THE U.S. SURGEON GENERAL’S FAMILY HISTORY INITIATIVE.
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Transcript of THE U.S. SURGEON GENERAL’S FAMILY HISTORY INITIATIVE.
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THE U.S. SURGEON GENERAL’S
FAMILY HISTORYINITIATIVE
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Why Family History?
• Almost every disease is due to interactions of multiple inherited (“genetic”) factors and non-genetic (“environmental”) factors.
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> 9 of the 10 Leading Causes of Death Have Genetic Components
• 1. Heart disease (28.9% of U.S. deaths in ‘01) • 2. Cancer (22.9%) • 3. Cerebrovascular diseases (6.8%)• 4. Chronic lower respiratory dis. (5.1%)? 5. Injury (4.0%)• 6. Diabetes (2.9%) • 7. Pneumonia/Influenza (2.6%)• 8. Alzheimer disease (2.2%)• 9. Kidney disease (1.6%)• 10. Septicemia (1.3%)
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Indeed, ALL Diseases Have a Genetic Component
• In causation
• In how each individual responds physiologically to the disease
• In how each individual reacts to drugs used to treat them
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GENES + ENVIRONMENT =
HEALTH AND DISEASE
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Family History ChangesDiagnosis of Many Diseases
• It is the key to presymptomatic diagnosis
• If someone is sick, it informs the differential diagnosis – what diagnoses to consider
• It guides testing to nail down the diagnosis
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Family History Changes Population Screening Guidelines
• Visual Impairment
• Hearing Impairment
• Thyroid Disease
• Thromboembolism
• Hypertension
• Diabetes
• Coronary Artery Disease
• Dyslipidemia
• Breast Cancer
• Colon Cancer
• Prostate Cancer
• Liver Cancer
• Hip Dysplasia
• Iron Def Anemia
• Osteoporosis
• Cardiomyopathy
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Family History ChangesManagement of Common Disease
• Coronary Heart Disease
• Hypertension
• Heart Failure
• Emphysema & COPD
• Syncope
• Pancreatitis
• Diabetes
• Thromboembolism
• Thyroid Cancer
• Breast Cancer
• Colon Cancer
• Urticaria
• Developmental Delay
• Pancreatitis
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But Do People Care About Family History?
• In 2004, Research!America and Parade conducted a nationwide survey of 1,000 individuals:
– 65% have found health information on the Internet to be very or somewhat helpful
– But, 96% thought, in thinking of their own health, that knowledge of family health history was very or somewhat important
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But Do People Care About Family History?
• In a CDC survey of 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.
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In the “Age of Genomics,” Why Family History?
• Although we will gain important new genomic tools, family history will remain highly relevant for years.
• Family history helps predict risk for such varied health concerns as single gene disorders, chromosomal disorders, heart disease, colorectal cancer, breast cancer, ovarian cancer, osteoporosis, atopy or asthma, type 2 diabetes, suicide, etc.
• Yet, many people are unaware of relatives’ medical histories, and many health professionals continue to underutilize this information in advising patients on how to maintain good health.
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If Family History Is So Useful, Why Don’t Health Professionals Use It More Consistently & Effectively?
1) Clinicians often underestimate the utility of the family history (tree)
• Requires better teaching and more pervasive role modeling of effective use of the family history
2) Not enough time to obtain, organize, and analyze family history information
• Requires creative approaches to the family history that demand less practitioner time
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So, What Can We Do?
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U.S. Surgeon General’s Family History Initiative
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Goals of the U.S. Surgeon General’s Family History Initiative
• Increase the American public’s awareness of the importance of family history in health;
• Give the American public tools to gather, understand, evaluate, and use family history to improve their health;
• Increase the awareness of health professionals about the importance of family history;
• Give health professionals tools to gather, evaluate, and use family history information; and to communicate with their patients about family history;
• Increase genomics and health literacy;
• Prepare both the American public and their health professionals for the coming era in which genomics will be an integral part of regular health care.
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So, What Can We Do?
www.hhs.gov/familyhistory
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Available in Both English and Spanish
• To order print versions:
– Call 1-888-275-4772
– Or go to: www.ask.hrsa.gov
• To access the computer-based version:
– Go to: www.hhs.gov/familyhistory
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Next Steps
• Improve “My Family Health Portrait” – a new and much improved version will be on the web in Fall 2005
• Continued media attention and outreach
• New projects and uses by any and all
• Make Thanksgiving the Annual Family History Day
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Let’s Make Thanksgiving Day Annual National Family History Day
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For More Information
Visit The U.S. Surgeon General’s Family History Website at
www.hhs.gov/familyhistory
or
Contact Susan Vasquez [email protected]