Knowing what diseases or disorders run in your family is important for your own health. In this episode, Dr. Bjorn Mercer talks to APU nursing faculty Dr. Jameelah Powell about understanding your family health history. Learn ways to start this sometimes difficult conversation with family members, what information you should gather from whom, and ways to store that information so it’s easily accessible.
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Dr. Bjorn Mercer: Hello, my name is Dr. Bjorn Mercer. And today we’re talking to Dr. Jameelah Powell, full-time faculty in the School of Health Sciences. Today, we’re talking about the importance of sharing family health history. Welcome Jameelah.
Dr. Jameelah Powell: Thank you. Thank you for having me back.
Dr. Bjorn Mercer: Yeah. I love having you here. And this is an important topic. I think every family should share their health history, because it could help all of us live healthier lives. And so, the first question is, what is family health history?
Dr. Jameelah Powell: So, basically it’s a record of all of the diseases and health conditions in a family. So, that’s everyone that’s related to you by your bloodline. So, it’s not just your parents or your siblings or people live in your home, but it’s also just people that you are connected to, your uncles, cousins, anything like that. So, it’s a record of any types of diagnoses or health issues that they may have experienced.
Dr. Bjorn Mercer: Why are some families hesitant to talk about their family health history?
Dr. Jameelah Powell: That’s a really good question. I think in some cultures it’s taboo, especially if you’re talking about information that’s being shared across genders. So, you’re asking women about their health history and you might be a man, it’s very taboo.
In some cultures it’s taboo to have a male doctor when the patient is female. So, I think in some cultures that gender thing is a big issue. The unfortunate part about that is, it’s important because what may be going on in a woman’s line of your family history, can affect your children even if you’re not a woman. If you are the son of that woman, if there are things that are shared on the female gene, basically, it’s still something that you’d want to know.
Even if it’s not taboo, it’s just not something people think about. I can tell you for. me and my family, it doesn’t come up. It’s not something that people just offer, it’s something you have to actually dig for. And it can be uncomfortable digging for things like that because health history is not always information that people want to share. They find that it’s private or it’s secret and it’s not something that should be allowed to just exist for other people to know.
But I think people just really don’t understand why it’s important. They just want to keep that information for themselves because they think it’s private. Sharing private information with a friend, unless you’re really close with that friend, it probably isn’t something that you’re going to share and I think people have that same sentiment when it comes to family members.
Dr. Bjorn Mercer: And that totally makes sense and it also makes me think of just like sometimes guys, I’ll say guys, don’t want to share how they are or potentially what they’ve been doing, “wrong” in relation to their health. If they haven’t had a good diet or if they haven’t exercised enough or if they’ve been smoking or drinking, I mean, there’s all these different things that people can feel like others will judge them.
And I would say it’s not about judgment versus try to do as much as you can to live a healthy life. And we all know now, today, that there are certain activities that actually are a detriment to your health, such as smoking or drinking too much or not exercising. If you are working eight hours a day sitting in a chair, you need to move, you need to exercise because that could create some sort of blood clots eventually.
Dr. Jameelah Powell: Absolutely. Actually, I think we may have mentioned this on another podcast about like when you’re traveling on a plane, especially women who are on birth control because it does actually heighten your chances of blood clots. So, a lot of celebrities actually suffer from this because they’re traveling, doing tours and things like that, and they’re on these private planes for like 12 hours going to another country. And if they don’t get up and move, they’re greatly at risk for these blood clots that can travel to your lungs and really cause a lot of issues. So it’s important.
But I wanted to mention something as you were talking about this sort of shame that people feel about their health and their health habits, because when you were talking I was thinking about how people lie when they go to the doctor, you know. You go to the clinic or the doctor’s office and they’re asking you these questions and you’re like, “Yes, I exercise every day for 30 to 45 minutes, five times a week, or yes, I do not smoke.”
When you do that, you are limiting the benefits of you going to the doctor because they’re there to try to figure out, “Oh, with all of the information that you’re giving them what can we help you with or how can we better increase optimal health for you.”
But if you’re not giving them all of the correct information, they’re not going to be able to do that. So, it’s sort of that same thing when you’re sharing family history, you can’t give people little bits and pieces of something. They need to know because it could help them in the long run.
Dr. Bjorn Mercer: Exactly. And it makes me think like, unless you know that the doctor or the nurse who is providing your care, they just want you to be healthy and they want the correct information so they can give you the best possible ways to live a better life. This transitions to the next question is: How can you collect your family health history?
Dr. Jameelah Powell: This is going to be different for a lot of families and a lot of cultures. You’re going to have to find the best way to do it, like what’s a good “in” for people. I find that sometimes when people are having a good time and enjoying themselves, that’s the time that you can ask questions because people are feeling a little good, they’re feeling a little giddy. I think family gatherings are the best time to collect that information, you have everybody there, hopefully everybody’s enjoying themselves and having a good time. And it’s a good time to check in with people that you don’t get to see very often, don’t get to talk to very often, and ask those questions. Especially if there’s something that just recently happened.
I had an uncle that just had a heart attack and I’m really wondering now, is that something I should be asking other people in my family, it was very mild and he may not even think about it as a real heart attack, but that’s still something that I think people in the family need to know because it sounds like there might be a theme of heart issues here. So, I’d want to know more from him. Did you have high cholesterol? Did you have high blood pressure? Or is this something that came from a heart condition? So, I think that family gatherings are a good way to collect information.
I also think that death certificates are a good way to collect family information because it will tell you specifically what that person died of. I think sometimes what happens in families is that they’ll just give you like a generic, yeah, he had some heart issues and you’re like, “What does that even mean? What did he actually die of?”
I think death certificates will be very clear about what was the specific thing that they died from, because that can help you ask more questions. It can lead you, just like I said about the heart attack. So, I know this person suffered a heart attack, but I want to know more about that. Is there a heart issue? Do we all share some sort of genetic heart condition that we need to be aware of?
How old were they when they died? That’s a very good indicator of, he was 50 years old. That’s kind of young, so you really want to put emphasis on that because people who are around that age really then need to start taking a look at what are they doing that’s contributing to either the decline or the promotion of heart health.
Dr. Bjorn Mercer: I’m really glad you talked about family health history because, honestly, it makes me think of my own father and he died, what I would describe as young, 67. There’s a variety of things, which led to, potentially, I should say, an early death for contemporary humans. But also at the same time, he was in the Army for 24 years and he was in air defense and he was around jet fuel, and as I’ve come to realize that when you’re in a high-risk career such as the military, firefighting, police, there’s a lot of toxins that people are exposed to. So I can see how, even when you share a family health history and you find, say, a family member who died early, you also need to look at their job.
Dr. Jameelah Powell: I think that’s absolutely correct. And, unfortunately, you may not see that on a death certificate, you may see just sort of the remnants of something that they did. So even a heart attack, as specific as it sounds it’s kind of broad because it can be caused by so many different things: stress, it can be caused by a genetic condition, it can be caused by a heart condition that went undiagnosed for many years. It can also be caused by poor habit, poor eating habits or poor exercising habits.
When you hear those things, you have to investigate it more because it really doesn’t give you the whole picture. It’s just going to tell you, this is something that happened in your family, but you still don’t know why, I mean, there could be many factors. There could be all of those things involved. But what it means is that you need to do a little bit more investigation, especially if there’s other people that have that same thing.
So like with your history, I don’t know if your dad had siblings, but I would want to look at, did they suffer from many health issues themselves? And then I want to look at, did they all have the same eating habits? Did they all have the same sort of routine as far as exercise or what differentiates them as far as like career or lifestyle? So, I think that is like a really good example of hearing that and knowing that information, but still needing more to really put a good picture together.
Dr. Bjorn Mercer: And it is, it’s so difficult to put that picture together. Because then like we were talking about sometimes family members and people in general are hesitant to talk about health history. People don’t want to talk about mortality and death. We humans when we’re alive we feel, for the most part, like we’re immortal. We will live forever and it’s hard to imagine a time when we will die. So, I can see how people would be hesitant to talk about health issues that could lead to death.
Dr. Jameelah Powell: I think that’s again how you approach the topic and knowing who you’re talking to. I think in different people in my family, I can say, “Oh, this person’s a little more open so I think I’m going to ask them about this.” It’s all in how you ask the question because it can be a celebration of life. If I were asking questions about my grandma who I adored and loved, I just want to know more about her life and that’s how I would be posing this or approaching that when I ask these questions, because, to be honest, I really am curious about my grandmother’s life. I would want to know, so what kind of things did she cook in the kitchen? That’s how I would approach that as opposed to in a more morbid way.
Because I do think talking about death and mortality and things like that, morbidity for people can be very strange. I know for me, because I’m in healthcare, it’s not super strange but I know that’s not the case for everybody. So I try to approach that in a very different way. Just in a way that I just want to get to know this person because I didn’t get to really know them as well. So, please, tell me more about them. What did they do? What were they like? That type of thing. And even from that, just getting that dialogue going, just getting it started, I think will allow people to open up a little bit more.
Dr. Bjorn Mercer: Exactly. And that actually leads to the next question is why is family health history important for your own health? Because we live so long, the health issues we encounter a lot of previous generations have not encountered because most people, well, they died in their 50s or 60s, if not before that. And today we’re encountering all these issues with our bodies and diseases in our 70s and 80s. Our bodies are wearing out and so we’re really encountering issues of the human body wearing out, versus in the past, again, different things that killed us because of environment, of different diseases or different things like that.
Dr. Jameelah Powell: I think that’s absolutely right. And that may make things a little bit more challenging in trying to identify what, you as an individual, have been exposed to because it may be a little bit different from your ancestors or people in your family who have passed on before you, because I think you’re correct, I think in many years past a lot of the jobs were working jobs. You do with your hands, you do a lot of physical movement.
And I think the food was very different, you eat off the land or you eat things that you cook. I think we live in a very different society where I think a lot of people don’t even know what they’re eating half the time, they probably can’t even pronounce the ingredients in the food that they’re buying. And because that hasn’t been around for that long, we actually don’t know the effects of that. We don’t know how that’s contributing to mental health issues or physical health issues.
So, it may be a little bit different in how we are exposed to our environment as opposed to how our ancestors were exposed to their environment. Because what was plaguing them was infectious diseases. Since we now have a little bit more handle on that with antibiotics and just medications, that’s not something that we necessarily are at risk of, but we have these other risks that we’re still trying to figure out.
Dr. Bjorn Mercer: Exactly. I remember this one great YouTube video I watched about the life of a medieval peasant, which is always fun because as today we think, “Oh, medieval peasants just might had miserable lives, hard, hard lives and died early.” But the narrator went through what they ate, which was fresh fish caught in the local stream, whole grain bread. And so from that perspective, their diet was actually great.
In the medieval times the kings and queens basically exclusively ate meat, they actually had severe constipation, which is kind of funny to think because all they did was eat meat because that’s what rich people did. And then you compare it to today where we have a glut of food for most people in the West, especially in the U.S., but the quality of that food as we’ve talked about in our previous podcasts can be so poor that we have so much food but it’s not nutritious.
Dr. Jameelah Powell: Absolutely. I think that’s kind of interesting because I think people think, as you were saying, the rich in these times were eating a lot of meat. And, unfortunately, if you’re not conscious of how much meat you’re eating, in relation to how many vegetables and fruits you’re eating and grains and things like that to balance it out. I think that actually will probably have much more of an impact on your morbidity than anything else that you could be doing because there’s a lot of cholesterol in meat.
Back then, because they probably didn’t know, obviously, how that’s going to affect their heart. And I can imagine just hearing you thinking that I wonder if the lifespan of the kings and queens was shorter than these peasants just because of their diet.
Dr. Bjorn Mercer: And that’s actually a great question. I’d be curious to see a study of that because then the peasants and the kings of queens they also had to deal with raiding armies walking through their lands, which could also kill them and then like a bad cold that eventually killed them, where today, which just take some medicine, luckily.
Dr. Jameelah Powell: Sure. But your original question, why is family health history important for your individual health. I think, again, as we’ve been talking about knowing someone else’s family history or knowing someone else’s diagnosis or health conditions affects you as a person because you are much more at risk for whatever your family members may have had.
So, if we take the example of breast cancer, that’s actually not just an issue for the women that come from that woman. It’s actually affecting her grandchildren as well because if it’s a genetic component related to this breast cancer, especially if it’s something that happened early on, like she got breast cancer when she was 40, that’s a red flag. That is something that your children need to know, that is something that your grandchildren need to know because maybe they need to be tested for that.
I think things like chronic diseases, things like cancer, heart disease and diabetes, those are especially important things that you want to know because those have very large genetic components to them. I can say someone died from pneumonia, that’s doesn’t necessarily have a genetic component to it.
But, something like diabetes or something like heart disease or cancer specifically, those all have genetic components to them. Meaning, if somebody in your family has them, you are probably much more likely and at a higher risk to have that as well. So, it’s really important for you to investigate that a little bit more so that if you know that you are at risk for something you need to take the opportunity that you have to sort of reduce that risk in whatever way that you can.
Dr. Bjorn Mercer: And very well said. So, this leads me to my last question, which is a tough question and there’s no right or wrong answer. Since we potentially know so much about our family health history, our genetic health, if family members had the big C, had cancer, or if they have a genetic disorder in the past or different things like that. How do families decide to have a baby or not? If a family has a pretty serious marker in their family history, how difficult is that?
Dr. Jameelah Powell: I think that’s an excellent question actually, one that I hadn’t thought about, but I know I’ve discussed with people and friends. I think with something like that you really want to talk to a geneticist. I think you want to know what your chances are because it’s very easy to sort of map based on what you know of your family who has particular diseases to identify and hone in on what is your exact percentage and your chance, your risk, of your child having that disease.
We can take something like sickle cell. There is sickle cell disease and there is sickle cell the trait, you can have the trait and not have the disease. But once you have two parents that have the trait, well, then your chances of your baby having the disease actually goes up. So, you need to take into account, not just the person whose side of the family has that. So, if it’s me let’s just say, I have sickle cell in my family, which I actually do, but does my husband have sickle cell in his family? Because once you know those numbers, then you can sort of combine that to find out your exact risk of your child actually having the disease.
Actually, there are gene maps that will tell you have a 25% chance of your baby having the disease, a 25% chance of your baby having the trait, and a 25% chance of your baby having nothing. I think it’s important to know that instead of just, we’ll just see what luck says.
You need to see a geneticist. You really do need to find out what your chances are, risk factor I guess, of these particular disorders, because sometimes it will depend on if the baby’s a boy or a girl. There are some genetic things that are linked to the X and there are some things that are linked to the Y.
So, I think, again, that is a challenging discussion, obviously, because you don’t know what you’re going to have. You can never determine, is it going to be a girl or is it going to be a boy. But I think your best bet is to really talk to your doctors and talk to, at best, a geneticist.
Dr. Bjorn Mercer: I think that’s a great suggestion because we live in a time now where we have so much information and going to a geneticist is perfect because then you can test you and your spouse and see how they are and different factors that exist within your DNA or your biology. And I can’t say that I know what that’s like because, knock on wood, my wife and I didn’t have any markers like that. So, we didn’t have to make that hard decision, but I can imagine for some people that’d be very, very difficult.
So, it is a very interesting topic because there’s no easy answer and it doesn’t even mean that if you do choose to have children, if you have those markers, that’s the wrong decision.
Dr. Jameelah Powell: Absolutely. I think you have to be prepared. So once you go to the geneticist or whatever doctor that sort of specializes in this, once you go and you find out what your risk is, then it’s up to you and at least you have that information now to really make an informed decision about what you want to do. Because you can say, well, our chance is 25%. So the chance is higher that we will not have a child that has this particular genetic disease. However, you could at least be prepared for that 25% chance that you might have a child with that disease.
So, I would say in that case, are you willing to take that risk? And, what kind of impact would that have on your lifestyle or is that something that you can manage at this time in your life? And I would want to do all the research on this disorder, this disease, and just be prepared. But, I think it’s better to make an informed decision about that.
Dr. Bjorn Mercer: And being able to make an informed decision is one of the things we hope to do in every aspect of our life, especially health and health decisions. So, absolutely wonderful conversation today Jameelah, any final words?
Dr. Jameelah Powell: My final words would be just get that information the best way that you can, I would say, also try to use a form called the, My Family Health Portrait that you can get to through the Surgeon General, where you can sort of store all of this information. Because I would not task anybody to try to remember who died of what and what age they were and whatnot. I think it’s very important to have this information somewhere stored. It’s an electronic thing, but I would also ask that you print it out so that you could just have a hard copy.
I can’t stress how important it is for people to know what’s going on in their family so that they know what’s going on with themselves and for their children. Just know yourself, know your family, try to have those conversations as best you can and continue having those conversations. Don’t have one conversation and leave it there, try to continue talking about it because I think what you also do when you do that is make it not so taboo. You make it not such a difficult thing to talk about. You change the culture of your family by asking these questions. So, now people in the family can be open. And now maybe your future generations will have these conversations as if it’s nothing, as if it’s something we do every time we get together just to see what’s going on with everyone.
Dr. Bjorn Mercer: And I love that every conversation about health should be about improving our health and it should never be taboo. Like many conversations I think that people have, the more you do it, the easier it becomes and it’s all about communication and it’s all just about caring for each other. Absolutely wonderful conversation and so thank you so much. And today we’re speaking with Dr. Jameelah Powell about the importance of sharing family health history. My name is Dr. Bjorn Mercer and thank you for listening.