Family Health History Transcript

[Announcer]
This podcast is presented by the Centers for Disease Control and Prevention. CDC – safer, healthier people.

[Curt Shannon] I’m your host, Curt Shannon, and today we’re talking about the importance of documenting a family history. Joining me on the phone is Dr. Tracy Trotter, a practicing pediatrician from San Ramon California, and here in the studio is Dr. Paula Yoon, an epidemiologist with CDC. Dr. Yoon, can you tell us what a family history is, and why it’s important for your child?

[Dr. Yoon] In medicine, family history is about the health of your family and your relatives. For example, did your father have diabetes? Did your sister have breast cancer? And, at what age did Aunt Dora start having heart trouble?This is the information that makes up a family health history. There are lots of factors that contribute to your family history – the most important is genetics. But environment, behavior, and cultural factors are also important. Families share not only their genes, but they also may live in the same area and be exposed to similar environmental factors, such as pollution. Families may also have similar exercise habits, whether that means running marathons or marathon sessions of sitting on the couch. Cultural factors, such as what type of foods we eat and how they are prepared can also affect our health and can be shared among family members. Family history incorporates all of these factors. So your father’s genes may have contributed to his type 2 diabetes and you may share some of those genes, but the fact that he never exercised and ate fast food every day also influenced his health, and you may share some of those habits, as well.

[Curt Shannon] Dr. Trotter, you want to add to this?

[Dr. Trotter] Sure. We’ve been talking mostly about conditions like type 2 diabetes and heart disease that usually affect people in adult life. But we use that information to screen children as well. A family with high cholesterol might practice–get their children screened earlier than not. But we also use family history for children’s health in a more specific way. And family history can help your child’s doctor make a diagnosis if the child is already showing a sign of disease. A family history may also indicate that your child’s at an increased risk of getting a disease and your child’s doctor might suggest screening tests for your child, based purely on your family history. Many genetic disorders first become evident in childhood and being aware of a family history of genetic conditions can mean that if the child’s affected, the condition can be detected much earlier. The child can then receive treatment earlier and early treatment for genetic conditions frequently benefits your child’s health in the long run. So family history is also very important if you’re considering having a baby. The family history can tell you if you as prospective parents have a higher risk of having a child with a birth defect or genetic disorder. And there are steps that you can take to reduce that risk of having a child born with a birth defect. For example, a well-known preventive mechanism is consuming 400 micrograms of folic acid daily, before and during a pregnancy, which is known to reduce the woman’s risk of having a baby with spina bifida, whether or not she has a family history. And with a positive family history, we might increase that dose as well.

[Curt Shannon] Can you give us some examples of when a family history can help shed light on a medical condition or problem?

[Dr. Trotter] Sure. In my own practice, I had a new patient who was a 4-year old girl that had been diagnosed oh, somewhere around 18 months of age, with the diagnosis of autism spectrum disorder, and when I saw her for her 4-year visit, her mother related to me that in the previous six months, her sister’s two boys had been diagnosed with the genetic disorder called Fragile X Syndrome. This new history prompted genetic testing that was specific for the gene, which is called FMR1, responsible for Fragile X, and this lead to the subsequent diagnosis of Fragile X in this girl, my patient. And further testing of the family revealed both the mother and an older sister of hers were at risk of having children with Fragile X Syndrome. So for this family, the family history update that the mother gave me focused the evaluation, saved thousands of dollars and a lot of frustration for the family in finding out a diagnosis, and ultimately led to the correct diagnosis and provided a basis for both prognostic and reproductive counseling. So having a child with a birth defect or genetic disorder can shed light on the health of parents or older children.

So not only can we go in the direction of a parent who has high cholesterol and then we want to test the children early, we might find something in the children that would allow us to test the parents early. Parents or older children often have a genetic condition which has caused or could in the future cause health problems and the reasons have gone undiscovered until the initial diagnosis. An example of that is mothers of boys with Duchenne’s Muscular Dystrophy might find themselves to be at risk of having heart problems and so should talk with their physician about their own heart health.

[Dr. Yoon] Although people don’t usually think of diseases like heart disease and type 2 diabetes affecting children, those children with a strong family history of these conditions may begin developing these conditions in childhood, even though they appear perfectly healthy. Children with family histories of chronic diseases would really benefit from starting good lifestyle habits right away, such as exercising and eating a healthy diet. And if parents know their children are at increased risk, perhaps they might be motivated to help their child make these changes. Since conditions like heart disease and diabetes can affect the whole family, everyone in the family would benefit from better health habits. And doing these activities together could really help everyone stick with them—and maybe make them more fun, too!

[Curt Shannon] How can someone make sure they’re getting a complete family history for their child?

[Dr. Yoon] Well, one approach which works well, especially for common conditions like heart disease and diabetes, or even cancer, is to first write down the names of your child’s close relatives. These would include mother, father, brothers, sisters, grandparents, aunts, uncles, and even nieces and nephews. Remember to include relatives from both the mother’s and the father’s side of the family. Then, go through the list and write down any major conditions that each relative had and make a note when the relative was first diagnosed with that condition. There are also tools that can help you collect your family history, such as the Surgeon General’s “My Family Health Portrait.” This is a web-based tool can help you organize the information. It even draws a family tree with each relative and the conditions that they had. You can find this link, along with several other good family history tools, on the CDC website – www.cdc.gov.

[Dr. Trotter] Your child’s doctor may ask you to fill out a family history form for your child. Take the time to fill that form out carefully. It could be a paper form; it could be a computer desk in the doctor’s office; it could be a website. It really makes a difference in your child’s health for us to know this information. You should even consider collecting your family history information before your child’s appointment, for instance, by using the “My Family Health Portrait” that Dr. Yoon just spoke about. You might have to call relatives to find out more about their health conditions. For most common conditions, you need only to consider your child’s close relatives. However, for such genetic conditions such as cystic fibrosis and sickle cell disease, you might need to consider more distant relatives. Family members may be diagnosed with new conditions between health care visits. Be sure to update your family history periodically and please share this information with your child’s doctor. Also, take advantage of family gatherings to collect family history information. In fact, Thanksgiving is National Family History Day.

[Curt Shannon] Once it’s collected, what should families do with their family history information?

[Dr. Yoon] It’s very important to discuss your family health history with your child’s doctor. Your doc—your child’s doctor will review this family history information and try to identify any conditions where your child could be at increased risk because of the family history. The doctor should discuss these conditions with you and any relevant interventions or screening tests that might benefit your child or even other family members.

[Dr. Trotter] Well-child exams are also a very good time to discuss any family history concerns, or most importantly, new information you have, with your child’s doctor. Families considering having another child should take that as an opportunity to share this family information with the mother’s doctor as well.

[Curt Shannon] Is there a takeaway message you’d like to leave with our listeners?

[Dr. Trotter] Absolutely! Family members share their genes, their environment, lifestyles, and habits, and family history can reveal conditions for which your child is at risk. If you don’t have a family history for your child, please take the time to complete one, using the tools on the CDC website – www.cdc.gov.

[Dr. Yoon] And it’s important to remember that just because you or your family has a family history of a disease, it doesn’t mean that you will definitely get that disease. It’s not your destiny. It means that you’re at increased risk for the disease, but there are things that you can do to reduce your risk. Screening, early intervention, and lifestyle changes, particularly healthy eating, exercising, and maintaining a healthy weight might help prevent or even delay the onset of common chronic conditions. Knowing your family history really can help your child, and you, and the whole family.

[Curt Shannon] Thank you, Dr. Trotter and Dr. Yoon, for taking the time to discuss this important subject.

• cultural and family health history

Controlling Blood Sugar

More than 20 million people in the United States suffer from type 2 diabetes and tens of millions more are at risk. The BLOOD SUGAR & FEARS video offers simple steps that can prevent or delay type 2 diabetes, such as choosing healthier foods, increasing physical activity and losing 5 to 7 percent of body weight.

Blood Sugar & Fears Transcript

[Narrator] Diabetes is a serious chronic health threat in America. It affects tens of millions of people, and one of the biggest problems? Many people don’t know they have the disease. Some of the statistics are staggering. More than one in ten adults has the disease. Experts warn that the problem often gets worse with age.

[Ann Albright] When you’re at age 60 and beyond, the likelihood goes up to one in four.

[Edward Gregg] The risk of diabetes is higher among certain ethnic groups in the United States.

[Ann Albright] The other risk factors for developing Type 2 diabetes are being overweight or obese, having a family history of Type 2 diabetes.

[Edward Gregg] In addition, if you had diabetes while you were pregnant or if you have a history of high blood pressure, those are also risk factors for developing diabetes at a later point.

[Wayne Millington] I was, you know, relatively healthy, fit, doing the right things I thought, and never thought that I would be someone with prediabetes.

[Narrator] Milington works with diabetes prevention and control programs across the United States and understands the long-term consequences of the disease.

[Wayne Millington] I mean shocked is an understatement.

[Ann Albright] Prediabetes is a condition in which your blood sugar, blood glucose, is elevated but it’s not yet high enough to be considered diabetes.

[Wayne Millington] The notion that people have about sugar is that sugar causes diabetes but it’s not really that – it’s the body’s inability to break down sugar in the blood, and it’s not just from foods but from food and drink.

[Narrator] Many people who have the disease don’t know it. Diabetes can cause serious health problems, such as heart disease, stroke, amputations, and blindness.

[Ann Albright] The classic symptoms of diabetes are excessive thirst, frequent urinations, you may feel really significant hunger, people are also fatigued, they may get blurry vision.

[Edward Gregg] Sometimes people can develop diabetes without having any warning signs at all.

[Wayne Millington] I have a child and I have a wife and I wanted to make sure that I would do the things that was necessary for me to be around.

[Ann Albright] Healthy eating and physical activity keep your body weight in a healthy range.

[Edward Gregg] Just losing five to seven percent of their body weight seems to make a big difference in their risk of developing diabetes later on.

[Narrator] That weight loss and exercise combination is often enough to prevent prediabetes from progressing into full, Type 2 diabetes. It’s important to follow up with your doctor.

[Edward Gregg] Knowing your risk and then working with your doctor to develop a plan.

[Ann Albright] Your healthcare professional can help you determine whether or not you need to have a simple blood test to determine what your risk status is for diabetes.

[Narrator] Lifestyle programs can help you battle the disease through exercise and advice on making healthier food choices.

[Wayne Millington] Knowing when to eat, what to eat, and how to eat, portion controls, those were the things that really helped me, and it empowers you.

[Narrator] Some health studies have shown diabetes can shorten your life span by an average of 15 years.

[Wayne Millington] Having a support network is very important and understanding that this is not a disease that you can fight by yourself is also important.

[Narrator] Talk to you doctor, get screened if you are at risk, and learn how to avoid becoming one of the millions of new case of diabetes each year. Change the course. You can help prevent diabetes.

• what causes a diabetics blood sugar to drop

Obesity is a Frequent Chronic Disease

More than one third of U.S. adults are obese. Weight gain occurs when you consume more calories than your body uses. Reaching and maintaining a healthy weight will help you prevent and control many diseases and conditions. The key is FINDING A BALANCE in your lifestyle that includes healthy eating and regular physical activity.

Finding A Balance Transcript…

[Voice of Dr. William Dietz] Obesity may be the most frequent chronic disease that we have in front of us.

[Voice of Dr. Beth Tohill] It’s the lifestyle that we’ve come . . . that’s become prevalent.

[Voice of Dr. Janet Fulton] People all the time looking at screens, whether it’s the television or the computer or your PDA.

[Announcer] CDC-TV presents…Health Matters.

[Dr. William Dietz] Obesity may be the most frequent chronic disease that we have in front of us and it’s important because it’s a major contributor to other diseases like cancer, diabetes, and heart disease.

[Dr. Beth Tohill] It’s the lifestyle that we’ve come . . . that’s become prevalent. The lifestyle of eat quickly, maybe not stop and look to see what you’re eating. Grab something on the go.

[Dr. Janet Fulton] There’s technological advancements. People are all the time looking at screens, whether it’s the television or the computer or your PDA.
[Nealon Hightower] I know I used to eat probably three, four, five thousand calories a day. Didn’t even know I was eating it.

[Voice of Janet Fulton] We’re eating a lot of the wrong foods and too much of the wrong foods and we’re not moving as much as we should be.

[Voice of Dr. William Dietz] Weight is a result of caloric balance. If we eat more calories than we use, we gain weight. If we eat less calories than we use, we lose weight.

[Voice of Dr. Beth Tohill] We know that eating lots of fruits and vegetables is the healthy way to start.

[Voice of Dr. Joel Kimmons] Whole grains. Beans. Lean meats. Poultry. Nuts.

[Dr. Beth Tohill] Fat-free or low-fat dairy products. All these together will lead you to a healthier diet.

[Cherylann McGirt] Keeping fresh fruits and veggies available really has changed my life.

[Voice of Dr. Beth Tohill] Read the nutrition facts label. This will let you know how many calories are in your food.

[Dr. Joel Kimmons] Planning meals a couple of days in advance can save you both time, money, and leave you with a healthier menu overall.

[Voice of Dr. William Dietz] The best fluid is water. We don’t need the extra calories that come from sugar-sweetened beverages like soda or 10 percent juice.

[Voice of Dr. Beth Tohill] The prevalence of overweight and obesity has tripled in our children.

[Cherylann McGirt] I want to live to see her graduate and have children.

[Voice of Nealon Hightower] And if they see, you know, dad exercising and eating healthy, they have a much higher chance of going that route themselves.

[Voice of Dr. Janet Fulton] Well, physical activity is really good for prevention of weight gain. And it’s also good for weight loss if you adjust the calories that you eat, accordingly. The minimum level of physical activity to get health benefits is 150 minutes of at least moderate-intensity physical activity a week.

[Voice of Nealon Hightower] When I started I just added 15 minutes of walking three times a week.

[Voice of Dr. Janet Fulton] You can start low. You can go slow to try and achieve the 150. You don’t have to achieve it all in one day.

[Dr. Brooke Belay] In fact, as little as five to ten percent weight loss over time can really reduce the risk for heart disease and high cholesterol and high blood pressure and even diabetes, as well.

[Voice of Nealon Hightower] Just a renewed sense of energy just in my, my day-to-day life — ability to keep up with my kids.

[Eric Tumperi] We think it’s important to maintain a good balance. We start, think it starts inside the house. No junk food. No TV games, electronic games in the house. We play outside a lot. My wife and I participate when we can. We think it’s important to set a good example.

[Nealon Hightower] My mind is sharper. Every which way you can think of my life is better.

[Dr. Heidi Blank] Many American’s step on a scale daily or weekly to see how their weight is doing. But we also need to think about that balance in choosing foods and activity.

[Cherylann McGirt] And the only way you’re gonna want to do it is to feel good about yourself.

[Dr. William Dietz] Weight loss is a decision that only individuals can make and the types of decisions that we hope they make are ones which are permanent changes in lifestyle.

[Cherylann McGirt] I’m feeling the difference. I’m seeing the difference.

[Voice of Dr. William Dietz] We need to invest in changes in our communities, as well as changes in behaviors.

• beth tohill cdc
• Eric Tumperi

How to Practice Proper Hand Hygiene

Each year in the United States, patients get more than a million infections in the hospital while being treated for something else. The best way to help prevent infection is to practice proper hand hygiene. Hand Hygiene Saves Lives shows how patients can play an active role in reminding healthcare providers to practice hand hygiene in hospitals and other healthcare facilities.

Hand Hygiene Saves Lives Transcript

[Dr. Jernigan] Hello, I’m Dr. John Jernigan from the Centers for Disease Control and Prevention. Your doctor has chosen to admit you to this facility because you need high-quality medical care. The healthcare providers here want to do everything they can to help you get well and to avoid complications. You came to the hospital to get well, but you should know that, each year in the United States, patients get more than a million infections in the hospital while they’re being treated for something else. Examples of infections patients can get in the hospital include infections in their bloodstream, surgical wound, or urinary tract, as well as pneumonia. These infections can be serious and hard to treat, but there’s one simple thing you and your family can do to help prevent these infections — wash your hands and make sure that everyone who touches you, including your doctor, cleanses their hands, too. Patients and their loved ones who take an active role and become involved in their treatment may have better experiences in the hospital than those who don’t. In the following video, you’ll see how easy it is to be involved in your care and make sure everyone around you washes their hands.

[Gayle] Hi, I’m Gayle. Now that you’ve been admitted to the hospital, I’m here to tell you about the single most important thing you can do to help prevent infections. Everyone around you must practice proper hand hygiene. This means that people should wash their hands, either with soap and water, or use an alcohol-based hand sanitizer. You and your loved ones should wash your hands very often, especially after touching objects or surfaces in the hospital room, before eating, and after using the restroom. It is important that healthcare providers, including doctors and nurses, either wash their hands with soap and water or use an alcohol-based hand sanitizer every time, both before and after they touch you. Healthcare providers know to practice hand hygiene, but sometimes they forget. You and your loved ones can play a role in asking and reminding healthcare providers to wash their hands, especially while they’re caring for you. You shouldn’t feel embarrassed to ask everyone, including doctors and nurses, to wash their hands. They really want to do all they can to help prevent you from getting an infection. Let’s check in on some patients.

[Mom] Steven, I know that you washed your hands a little while ago, but would you mind washing them again?

[Son] Sure, Mom.

[Gayle] It’s important to remember that healthcare providers aren’t the only ones who need to practice hand hygiene. Patients and visitors should also wash their hands very often, especially after touching surfaces in the patient’s room, before eating, and after using the restroom.

[Gayle] Our patient’s son could have also used an alcohol-based hand sanitizer to cleanse his hands. Both of these practices can help prevent the spread of germs. Let’s take a look in another patient’s room.

[Doctor] Hello. How is the patient doing today?

[Wife of Patient] About the same, I think.

[Doctor] Well, I’m just going to examine him briefly.

[Wife of Patient] Doctor, I’m embarrassed to even ask you this, but would you mind cleansing your hands before you begin?

[Doctor] Oh, I washed them right before I came in the room.

[Wife of Patient] If you wouldn’t mind, I’d like you to do it again, in front of me.

[Doctor] Sure, no problem.

[Wife of Patient] Thanks, Doctor. I know how important hand hygiene is in preventing the spread of infections.

[Gayle] Your loved ones can play an important role in keeping you healthy by making sure that your healthcare providers wash their hands every single time they touch you. Doctors and nurses don’t mind being asked to wash their hands because they want to prevent infection as much as you do. I hope that you feel comfortable asking your healthcare providers to wash their hands.

[Dr. Jernigan] I hope that you’ll become involved in your medical care by reminding everyone, especially your healthcare providers, to wash their hands. Please remember — you can get an infection in the hospital while you’re being treated for something else. You can help prevent infections by asking your doctors, nurses, and visitors to wash their hands. Doctors and nurses encourage you to remind them to wash their hands. Thank you for your attention, and I wish you a speedy and uneventful recovery.

• Would you mind washing your hands doctor?

Eating Healthy As We Grow Older

In the below video Brenda Walsh, an outpatient clinical dietician discusses ways of eating healthy as we grow older.

Making sure to have 3 servings of a fortified dairy product daily and 2 servings of a fatty fish such as salmon every week will supply the required amount of calcium and vitamin D.

Although balanced supplements such as Boost and Ensure can be beneficial they should not be used as a meal replacement.

Brenda also discusses the importance of variety in your diet specifically in relation to vegetables. The more colors of vegetables you consume the more likely you are of getting the proper balance of vitamins and minerals you need.