My beloved and previously indestructible aunt, now in her late 80s, recently had a minor stroke. Related complications landed her in the hospital for a few days. When she was home and fairly well recovered, she told me about her high blood pressure and cardiovascular concerns. I said something to the effect that my levels were strong and I was happy that at least our family did not have much history of cardiovascular illness. (My aunt is my father's sister; he died of complications from Parkinson's disease.)
My aunt laughed. "What are you talking about?"
She then reeled off a list of relatives in her father's generation who had died early of heart attacks.
"I thought your side of the family was very long-lived," I said.
"We are," she told me. "Except for everyone who died young that you never heard of!"
What We Don't Know Can Hurt Us
Many of us pride ourselves on knowing the story of our parents, grandparents and their extended families — when they came to America, where they lived, whether they served in the military, how they met their spouses, what their favorite holidays and recipes were. What too many of us don't know is the information that could save or prolong our own lives: the medical history of our blood relatives.
Thanksgiving, when families gather, seems like an obvious time to try to collect some data about what's been killing your family over the generations. As it happens, the U.S. Surgeon General's office agrees and has, since 2004, declared turkey time National Family History Day.
The Surgeon General's office reports that although 96 percent of adults responding to a survey agreed that knowing their family history was important, only 1 in 3 say they've ever tried to gather and record that information.
Creating what amounts to a family tree of illness, whether online or with pen and paper, may seem like an old-fashioned effort in an era of high-tech testing. But there's evidence that no-cost family history is at least as strong a predictor of one's likelihood to develop certain conditions as expensive modern screening techniques.
A recent Cleveland Clinic study found that a complete family history more successfully predicted patients' risks of developing breast, prostate and colorectal cancers than genomic screening. That high-tech process evaluates the makeup of genes to determine the presence of variants indicating a predisposition for certain conditions.
"Evaluation of family health history still remains the gold standard in personal disease risk assessment," said Dr. Charis Eng, director of the clinic's genomic institute, who led the study.
However, Eng pointed out other research that revealed only about 30 percent of primary care physicians ask for any family history information from their patients, often because of the time it takes to do a thorough job. But the background check is crucial, not only for predicting the risk of illness, but for insights into how someone may respond to certain treatments.
What You Can Do at Thanksgiving
To assemble your family medical history, ask relatives coming to the table on Thanksgiving to prepare notes in advance about themselves and their parents, siblings and grandparents. Take on the responsibility for reaching out to relatives who can't join you; ask them to email the same information. After clearing the turkey, you can exchange notes, fill in gaps and correct errors.
Then designate someone in your family to go to the Surgeon General's website and enter the data in its free and secure online tool, My Family Health Portrait. The site allows you to enter health histories for yourself, your parents, siblings, children, maternal and paternal grandparents, aunts and uncles, nieces, nephews and cousins. (The National Institutes of Health defines a reliable family history as a record with information three generations deep.)
For each person, living or dead, you can also select from a pulldown list of conditions — including cancer, heart disease, diabetes, Alzheimer's and high blood pressure — and enter the relative's age at diagnosis and, if applicable, death.
When the history is complete, share it with your family. Encourage everyone to bring the information to their physicians, who can then better gauge their risk of developing certain conditions and prescribe preventive measures, like lifestyle or diet modifications or more frequent screenings.
When I bring my family to Boston for Thanksgiving weekend, I know that I'll be seeking this data from my aunt. Besides her life-changing brownie recipes, she's also got some potentially lifesaving knowledge.