Family Health History

Host: Dr. Jennifer Hunter, Assistant Director for Family and Consumer Sciences Extension, University of Kentucky 

Guest: Natalie Jones, Extension Specialist for Family Health

0:02 Welcome to Talking FACS; what you need to know about family, food, finance and fitness. Hosted by the University of Kentucky Family and Consumer Sciences Extension Program, our educators share research knowledge with individuals, families and communities to improve quality of life.

0:21 Dr. Jennifer Hunter: Hello and welcome back to Talking FACS. This is your host, Dr. Jennifer Hunter, Assistant Director for Family Consumer Sciences Extension at the University of Kentucky.

Today, I'm pleased to have joining me, Natalie Jones, our Extension Specialist for Family Health. Welcome, Natalie.

0:35 Natalie Jones: Thanks for having me.

0:36 Dr. Hunter: Today's topic focuses on family health history and understanding why our family health history is important. And as I was thinking about and prepping for today's show, I was really thinking about how often family health history comes up. Because when you're at the doctor's office, they tend to ask about, “Have you had a family member that has had an (fill in the condition)” or “Have you had a family member that experienced…

And I think you often might hear this sometimes, in terms of increasing the potential of certain types of cancer, that it may be associated with genetics. And so, understanding and knowing our family health history is important.

And also, just as I was thinking about it, I was thinking about how much this is talked about, really just kind of in mainstream or promoted on social media. I remember last holiday season that several of the DNA ancestry testing type kits started promoting learning more about your health history and learning about the health history of your ancestors. So, it's something that's definitely out there and around us.

So, let's get started today in just talking about why it's important to know your health history and how do you begin to have that conversation with your family.

1:50 Natalie: Yeah. So, I think you've hit, a lot of things, nail on the head. That's exactly why we want to know about our family history. It is so important to know for that conversation, not only with your doctors, but also with your family members. Some people may not know what their family history is. So, that's why it's a perfect time to sit down and talk to your family about the health history.

I'll start with just why it's important. Because that's the basis of why you need to even start having these conversations, is that your family health history, like you mentioned, can help your doctor decide what screening tests that you get, what interventions or when and how you'll need certain care.

So, for example, if you have a parent or sibling with breast cancer, then your doctor might recommend that you start having that mammogram earlier. And your doctor also might refer you to cancer counselor, especially if your relative was diagnosed before the age of 50. So, that's something important.

Another thing is that if you're an older member of your family, then you may know more information and diseases and health conditions that previous members of your family have had. And so, you want to be able to share that with those younger relatives who may benefit from knowing their family health history, like being able to fill out those forms at the doctor's office.

And then it's also important for you, if you have any medical conditions, such as cancer or heart disease or diabetes, to really be sure to let your family members know about your diagnosis, not only for support and help throughout your process, but also so that they know what they may be susceptible for as well.

3:27 Dr. Hunter: Often, I think it's difficult for families to talk openly about health history. I think sometimes there's a running joke that often families don't communicate about money or sex. But really and truly, health history sometimes fits in there, too, that just folks are uncomfortable with sharing personal information about themselves. And I can see especially maybe a parent sharing with a child, just information, even adult children, but just information that they like to keep private.

How can folks go about starting this conversation and what really is it that needs to be asked right now?

4:00 Natalie: I think that's exactly right. It's definitely not going to be easy for every family; some maybe a little more open than you wish.

4:07 Dr. Hunter: That might be true.

4:09 Natalie: Others, it might be hard to get out that information. But the best thing is really to start those conversations and just remind them how important it is and that you're asking, not just for your own health, but for the health of everyone in your family.

And so, to find out about those risk for chronic diseases, you want to really ask your relatives about diseases that they've had and when they've been diagnosed.

So, some of those questions that you could ask could include like, “Do you have any chronic diseases?” And that could include heart disease or diabetes or any health conditions, such as high blood pressure or high cholesterol.

And another one would be, “Have you had any other serious diseases such as cancer or have you ever had a stroke?” “How old were you when each of these diseases and health conditions were diagnosed?”

And then another one would be like, “What is our family ancestry? “From what countries did our ancestors come from in the United States?” So, that may be a good way to really figure out your past. That could be an easy question to go into it, to figure out about those relatives who have died and then, of course, figuring out the cause as well.

5:15 Dr. Hunter: Now, as you mentioned that, it's been fairly recently that I had our little girl, a doctor's appointment and the doctor asked me, “Do you have a family ancestry from this part of the world?” And that really was not a question that I knew the answer to. And it wasn't really any big deal of anything that he was trying to diagnose with her, but it was just a question that’s one of those pieces of the puzzle to kind of put it all together.

But it was one that, as a parent, that I couldn't answer. I had to call my parents and say, “Do you think we have any ancestry from this part of the world?” So, you know, that drives home your point, I think.

5:54 Natalie: Right. And I think that that's exactly why you want to start having these conversations is because what if your parents weren't able to answer that question for you, then your doctor would have to fill in that puzzle when it could be a piece that you could hand to them easily.

6:08 Dr. Hunter: Right.

6:09 Natalie: So, one thing that I do want to touch on to real quick is like who you want to talk to. Because in a lot of families, there's family members that there are multiple families and a lot of people involved.

6:21 Dr. Hunter: Right.

6:22 Natalie: So, you don't need to have this conversation with everyone. However, you can if you're feeling it, but there are some key players.

So, the first and most important people to include in your family health history is your parents, any brothers, sisters, your siblings and children. So, making sure that those people who are in your direct family know the family health history for everyone.

And then the next, you may want to talk to those grandparents, uncles, aunts, nieces, nephews, half-brothers, half-sisters, anything like that. They can be included as well.

But really, those parents and siblings and your children are the most important key players there for your family health history. And you may end up finding more names of blood relatives that you need to include in this health history as you start talking about it with people as well.

7:11 Dr. Hunter: So, as we're thinking about health history and family health history, let's talk a little bit about genetic testing. Because I think that that's a term, again, that we hear a lot maybe in mainstream news or on social media. But I don't know that individuals really understand much about it or what it even actually is.

7:29 Natalie: Right. So, this is going to be a lot of the genetic testing from those different kits that you're talking about or the different types of going to a genetic counselor. So, I'll break that down in a second. But genetic testing is basically looking for a change or it's sometimes called a “mutation” or a “variant” in your DNA.

So, the genetic test is useful in many different areas of medicine because it can alter the medical care that you or your family member might receive, based on the results of that genetic testing.

There are a wide variety of genetic tests that are out there and available. And so, some are done using like blood or a spit sample or they'll just swab your mouth. Results are usually ready within a few weeks. And because we share our DNA with our family members, exactly why we want to have our family health history.

8:19 Dr. Hunter: Right.

8:20 Natalie: If you are found to have a genetic change, then your family members may have the same change. So, that's where it may be helpful with family health history to share that information.

And then genetic counseling is before and after a genetic testing. They can help make sure that you are the right person in your family to get a genetic test and that you're going to get the right genetic test for you and that you understand your results. So, there are the people that will help you pre- and post that genetic testing as well to understand those results and then to share those results with family members or to make sure that other family members get tested as well.

8:57 Dr. Hunter: I've had a few individuals, that I know were friends, that their health care provider has recommended to them genetic counseling or genetic testing. And I know that as they walk through that process, that it was a decision on their part. If it was something that did they want this information and what would they do with the information if they did have the information?

But what are some of the benefits of genetic testing? How can genetic testing help?

9:24 Natalie: All right. And it can be a really sensitive topic with genetic testing. A lot of times, it's scary; it’s a really daunting test to take because you aren't sure if you want the results or not, depending on what you're testing for.

But it is helpful and it can help learn whether you have a genetic condition that runs in your family before you have symptoms, so it can help learn about a chance or current or future and different diagnosis that your doctor can help you move through.

It also can help if you are thinking about becoming pregnant or future pregnancies and those genetic conditions that can take place during that as well.

And then it also can help you to diagnose a genetic condition, if you or your child, for instance, has symptoms, but you can't figure out what it is. And then again, it can help with understanding cancer prevention or treatment plan.

I know that I've had friends who have gone through different genetic testing for certain cancers that have run in their families. I think that that is one of the most prevalent ones that people hear about of recent.

And again, it's just if your doctor recommends it or if it's something that you are passionate about that you want to know, like if you have a family history of a genetic condition, then maybe you should, talk to your physician or your healthcare provider about learning more about the chances of you having that genetic condition and if genetic testing is right for you. So, they should be those people who you talk with about, but it can help in certain circumstances.

10:55 Dr. Hunter: Whether an individual goes through genetic testing and genetic counselling or if it's just interviewing their family members and developing that family health history, it can be a lot of information for someone to track and maintain.

How do you suggest keeping that that organized? How an individual hold onto this information?

11:18 Natalie: Yeah. So, it is a lot of information, especially depending on how large your family is. So, for people who may have nine siblings, there could be a lot going on there. For people who are an only child, it could be a little less daunting.

But it is something that you want to make sure that you keep, like a typical health record. We want to make sure that it's up to date and from time to time, maybe every year during the holiday, you sit down and have conversations together while everyone is already gathered.

And then there are different ways that can help you with tracking and keeping everything in order for your family. I will say that there is one that the Surgeon General has posted about family health history, and it's a free web based tool and it's called My Family Health Portrait. So, this allows you to share information easily with your doctor and your family members and you can enter it in.

I will say that my family doesn't utilize this, but we have a family Facebook group, and then my brother is very organized and has made spreadsheets for our family as well.

So, depending on if you have someone in your family who likes to know that information…

12:29 Dr. Hunter: Depending on what works for your family.

12:30 Natalie: Exactly. Then maybe you have a scribe who has everybody's information and then is able to share that out and add, make edits as different health factors take place.

12:42 Dr. Hunter: For listeners, we’ll be certain to link the Surgeon General's My Family Health Portrait web based tool in the show notes so that they can easily access it.

Natalie, as we begin to wrap up today, I want to ask you to leave us with the, “So, what?” or “What now that I have my family health history, I have organized it, I have it all together, so what do I do next?”

13:07 Yes. So, the biggest thing is once you have your family health history, including chronic diseases like cancer, heart disease, diabetes, share it. Share it with your family members. Share it with your doctor.

And if you are concerned about any of those diseases that maybe you find, as you start talking to your family members that are common in your family, then talk to your doctor about that at your next visit, because your doctor can evaluate all of your personal factors and your genetics as well to include that in some of what your risks would be for a disease, including that family history.

And that way they can recommend ways to reduce your risk and you could potentially share that with your other family members to keep everyone healthier longer.

13:54 Dr. Hunter: So, Natalie, as we begin to you head into the holiday season that you've definitely given folks conversation topics for the dinner table.

14:04 Natalie: Thank you. Yes, it will be good talk about health.

14:06 Dr. Hunter: Thanks so much.

14:07 Natalie: Thank you.

14:09 Thank you for listening to Talking FACS. We deliver programs focusing on nutrition, health, resource management, family development and civic engagement.

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Visit us online at fcs.uky.edu to learn more about the University of Kentucky Family and Consumer Sciences Extension program or contact your local extension agent for Family and Consumer Sciences. We build strong families. It starts with us.