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Harvard Commentaries
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Holiday Time -- Start Your Family Health History


January 24, 2013

By Harvey B. Simon M.D.

Harvard Medical School

For many men, holiday time is family time. It's a time for sharing meals, exchanging gifts, and swapping memories with relatives from across the street — and across the country. The holiday season can also be a wonderful time to collect information about your family's health history.

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Why Your Family's Health History Is Important

Creating a family health tree is important for several reasons. It can help:

  • Determine your risk for certain diseases
  • Give your doctor a better understanding of your health
  • Identify lifestyle factors that you may need to change

Some genetically-influenced diseases, such as sickle cell anemia and muscular dystrophy, show up at birth or in early childhood. But many don't occur until adulthood: hypertension, coronary artery disease, Alzheimer's disease, type 2 diabetes, autoimmune diseases and certain cancers.

Having a history of your family's health might save your life. In fact, it saved mine.

So, while you're rubbing shoulders with relatives, collect some health information about them. (It doesn't have to interfere with your holiday celebrations.) Plan to add to it during the coming new year. It'll be worth the effort.

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How To Get Started

Here are the people you need to include in your family health history:

    • First-order relatives such as your mother, father, siblings and your children – These are the people closest to you genetically. Their medical stories have the greatest implications for your health
    • Grandparents, great-grandparents uncles, aunts and cousins – Be sure to include those from both your mother's and father's side of the family.
    • Male and female family members – For example, men should take note of female relatives with breast cancer because a strong family history of breast cancer may put a man at increased risk for prostate cancer.

Try to find out the following information about each person:

    • Diseases they were diagnosed with and the age at which they were diagnosed – In general, an early onset is more likely to be significant for your health than a disorder that didn't rear its head until old age.
    • Treatments a relative received and if therapy was successful
    • Cause of death
    • Ethnicity, if you are part of a multi-ethnic family

Whenever possible:

  • Verify information with several other relatives.
  • Ask to see medical records for any relatives that died prematurely or had multiple cancers.
  • Record the health habits and lifestyle factors for family members along with medical diagnoses. It's fairly obvious that your dad's heart attack is relevant to your own heart's health. But you might not realize that his lifestyle is a crucial part of the equation. If your father was a slim, non-smoking, physically active guy, his heart attack might have a genetic basis that you could inherit — but if his health habits were asking for trouble, he would be less likely to pass his cardiac troubles down to you.

And since everyone in your family stands to benefit from a complete and accurate medical pedigree, other relatives may be willing to share the responsibility for researching and compiling the family medical history.

The U.S. Surgeon General has a website called My Family Health Portrait where you can create a family health history online. You may wish to share it with the rest of your family. Consider sending it to your doctors so it will be part of your permanent medical record.

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Remember, Genes Don't Act Alone

In almost 40 years of medical practice, I've heard it all — or almost all. "It's all in the genes, Doc" is a particularly common excuse for continuing unwise lifestyle choices. But genes don't act alone; instead, they are powerfully affected by environmental influences.

Cancer is a good example. All malignancies develop because of errors in a cell's genes. In some cases, those errors are purely inherited, but in many others, the errors are triggered by external factors. A good example of this is lung cancer.

So, while your family medical history can be very important, don't fall into the trap of believing that it will predict your own health. Instead, think of your family history as the hand of cards that was dealt to you at birth. Those cards are important — but how you play them is more important still.

My own story is a good example. My family history is riddled with early death from heart disease. My mother died at age 42; my uncles and two first cousins died before they were 50.

So, I was pretty fatalistic until medical research discovered the importance of heart disease risk factors that you can change. It's an old story now, but was hot news when I was a young physician. I realized that my family history was also riddled with tobacco abuse, lack of exercise, poor diet and obesity.

I'm embarrassed to admit that I was heading for all of these risky behaviors, but I changed my ways. My pipe was the first to go. Next, I started running, switched to a low-salt, high-fiber, Mediterranean-style diet and shed 45 pounds. I'm still here at age 68, and I'm still following the same lifestyle, while also monitoring my blood pressure, cholesterol and blood sugar.

Even with a favorable family health history, you should play your cards right. But if you have family health problems, you may well have to be extra careful — and your doctor may recommend extra tests to detect things that have hit your relatives before they hit you.

Holiday time is family time. Enjoy your holidays but do a little family health history homework, too. Then resolve to do whatever is necessary to keep your limb of the family tree strong and healthy.

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Harvey B. Simon, M.D. is an Associate Professor of Medicine at Harvard Medical School and a member of the Health Sciences Technology Faculty at Massachusetts Institute of Technology. He is the founding editor of the Harvard Men's Health Watch newsletter and author of six consumer health books, including The Harvard Medical School Guide to Men's Health (Simon and Schuster, 2002) and The No Sweat Exercise Plan, Lose Weight, Get Healthy and Live Longer (McGraw-Hill, 2006). Dr. Simon practices at the Massachusetts General Hospital; he received the London Prize for Excellence in Teaching from Harvard and MIT.

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