread, if it was in one or both breasts, the tumor type and any additional known specifics.
• Talk about your family’s health history with as many relatives as possible. You may hear different stories, which can be the root of family health myths, or gain “secret” medical information, which previous generations chose not to discuss.
• Designate a family medical history record keeper. This gives relatives one resource where they can deliver and retrieve family health information. It also promotes a comprehensive family medical record that can be passed on to future generations.

A PARTNERSHIP FOR HEALTH

Ms. Djurdjinovic stresses that a family health history is a tool — not a magic bullet. “After you tease out other risk factors, like lifestyle, age and environmental factors, fewer than 15 percent of those who have a family pattern of chronic illness actually have a genetic predisposition.”

For example, if three of your grandparents died of heart disease, but they all smoked; consistently ate foods high in cholesterol, salt and fat; and were older than 50 when cardiac problems began, then genetic predisposition is not likely an issue. That, Ms. Djurdjinovic adds, is why it’s essential that you discuss your family health history with your physician before jumping to conclusions.

Even if a family health history identifies no genetic predispositions, creating the generational medical record is still a valuable exercise, Ms. Djurdjinovic says. “We found that it’s an important way to engage people in their healthcare. So staying well is no longer only the doctor’s job — now you’re a partner, too.”