As we approach the end of the second month of the new year, many are checking back on their 2023 resolutions to see if they're still on track. However, a lot of us may be missing out on one crucial resolution for this new year- talking to our families about their health history. Initiating conversations now gives you and your loved ones a head start on preparing for a year's worth of doctor visits ahead. During medical visits, doctors rely on family medical history to fully assess their patients. Cancer, heart disease, diabetes, and many other illnesses have genetic components where knowing that history matters. Collecting and understanding your family’s health history is key to receiving better, more focused care. But what’s the best way of going about it? The following will highlight the importance of family history as well as offer tips to help start this important conversation.

What is family health history, and why is it important?

Your family health history is a general list and understanding of the medical conditions that affect you and your family members. Although 99.9% of our genes are the same as everyone else’s, that 0.1% helps answer the question, “What runs in the family?” First-degree relatives are most significant when collecting information because their medical histories are directly relevant to the medical practice you receive. Relatives that are considered ‘first-degree’ are parents and siblings. That isn’t to say knowing that your grandparents were affected by a stroke is not relevant at all. However, understanding when this information is helpful is critical in helping your doctor be more proactive about your current and future health risks. 

What role does genetics play in disease?

Your genes play a part in your risk for disease, especially when it comes to some cancers, early heart disease, and diabetes. The specific increased risk can be hard to quantify. For example, your paternal grandmother having a heart attack at 86 is not as relevant as your mother, who had ovarian cancer at 35, because of the stronger chance of genetic predisposition.

How do you start the hard talk?

Older family members may be easier to approach about their medical history. Their health issues often come up naturally in conversation. Yet this conversation could be much more uncomfortable and difficult for younger loved ones and siblings to bring forward. Here are a few ways to get that discussion started:

Create a list

Compile a list of your closest relatives on both sides of the family. This includes parents, siblings, paternal and maternal grandparents, aunts, uncles, nieces, and nephews. Although the history of immediate family members is most useful to you and your doctor, collecting the health history of extended family members may be beneficial for caregivers. Additionally, you can capitalize on family gatherings to collect information as these are more casual settings where loved ones are more likely to feel comfortable sharing their personal experiences about their health.

Prepare for your conversation

Try to pick a quiet, private location to have the conversation. Whether it’s meeting up for a meal or pulling a loved one into a different room during a family gathering, their comfort is of utmost importance when discussing their personal health history. Next, have a way to record the conversation. Either through a recording device or with pen and paper. Therefore, you don’t have to rely on your memory alone when it comes to updating your medical records. Finally, write down some anchor questions ahead of time to start and guide the conversation, ensuring that you’re getting as much detailed information as possible. Here are a few questions you can ask:

• Did you experience any health issues or allergies as a child?
• Do you have any habits that could affect your health? Like smoking, drinking heavy alcohol, tanning, or working out?
• What do/did you do for work? What kind of environment is/was it?
• Do you remember your parents or grandparents taking medication on a regular basis? Do you remember what it was for?
• Do you know if anyone has ever had problems with pregnancy? If so, what kind?

While discussing their health conditions, be sure to note when the symptoms started and the disease itself. Here’s a non-exhaustive list of diseases and conditions to keep an ear for:

• Alzheimer's disease
• Asthma
• Birth defects (heart defects)
• Impaired vision or hearing
• Cancer
• Diabetes
• Heart disease/High blood pressure
• High cholesterol
• Mental health disorders
• Obesity
• Pregnancy complications
• Stroke
• Substance use disorders

Be sensitive

It’s important to understand that this conversation isn’t easy. Health care is complex, and medical conditions could carry upset feelings or uncomfortable memories. It would be helpful to remind them of how critical basic health information can be for the entire family's health care. However, be prepared for them not to know the answer to every question or even not want to answer the question at all. There are a variety of reasons someone may have large gaps in their personal medical history, from adoption to a family member dying without a record to pass on. Having this knowledge is also important for your physician to know.

Collect and compile results

The good news is that there are online tools available to help you in this process of gathering and organizing all of your family medical history. The Center for Disease Control (CDC) suggests the Surgeon General’s “My Family Health Portrait” to help you compile what you’ve found. You can enter your findings directly into the website, as well as save your history permanently, so you can update it as your family’s health evolves. There is also an option to print and share it with your family members or give it directly to your primary care physician. Finally, this tool is private and safe, ensuring that none of your information is shared or sold to the government or private entities.

Act on your knowledge

You can not change your genes, but you can change your behavior. Your family health history can be a blueprint and motivator for healthy lifestyle choices. Eating healthy, staying active, and refraining from heavy smoking and alcohol drinking keeps your body in its most capable state to combat illness and reduce the risk of diseases that run in your family. Additionally, if you discover a chronic disease in your family medical history, you can begin early health screenings like blood sugar testing, mammograms, and colorectal cancer screenings. Finding signs of disease earlier can often keep you healthier in the long run. You can initiate the conversation at your next doctor visit and turn a routine checkup into strategic, proactive care. However, if there are a few months until your next visit and you’re curious about the various risks, check out the National Human Genome Research Institute’s “Family Share.” This resource is filled with disease risk worksheets that not only assist you in assessing your risk for common diseases, but also provide you with tips on how to reduce that risk.

Ultimately, your family health history is a living, breathing document, and just like you and your loved ones, this document should grow and change. Although these conversations can be difficult, there is also the possibility of discovering positive trends within your family that you’ve never even heard at the dinner table. The information you learn and collect today can impact your family’s health for generations to come. Thus, enabling an environment where sharing your medical history could be as prevailing as passing down family photo albums and recipes.