Role Of Family History In Chronic Illness

Having an understanding of one’s medical family history gives clues about a person’s current health status, as well as potential predispositions for the future. And, this knowledge puts more power in the hands of the patient.

“Family history gives patients the opportunity to decide, ‘If I am likely going to head to this disease continuum because of my genetic history, then maybe I don't wait until I have that diagnosis. I’ll start doing things about it now.’ It really informs our decisions,” states Dr. Joseph Lach, Chair of Family Medicine for Franciscan Health Olympia Fields and Associate Program Director of Family Medicine Residency.

Uncovering Your Family History

Today, health records are largely digital—making information easily accessible and shareable. However, it wasn’t that long ago that this information was stored in pen-to-paper physical files. That, combined with an “unknown” diagnosis or cause of death, means some individuals must do a bit of detective work to uncover their family’s medical past.

“A lot of times patients don't even know where their grandparents were treated or how they were treated,” explains Dr. Lach. “We have to go based on contextual clues to help determine what this person we're seeing in our office might be more predisposed to.” For example, he will often ask patients questions like:

• Did your aunt, uncle, grandfather, grandmother have to give themselves injections?
• How many pills did they take (and how many times per day)?
• Did they have trouble moving around (e.g. trouble getting up stairs, using a walker/cane)?
• Did they have any major surgeries?
• Were they losing or gaining weight towards the end of their life?

“We are able to draw insights out of basic history, and because of that, we're able to apply that ‘data’ to what we're looking at right in front of us,” adds Dr. Lach. If a strong predisposition is identified, patients can then choose next steps—including being proactive for the next generation of the family tree.

Common Genetic Conditions

Certain conditions persist along the family line, even if individuals take measures to prevent them. Despite his own efforts with diet and exercise, Dr. Lach suffers from high blood pressure (hypertension) after developing it at age 28. Cholesterol levels are also tied to a genetic history, even more so than high blood pressure.

“I have patients who are triathletes, marathon runners, who do everything they can to stay healthy and are on no other medication except cholesterol medication. And it's because they have a strong genetic predisposition,” he notes. “The goal is always to be on the lowest dose of medications to control these disorders, but you still need to recognize that in some ways, trying to deny your genetic predisposition, you're going to lose that battle nine times out of ten.”

Diabetes is another condition that has strong links to family history. While not inevitable, it’s important to understand the actions one can take in their early years to stave off a diabetes diagnosis—or at least keep it at bay until much later in life.

Optimizing Health Now & Into the Future

One of the key messages Dr. Lach has for his patients is that he is here to take care of them as they are right now, but his actual priority is to help improve health for the person they will be in five years, ten years. This is the type of care that should be present in any primary care provider’s office—and he encourages individuals to have family history conversations early and often.

“My goals for my patients are for them to always try to attain a happy, healthy, long life. If you're not going to be happy and healthy, then the length of your life is really of little consequence,” he cautions. “Life is worth living when you add value to those people around you and to your life as a whole—if it brings joy to yourself and others. That can’t occur if you are sick all the time, and decisions made now affect who you are in the future. You have to try and do the best you can to minimize your risk.”

Listen Now: Family Health History

Dr. Joseph Lach, Chair of Family Medicine for Franciscan Health Olympia Fields and Associate Program Director of Family Medicine Residency, talks about the role of family history in illnesses in the Franciscan DocPod podcast.