Dr. Jonathan Jacobs is an internist who practices at Menorah Medical Center. He wants you to spend more time getting to know your family.
Your health could depend on it, and Thanksgiving is a great time to start. This quintessentially American holiday — a day to gather with family, enjoy a feast and count your blessings — also is National Family History Day, part of the U.S. Surgeon General’s Family History Initiative.
The U.S. surgeon general and other agencies of the U.S. Department of Health and Human Services (HHS) jointly launched the initiative and designated Thanksgiving as National Family History Day in 2004 “to encourage all American families to learn more about their family health history,” according to the HHS website. Many common diseases such as heart disease, cancer and diabetes, and rare diseases such as hemophilia, cystic fibrosis and sickle cell anemia, are known to sometimes run in families.
“If one generation of a family has high blood pressure, it is not unusual for the next generation to have similarly high blood pressure,” according to HHS. “Tracing the illnesses suffered by your parents, grandparents and other blood relatives can help your doctor predict the disorders to which you may be at risk and take action to keep you and your family healthy.”
Family history is a large part of Jacobs’ practice. Knowing family health history is important for Jewish people and all others because it’s “a cheap and easy way to get a lot of information,” he said.
“People nowadays are increasingly very excited about getting genetic testing for all kinds of conditions,” Jacobs said. “While that can be helpful and important, (learning about your family’s health history) in some ways can be helpful in ways that genetic testing (can’t).”
Genetic diseases are more likely to occur among people who reproduce within a relatively small population, he said. Ashkenazi Jews, for example, are genetically predisposed to a higher incidence of certain diseases, including Tay-Sachs disease and Gaucher’s disease. The breast cancer gene BRCA is commonly found in Jews; a Jewish woman with BRCA has a 90 percent chance of developing breast cancer and a 60 percent chance of developing ovarian cancer.
Jews should ask about these diseases while exploring their family history, Jacobs said.
For the general population, the most common diseases in a person’s family that can be screened for are cardiovascular (“the biggest killer in our country,” he said), heart attack, stroke, colon cancer, breast cancer, bipolar disorder and other mental illnesses. Family history is one of six cardinal risk factors for heart disease and stroke. Along with genetics, lifestyle — including smoking, diet, exercise and stress management — is very important regarding disease.
As powerful a tool as genetic testing is, it is extremely complicated by many variables and unknowns, Jacobs said. Many diseases, including hereditary ones, don’t have identified genes, so genetic testing doesn’t show every disease. Eight to 10 studies are currently being conducted on various genetic diseases.
“It’s a huge process underway, he said. “Sequencing the human genome is a huge study, and finding out what each means is an entirely new job. … Ultimately, with all the noise out there, it’s hard to interpret what’s best.”
People seeking that kind of interpretation should visit their family doctor, who can refer them to another medical professional if necessary, Jacobs said.
The Surgeon General’s Family History Initiative refers people to an online tool it developed called My Family Health Portrait (https://familyhistory.hhs.gov/). The initiative recommends talking with family members to get details of their health histories before using the tool, and it suggests ways to plan for and engage in these conversations, including:
Make a list of the blood relatives to include in your family health history, starting with parents, siblings and children and including grandparents, uncles, aunts, nieces, nephews, half-brothers, half-sisters, great-uncles, great aunts and cousins.
Write your questions ahead of time to help focus your discussion (My Family Health Portrait suggests a list of questions).
Talk with family members when gathered in a relaxed setting, such as at Thanksgiving.
Explain to your relatives what you’re doing with the family health history.
Keep a written record of the conversations.
Ask one question at a time, and keep questions concise and focused.
Respect your relatives’ feelings regarding sharing their medical problems.
Don’t panic if you discover a serious health problem in your family. Go ahead and create your Family Health Portrait and then take it to your health care provider and ask to discuss it.
Ask relatives for health information about deceased relatives or living relatives whose health histories you don’t know. Get copies of medical records and birth and death certificates, if possible, to document diagnosed health conditions in your family.
Diligently update changes in your family’s health history.