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The Medical Minute: How to discuss family health history with children

Parents spend hours planning to talk with their children about the “birds and bees.” But moms and dads often ignore an equally important conversation—discussing their family’s overall health history.

That’s why, in 2004, the U.S. Surgeon General declared Thanksgiving Day as National Family History Day.

“The more parents know and share about their family’s health history, the better they can help their children prevent health problems later in life,” said Dr. Mack Ruffin, chair of the Department of Family and Community Medicine at Penn State Health.

Many health conditions carry a genetic link that will be seen in your family. These include diabetes, hypertension, heart disease and cancers of the breast, colon, pancreas and prostate. So too do many behavioral health conditions. People in certain ethnic groups also may be at higher risk for certain conditions.

When starting the family health history discussion, parents should make the conversation age appropriate. “For younger children, talk about it in general terms, the way a 9 or 10-year-old might understand it,” Ruffin said.

Get more detailed when talking to teenagers. If a history of addiction runs in the family, begin conversations about avoiding alcohol, tobacco and recreational drugs in the early teen years. “All children should know their full family health history by the time they start making their own health care decisions,” Ruffin said.

Some tips to help parents shape the conversation:

Gather pertinent information. Write down the names of blood relatives—parents, siblings, grandparents, aunts, uncles, nieces and nephews. Talk to them about the health conditions they have or had, and when they were first diagnosed. What about stepparents? “While they can help lead the conversation, a stepparent’s family history will not affect their stepchild’s health because they aren’t blood relatives,” Ruffin said.

Get details. Knowing that “Grandpa died of cancer” won’t give a physician enough facts to help children potentially avoid cancer in the future. So, give children as much information as possible. “Knowing that Grandma had breast cancer before age 50, Uncle Dave had colon cancer in his 70s or that all men in the family had prostate cancer by age 60 gives us useful clues,” Ruffin said.

Discuss lifestyle factors. Just because a health condition runs in the family doesn’t mean it’s genetic. “If grandma and great-grandma died of lung cancer but both smoked two packs of cigarettes a day, children might reduce or eliminate their risk by simply not smoking,” Ruffin said.

Review family photo albums. Notes scribbled in the margins may provide information about a blood relative’s health. Also check the family bible.

Write it down. Keep a record of the discussion in a familiar location so children can access it at any time. Write it, type it, or use a free online tool like the Surgeon General’s My Family Health Portrait.

Provide action steps. For younger children, having an awareness of family health history is enough. For younger teens or older children, ask them to talk with their health care providers about their family history and steps they can take to prevent disease.

Rinse and repeat. Discussing family health history annually keeps it top of mind for everyone.

While some people give the gift of DNA genetic test kits for the holidays, the family health history discussion should come first. “That way a doctor can help properly interpret any genetic testing results,” Ruffin said. Ruffin does recommend adults with no biological family information consider DNA genetic testing.

The Medical Minute is a weekly health news feature produced by Penn State Health. Articles feature the expertise of faculty, physicians and staff, and are designed to offer timely, relevant health information of interest to a broad audience.

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