Public Health Genomics Program Review
4.2 Family History Public Health Initiative
Family History Analyses
To assess the risk of common chronic diseases and conditions in the U.S. population attributable to family health history, OPHG analyzed data collected through the National Health and Nutrition Examination Survey (NHANES). OPHG stratified the
U.S. population in three levels of familial risk (average, moderate, and high) and examined the association between risk and the prevalence of specific diseases.
OPHG found that several studies indicate that the risk for type 2 diabetes or cardiovascular disease is detectable in childhood, although these disorders may not emerge until adulthood. A simple way to detect risk for either diabetes or cardiovascular disease is to examine the family history. Numerous studies have shown that adults who have one or more first- or second-degree relatives affected with diabetes or cardiovascular disease are at high risk of having or developing these diseases. Although there are currently no overall screening strategies recommended for either disease among children or adolescents, family history should become part of prevention campaigns aimed at reducing the burden of these diseases and their risk factors in children.
OPHG found that family history of diabetes has a significant, independent, and graded association with the prevalence of diabetes in the U.S. population. Independently of sex, race/ethnicity, age, BMI, hypertension, income, and education, people in the moderate and high familial risk categories for diabetes were 2.3 and
5.5 times more likely to have diabetes, respectively, than people in the average risk category.
In another study of the U.S. population, OPHG found that a positive family history of osteoporosis was present in 19.8% of women aged 20 years or older. Women aged 35 years or older with a positive family history of osteoporosis were 2.3 times more likely to have the disease. The association grew stronger (to 8.4 times) when two or more close relatives affected with osteoporosis had a family history of the disease.
Valdez R, Greenlund KJ, Khoury MJ, Yoon PW. Is family history a useful tool for detecting children at risk for diabetes and cardiovascular diseases? A public health perspective. Pediatrics 2007;120 Suppl 2:78-86.
Valdez R, Yoon P, Liu K, Khoury MJ. Family history and prevalence of diabetes in the U.S. population: The 6-year results from the National Health and Nutrition Examination Survey (1999-2004). Diabetes Care 2007;30:2517-2522.
Manuscript in clearance:
Robitaille J, Yoon PW, Irizarry-Delacruz M, Liu T, Moore CA, Looker AC, Khoury MJ. Prevalence, Family History, and Prevention of Reported Osteoporosis in U.S. Women.
In October 2007, three OPHG-sponsored research centers at the University of Michigan School of Medicine, Evanston Northwestern Healthcare Research Institute, and Case Western Reserve University School of Medicine completed data collection for an evaluation study of the Family Healthware™ tool. This web-based tool provides users with a familial risk assessment for six chronic conditions (breast, colorectal, and ovarian cancer, coronary heart disease, diabetes, and stroke) and a “prevention plan” containing personalized recommendations for lifestyle changes and screening recommendations. Researchers of the Family Healthware™ study are currently developing manuscripts on the study methodology and health risk perceptions of family history and chronic diseases. OPHG is currently collaborating with NIH to test Family Healthware™ in a longitudinal clinical trial as part of a new effort to combine Family Healthware™ with the U.S. Surgeon General’s tool “My Family Health Portrait.”