Family History, Genomics and Public Health
What is a Family History?
Family history is health information about you and your close blood-related relatives. Family members have many genes in common, which show up in recognizable traits such as eye and hair color and height. Family members typically share a common environment, lifestyle, culture and health habits. Family members (blood relatives) also share genetic traits to varying degrees. Both genes and environment influence risk of many diseases, such as diabetes, heart disease, cancer, and asthma.
A family history tool can help document the health history of family members and can be used to help understand what conditions or diseases run in a family. Identifying and tracing those conditions can help inform a clinical risk prediction model based on the genomics implied by the family health history tool. Family health history changes with time and should be updated regularly. For example, certain diseases may develop as family members grow older. Knowing your family health history can help you and your doctor understand your risk of developing certain diseases.
Why Is a Family History Important to Public Health?
Collecting family health information is not new; in fact, health care providers and genetic counselors have used family health histories for many years to help individuals understand what diseases or conditions run in their family. However, applying family health history information in a public health setting is a new application of this tool. In the United States, one of the most comprehensive sources of information on health risk behaviors, preventive practices and chronic diseases and injury is a state-based system of health surveys called the Behavioral Risk Factor Surveillance System, or BRFSS. BRFSS data can be used to gauge varying metrics, including disease conditions and prevailing health practices.
With increasing evidence that many diseases of public health importance are influenced by both genetic and environmental factors, it is important to use this knowledge to prevent disease. Effective genetic tests that can accurately screen populations at risk for a disease are years away from public health application. Because family health history is an important risk factor for most diseases of public heath significance, it is an appealing tool that is accessible and inexpensive.
Some of the potential ways family history information could be used in a public health setting include:
- as an early gauge to identify those at higher-than-average risk for disease
- as a mechanism to target prevention efforts
- as an indicator for increased or earlier screening
Additional work is needed to fully understand how to best use this family information in a public health setting. There are currently several initiatives focused on this need, including the CDC Office of Public Health Genomics Family History Public Health Initiative, and the Surgeon General's Family Health History Initiative.