1. Family History is Important for Your Health The U.S. Surgeon General’s Family History Initiative

2. What determines your risk for disease?

3. Risk Factors A risk factor increases your risk of developing a disease or health problem. Behaviors and lifestyle Environment Genes

4. Risk Factors for Disease Environment Environmental risk factors include exposures to harmful agents in food, water and air.

5. Risk Factors for Disease Behavioral and lifestyle risk factors include poor diet, lack of physical activity, smoking, abuse of alcohol, and failure to get recommended screening tests. Behaviors and lifestyle

6. Risk Factors for Disease Genes Genes provide the directions for building all of the proteins that make our bodies function. Genes are passed down by parents to their offspring. Some genes may not function properly leading to disease.

7. Interaction GenesEnvironment Behaviors Genes, environment, and behaviors interact with each other to cause disease. Risk Factors for Disease

8. Family history helps capture the effects of these interactions on disease risk. Risk Factors for Disease Behaviors GenesEnvironment

9. A family’s combination of shared genes, environment, behavior, and culture What is family history?

10. We all have a family history of something! heart disease cancer diabetes stroke obesity high blood pressure high cholesterol asthma arthritis emphysema allergies kidney disease osteoporosis depression Alzheimer’s curly hair blue eyes athleticism leanness acne

11. Family history is a risk factor for diseases throughout all stages of life infants children adolescents adults older adults birth defects blood disorders Alzheimer’s disease osteoporosis cancer heart disease diabetes depression asthma autism

12. Learn about diseases that run in your family Take advantage of screening tests that can detect disease at an early stage when it is most treatable Change unhealthy behaviors such as smoking, inactivity and poor eating habits How can your family history help you?

13. How can you collect your family history? Ask questions Talk at family gatherings Draw a family tree Write down the information Look at death certificates, family medical records, etc.

14. What information do you need? Major medical conditions and causes of death Age family member developed disease and age at death Ethnic background General lifestyle factors like heavy drinking and smoking Uncle Bill – smoked cigarettes since he was a teenager, had a heart attack at age 52 Example:

15. What relatives should be included? you children siblings parents grandparents aunts and uncles nieces and nephews

16. What should you do with the information? Organize the information Share it with your health professional Keep it updated Pass it on to your children

17. How health professionals organize family history you siblings childrennieces & nephews parents grand-parents aunts & uncles To learn to draw a family tree like this, go to http://www.nsgc.org/consumer/

18. What will your health professional do with the information? Determine your risk for disease based on: - number of family members with the disease - the age when they were diagnosed - how you are related to the family member Consider other disease risk factors Recommend screening tests and lifestyle changes

19. Both of Shirley’s parents developed diabetes by the time they were 60 With these risk factors - family history, overweight, poor diet – should Shirley be concerned about diabetes? Shirley knows she doesn’t always eat right and she is overweight. She is 5 feet 6 inches tall and weighs 175 pounds. Shirley wonders about her risk for diabetes

20. Diabetes: Strong Risk - losing weight, eating a healthy mother, 43 yrs diet and increasing physical activity father, 59 yrs - regular blood sugar screening uncle, 50 yrs ( father’s side) aunt, 59 yrs ( father’s side) Heart Disease: Moderate Risk - losing weight, eating a healthy mother, 66 yrs diet and increasing physical activity uncle, 68 yrs ( mother’s side ) - regular cholesterol screening - regular blood pressure screening - possibly take aspirin regularly Shirley’s doctor Family historyAssessment recommends: Shirley has heard that diabetes can run in the family, so she asked her health professional to assess her risk. Shirley’s Family History

21. She learned that she had increased risk for diabetes and heart disease. Her family history was a risk factor, in addition to her weight. How did Shirley’s family history help her? Shirley started getting more regular screenings for blood sugar blood pressure and cholesterol She talked to her health professional about losing weight through healthy eating and physical activity programs that were right for her.

22. People with a family history of disease may have the most to gain from lifestyle changes and screening tests!

23. Do people care about their family health history? In a CDC-based survey of over 4,000 individuals: 97% thought that knowledge of family health history was important But, only 30% had actually ever collected health information from relatives to develop a family health history. Healthstyles Survey, 2004

24. Goals of the U.S. Surgeon General’s Family History Initiative Increase awareness among the public and health professionals of the value of family history for disease prevention. Provide new tools to gather information, assess risk, and guide prevention strategies. Increase genomics and health literacy. Prepare the public and health professionals for the coming era in which genomics will be an integral part of regular health care.

25. A free web-based tool for collecting family history, available in both English and Spanish, can be accessed from: www.hhs.gov/familyhistory/ www.hhs.gov/familyhistory/

26. My Family Health Portrait: Print Version Free print version also available in English and Spanish Call: 1-888-275- 4772 or visit www.ask.hrsa.gov

27. U.S. Surgeon General’s Family History Initiative A collaboration of the following federal agencies:

28. Family History Resources U.S. Surgeon General’s Family History Initiative www.hhs.gov/familyhistory CDC, Office of Genomics and Disease Prevention www.cdc.gov/genomicswww.cdc.gov/genomics/public/famhist.htm

29. Prevention is Primary… Create Your Family’s Future!