Ah, the holidays.
It's the perfect time to kick back and bask in the goodwill of friends, family and neighbors, and oh, while you're at it, why not ask Uncle Frank about his prostate cancer?
That's the gist of the family health history initiative launched by the U.S. Department of Health and Human Services in November. The holidays often are the only time extended families come together, so it's an ideal time to compare health notes. Surgeon General Richard H. Carmona said the campaign, which was timed around Thanksgiving, has struck a nerve with the medical community.
"People say 'Gosh, this is something that's so simple, yet so important,'" he said. "The headlines are about trauma surgeons putting people back together, the kinds of things that drive the TV shows," Dr. Carmona said. Family health histories aren't "sexy, and it doesn't attract a lot of attention, but it's an essential cornerstone."
Paula Yoon, a leader for the family history team at the Centers for Disease Control and Prevention in Atlanta, said the initiative is in response to the center's findings that 96 percent of Americans feel family history is important to their health, but only 30 percent actually attempt to gather the information.
"Your family medical history provides clues to whether you'll come down with heart diseases and diabetes," she said. "It doesn't mean you should throw up your hands and say 'well, it runs in my family,' though, because things like diet, exercise and alcohol have an impact, too."
Dr. Yoon said family histories are an under-used but powerful element in the health-care toolbox.
"With the completion of the Human Genome Project, people are starting to really think about the influence of genetics," she said. "We don't know a lot about how individual genes affect chronic diseases, but we do know about family history."
To get started, the CDC has downloadable fill-in-the-blank forms on its Web site, www.cdc.gov/genomics, featuring a family-tree-style breakdown of who had what and when. The forms can be filled out and used by doctors as reference materials. Dr. Yoon said the center also is working on ways to teach doctors how best to use these forms.
"Americans are used to filling out a form in the doctor's office where it asks if any of their family has had certain illnesses," she said. "But a lot of times, the physician doesn't pay attention unless there's a specific red flag. There are some real barriers to collection of history. Physicians don't have a lot of time, they're not reimbursed, and the knowledge and skills needed to interpret that information is somewhat limited."
Of course, it's one thing to talk about gathering your family's medical history and another to actually do it. How are you supposed to bring up dementia, Alzheimer's disease or alcoholism while trimming the Christmas tree? Marilyn Williams, a clinical social worker with the Medical College of Georgia's Senior Health Center, suggested a back-end approach.
"Don't just sit down and say 'Grandma, what ails you?'" she said. "You want to start a conversation about the family in general; say 'I'd really like to know more about my family and my background.' Your ultimate goal may involve health information, but you may find out about other things in a roundabout way."
The beauty of this approach is that it's no different from regular holiday banter, except you're on guard for mentions of heart disease, cancer, dementia, kidney problems, sickle cell anemia and other maladies.
"If I ask you 'What did you grandmother die of?' you might say 'I don't know,' but as you talk about her, you may remember things," Mrs. Williams said. "And if you have several people from a generation and they begin to share their memories, it triggers some for others. There are frequently hints in those reminiscence or recollections of past events."
Dr. Yoon said it's in a family's best interest to learn each member's strengths and weaknesses.
"Raise the issue about how much we're learning about diseases, and how genes are passed down," she said. "When it comes to the environments we live, the diets we eat; we're all susceptible to these things because we're a family unit."
Reach Patrick Verel at (706) 823-3332 or patrick.verel@augustachronicle.com.
Web resources
• The Centers for Disease Control and Prevention Office of Genomics and Disease Prevention: www.cdc.gov/genomics
• U.S. Department of Health and Human Services Family History Initiative: www.hhs.gov/familyhistory
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