The holidays are a good time to discuss your family health history. Here’s what to ask about, and why it's important.
Thanksgiving is just around the corner, and there are plenty of topics of conversation — from politics to finances to the super-personal (i.e., “When are you getting married and/or having a baby?”) — that are bound to come up at the family dinner table and stress us out even further.
Another topic that might get everybody’s blood pressure boiling is, well, blood pressure. No one really wants to talk about their health and family ailments, but experts say the holidays are a perfect time to do just that. In fact, in 2004 the U.S. Surgeon General designated Thanksgiving Day as National Family History Day — a day for families to learn and collect information about their shared health history.
So don’t think of it as nosiness; consider it as being proactive about your health. Ahead, experts explain why our family health history matters — and share tips for getting the conversation started.
Why it’s important to discuss your family medical history
Discussing health and mortality isn’t exactly lighthearted table conversation, but here’s why you should do it anyway.
Lots of conditions and diseases are genetic. Dr. Laleh Gharahbaghian, a clinical professor of emergency medicine at Stanford University, says that as research and the way we study disease advance, the list of conditions that can be attributed to family genetics continues to grow. “Cardiovascular disease, certain types of stroke, some forms of cancer and certain mental health diseases — among others — have been studied and found to have a strong correlation to the same conditions running in the family,” Gharahbaghian says. “There are also specific diseases that are known to be genetic or hereditary, like some thyroid diseases, certain types of dementia and some neurologic diseases.”
It’s important to let your doctor know about your family history. “By letting your doctor know about your family's health, they can ensure you are up to date on appropriate screenings and further testing to either lower your risk for having the same condition or catch it early,” says Dr. Pravin Matthew, a primary care physician and assistant professor of medicine at Columbia University. Gharahbaghian points out that some genetic conditions are rare and not something a health care provider may think to look for first. Therefore, flagging that certain conditions run in your family can alert providers to be on the lookout for signs and symptoms, so that they can more quickly reach an accurate diagnosis.
Your family’s lifestyle habits matter, too — and can inform your own decisions. “Although most people probably think about genes when thinking about their family, families generally share more than just genetics,” says Dr. Jeffrey Linder, chief of the division of general internal medicine at Northwestern University. He points out that while research shows genetics probably contribute to about 30% of the risk of premature death, things like social circumstances, environmental exposures and behaviors can account for about 60% of the risk. Kari North, associate dean of research at the University of North Carolina Gillings School of Global Public Health, adds that families often share diets, exercise routines and other habits that can affect your chances of developing certain health conditions. “For instance, eating unhealthy foods as a family can increase the risk of obesity and type 2 diabetes,” she explains. Once you know more about how your family’s lifestyle might be contributing to your individual health, you can take steps to change your own behavior if necessary.
How to talk about it
Think of this as an extension of researching your family tree or digging into your DNA results on Ancestry.com or 23andMe. In other words, discussing family health history can actually be informative and even interesting. Here are some prompts to consider.
Be curious. North says the topic can come up naturally during other nostalgic activities, like looking at old family photos. And don’t forget that expressing interest in your family history in general can be fulfilling in many ways — not just for gaining knowledge about your shared medical background. “There’s a lot we can learn from elder family members especially,” Matthew says. “Just expressing curiosity about a family member's upbringing, hometown and parents can provide more than just medical insight.”
Be assertive. Since lifestyle plays a key role in family health, try suggesting that the family start putting a plan in place to get everyone on track. “A great way to bring this up is by discussing the overall status of the health of your family, and how you can work together to improve that,” says Dr. Michael Knight, a clinical associate professor of medicine at George Washington University. “It can be an activity like creating a ‘family tree’ of medical conditions to highlight opportunities to work together to improve the health of the family.”
Be honest. You don’t need to hide your motives. Matthew says it can be helpful to let family members know that you'd like to learn more about their medical history so you can better look out for your own health or your children's health. Gharahbaghian adds that you can let family members know that you’ve heard from health care professionals that getting this information is an important first step to taking care of yourself.
Be kind. And don’t forget to approach conversations “with empathy, gratitude and care,” Gharahbaghian says. North adds: “Be kind and let people share what they’re comfortable with, reminding them it’s to help everyone stay healthy.”
Some good questions to ask
Linder says it can be challenging to concisely collect a detailed medical history — especially for big families. For starters, he suggests prioritizing learning what conditions your grandparents have or had, and any conditions among first-degree relatives (like your parents, siblings or children). Then, try to learn more about any conditions that seem unusually common in your family among first and second-degree relatives (aunts, uncles, nieces, nephews or half-siblings).
Experts say you should bring up general health topics, in addition to asking more specific health questions. Here are some questions they suggest:
Are there any illnesses or conditions that run in our family?
Were there any complications during pregnancies or childbirths in our family?
Do you know of any family members who have or had diabetes, heart disease, dementia or cancer? At what age were they diagnosed?
If any family members have had cancer, what type of cancer did they have?
Did anyone in our family die at a young age (earlier than 60) of something not related to an accident or trauma?
What was the cause of death for family members who have passed away?
This is by no means an exhaustive list of all the things you can or should be asking your family about your shared medical history. Even so, it can help get those conversations going so that you can take proactive steps to keep yourself and your loved ones healthy.
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