Next holiday party, when you're standing next to Uncle Larry, ask him what his blood pressure is. And Grandma Helen – does she have any chronic diseases? Since when?
We know: It's not standard party talk, at least in most families. But broaching these topics could help save your life, according to experts who say 'tis the season to gather your family health history. That means asking questions about conditions, from heart disease to mental health, that may run among your relatives. Knowing these details can help your doctor predict your risk of certain diseases and personalize recommendations for screening and treatment.
In a conversation with U.S. News, Kathryn Teng, director of the Cleveland Clinic's Center for Personalized Healthcare, explained exactly what family health history means and why it's important. Her responses have been edited:
What kinds of questions should folks ask their relatives?
The kinds of questions you want to ask are: What diseases do they have? What medications are they taking? And you want to know the age of onset of these diseases, too. If certain relatives are deceased, ask why they died, how they died and how old they were when they died.
The conditions we want people to ask about are the cancers, heart disease, strokes, high blood pressure, diabetes, bone conditions like osteoporosis, mental health disorders and substance abuse.
[Read: Best Diabetes Diets.]
How many branches of the family tree are necessary?
Start with the first generation of relatives, which includes your father, mother, brothers, sisters and children. Then expand to second-degree relatives: your grandparents on both sides, and your aunts and uncles. And, then, if you can move on to third-degree relatives – your cousins – that's terrific.
The Cleveland Clinic has a mnemonic for the word "story," which guides people through the family health history process. Can you explain?
S: State your purpose clearly. Say to your family members: "I want to collect family health history because I want to make sure we have the opportunity to personalize our care by making sure we can prevent diseases by knowing what runs in our families."
T: Talk with living relatives. Often, families have a historian who documents these memories and facts about families, so if you can find that person, talk with him or her.
O: Stay organized. The Cleveland Clinic has an online toolkit so people can print out questionnaires, write down notes, keep them in a binder and then share that information and make photocopies for others.
R: Be respectful. We have to recognize that not all family members want to talk about their health conditions, and we can't push them.
Y: Update your family health history yearly, or at least every couple years, because it can change. New conditions come up; people remember different things.
How can family health history help improve someone's well-being?
For most conditions, family health is still more predictive of disease risk than any sort of genomic testing. And so this information can really help us identify who's at risk and who needs to be screened early or who needs to be seeing certain specialists.
Let's say someone has a family history of diabetes, which puts him or her at higher risk than the average person. That would allow me, as a clinician, to say to the patient: "You have a high risk and really need to work on diet and exercise." And that's another key point to this. Genetics is one piece of information that helps identify risk, but you can control a lot of the other risks with your lifestyle choices. You can control sometimes when you get the disease, how severe it's going to be and if you need medicine – all by working on lifestyle and behavior changes.
What if someone has a history of mental health issues? How is that handled?
If a family member is at risk for depression or anxiety, you'll know to look out for the symptoms. It's important to recognize that someone is at risk because if you see erratic behavior or mood changes in your family member – or yourself – you'll be more likely to reach out for help.