Tracking your family health history

I love going through old photos, listening to stories from relatives, and generally learning more about my family. Some of the information isn’t just interesting—it’s also helpful to know. That’s where your family’s medical history comes in. Many diseases are genetic.

If you know that certain cancers, mental illnesses, or heart problems run in your family, you can take care to particularly minimize your risk factors for those diseases and try to get the most appropriate screening tests.  My family has a strong history of heart disease, so we keep an eye on our cardiac risk factors and try to eat healthfully, watch our weight, and exercise. 

I also know—from my own family and from many of my patients—that sometimes we don’t know all the details. This can happen for many reasons. Many people have felt and still feel that it’s not polite to ask about family health history. Sometimes people just don’t know about the health of previous generations. Other times, people joined their families through adoption, like our daughter. And, yes, sometimes there is “bad blood” in a family, where Uncle Fred and Aunt Mabel haven’t spoken to each other in 40 years.  Gathering your family health history should not be stressful. Do the best you can. And don’t get upset—even if your family gave you a predisposition to being overweight, no doubt they also gave you many other wonderful traits as well.

The below article, first published in Harvard Women’s Health Watch, concentrates on the benefits of tracking your family history of heart disease. But the tips and information really apply to keeping track of all diseases. Here’s the Harvard Women’s Health Watch article:

It’s no secret that heart disease can run in families, showing up in grandparents and parents, children and grandchildren. Heredity is certainly a factor, but families pass on more than DNA. Family members live together, eat together, and can influence one another’s attitudes toward smoking, exercise, weight, diet, portion sizes, and other factors that have an impact on heart health and disease. The influence of family lifestyles is one reason why—even in this era of high-tech genetic mapping and testing—a simple medical family tree is still an important tool.

You don’t need special skills or tools to create a medical family tree—just paper and pencil and some memories and conversations can get you started. You can keep a list of the medical information, but arranging the items as a classic family tree or genealogical chart can reveal connections you might otherwise miss. Several health agencies and organizations have links on their Web sites to downloadable family-tree forms and instructions; books and computer programs are also available (see “Selected resources” below).

Start with your own health. List high blood pressure, high cholesterol, strokes, diabetes, blood clots, peripheral artery disease, heart attacks, heart failure, heart surgery, and other problems with your heart or blood vessels. Note when these problems first occurred or when you first became aware of them, because it makes a difference whether they appeared before age 50 or after age 70.

Branch out. The medical histories of your first-degree relatives come next. Start with the people who share half your genes—your parents, brothers and sisters, and children. For each family member, list date of birth, general health, medical conditions, and—if appropriate—age at death and cause of death. If you were adopted, the National Adoption Clearinghouse has information that may be helpful in securing medical histories of your birth parents (see “Selected resources”), but you shouldn’t feel that you have to search out your birth parents unless that is something you really want to do for other reasons in your life. Broadening your search to include grandparents, aunts, uncles, nieces and nephews, half-brothers and half-sisters, and cousins can reveal interesting patterns.

Get medical information about relatives. You’ll probably need to do some sleuthing, especially if your parents have died or you’ve lost touch with other relatives. One strategy is to ask questions at family reunions, although you’ll need to ask delicately, because such questions can raise guilt and anxiety for some family members. Perhaps there’s a “matriarch”—an older woman who knows a great deal about the extended family and is more than happy to share her knowledge. Old family letters or diaries may also contain clues. Death certificates can be helpful, because they list age at death, cause of death, and sometimes other medical conditions. A death certificate can be found at the vital records department in the state where your relative died (get help locating vital records departments from the National Center for Health Statistics).

A family tree is a map, not a crystal ball. A strong family history of heart disease doesn’t mean that you’re fated for the same, any more than its absence means you’re home free. The results are most telling when several family members are affected, they’re closely related, and they developed heart disease early in life.

If you don’t have heart disease but it shows up often in your family, talk to your primary care provider, who may refer you to a specialist. Depending on your family history, the specialist may go beyond the standard tests and suggest extra ones, such as measurement of C-reactive protein or homocysteine or an exercise stress test. You should also pay more attention to the familiar risk factors, such as cholesterol, blood pressure, tobacco smoke, and diet.

Keep in mind that the information you gather is important to your children, too, so make sure the family tree is both accessible and secure. You may want to keep a copy with other important family papers.

Charting a medical family tree can do more than merely alert family members to future problems. It can also be a catalyst for change. You can’t change your genes, but you can modify many other factors that affect your risk for heart disease or other conditions. For example, you might switch to a healthier diet, get more exercise, avoid tobacco smoke, and maintain a healthy weight.

Do you have a way to keep track of your family health history?  I’d love to hear about it.

More health information and tips from Harvard Medical School

Sign up for HEALTHbeat, the free weekly email newsletter from Harvard Health Publications.

For more tips on staying healthy and advice from Harvard doctors, visit The LifeMasters Community on Gather.

This content is not intended to substitute for personalized medical advice, diagnosis, or treatment from your healthcare provider. Read our full disclaimer.