Introduction
The generational relevance for determining disease risk for the leading causes of
morbidity and mortality for U.S. adults is a source of debate.
Methods
Data on 12,300 adults (Add Health Study Members) participating in Wave V (2016–2018)
of the National Longitudinal Study of Adolescent to Adult Health (also known as Add
Health) were merged with data from respondents’ parents (n=2,013) participating in the Add Health Parent Study (2015–2017). Analyses beginning
in January 2020 examined the concordance in lifetime occurrence of chronic conditions
across 4 generations, including cardiovascular disease, diabetes, hypertension, hyperlipidemia,
obesity, cancer, and depression and examined the associations between individual disease
history and ones’ family health history for the same condition.
Results
Mean ages were 37.4 years for Add Health Study Members and 62.9 years for Add Health
Parent Study mothers. The histories of mothers from the Add Health Parent Study on
hyperlipidemia (AOR=1.61, 95% CI=1.04, 2.48), obesity (AOR=1.77, 95% CI=1.27, 2.48),
and depression (AOR=1.87, 95% CI=1.19, 2.95) were significantly associated with increased
odds of Add Health Study Member report of these conditions. Maternal great grandparent
hyperlipidemia history was significantly associated with the Add Health Study Member
hyperlipidemia (AOR=2.81, 95% CI=1.51, 5.21). Histories of diabetes in maternal grandfather
(AOR=2.41, 95% CI=1.24, 4.69) and maternal great grandparent (AOR=3.05, 95% CI=1.45,
6.43) were significantly associated with Add Health Study Member diabetes. Each additional
point in the Add Health Parent Study mothers’ cardiometabolic risk factor index was
associated with an 11% increase (incidence rate ratio=1.11, 95% CI=1.04, 1.19) in
the expected count of cardiometabolic risk conditions for the Add Health Study Members.
Conclusions
Multigenerational health histories have value for quantifying the probability of diabetes,
obesity, depression, and hyperlipidemia in early mid-adulthood. Family health history
knowledge is relevant for health promotion and disease prevention strategies.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to American Journal of Preventive MedicineAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
REFERENCES
- American Cancer Society guidelines for the early detection of cancer.American Cancer Society, 2020 (https://www.cancer.org/healthy/find-cancer-early/cancer-screening-guidelines/american-cancer-society-guidelines-for-the-early-detection-of-cancer.html. Updated July 30. Accessed January 10, 2021)
- Screening for diabetes.Diabetes Care. 2002; 25: S21-S24https://doi.org/10.2337/diacare.25.2007.S21
- Third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) final report.Circulation. 2002; 106: 3143-3421https://doi.org/10.1161/circ.106.25.3143
A and B recommendations. U.S. Preventive Services Task Force.https://www.uspreventiveservicestaskforce.org/Page/Name/uspstf-a-and-b-recommendations/. Accessed January 10, 2021.
- Perceived familiarity with and importance of family health history among a medically underserved population.J Community Genet. 2012; 3: 285-295https://doi.org/10.1007/s12687-012-0097-x
- National Institutes of Health State-of-the-Science Conference Statement: family history and improving health.Ann Intern Med. 2009; 151: 872-877https://doi.org/10.7326/0003-4819-151-12-200912150-00165
- What you don't know: improving family health history knowledge among multigenerational families of Mexican origin.Public Health Genomics. 2016; 19: 93-101https://doi.org/10.1159/000443473
- Awareness of family health history as a risk factor for disease - United States, 2004.MMWR Morb Mortal Wkly Rep. 2004; 53: 1044-1047
- Awareness of family health history in a predominantly young adult population.PLoS One. 2019; 14e0224283https://doi.org/10.1371/journal.pone.0224283
- Community-based family health history education: the role of state health agencies in engaging medically underserved populations in understanding genomics and risk of chronic disease.Healthcare (Basel). 2015; 3: 995-1017https://doi.org/10.3390/healthcare3040995
Centers for Disease Control and Prevention. Family history is important for your health. Atlanta, GA: Centers for Disease Control and Prevention.https://www.cdc.gov/genomics/public/file/print/FamHistFactSheet.pdf. Accessed January 10, 2021.
Knowing is not enough—act on your family health history. Centers for Disease Control and Prevention.https://www.cdc.gov/genomics/famhistory/knowing_not_enough.htm. Updated November 9, 2020. Accessed January 10, 2021.
- Family history and prevalence of diabetes in the U.S. population: the 6-year results from the National Health and Nutrition Examination Survey (1999-2004).Diabetes Care. 2007; 30: 2517-2522https://doi.org/10.2337/dc07-0720
- Family history of cancer and the risk of cancer: a network of case-control studies.Ann Oncol. 2013; 24: 2651-2656https://doi.org/10.1093/annonc/mdt280
- Family-centered approaches to understanding and preventing coronary heart disease.Am J Prev Med. 2003; 24: 143-151https://doi.org/10.1016/s0749-3797(02)00587-1
- A 30-year study of 3 generations at high risk and low risk for depression.JAMA Psychiatry. 2016; 73: 970-977https://doi.org/10.1001/jamapsychiatry.2016.1586
- Parental history is an independent risk factor for coronary artery disease: the Framingham Study.Am Heart J. 1990; 120: 963-969https://doi.org/10.1016/0002-8703(90)90216-k
- Maternal and paternal history of myocardial infarction and risk of cardiovascular disease in men and women.Circulation. 2001; 104: 393-398https://doi.org/10.1161/hc2901.093115
- Parental cardiovascular disease as a risk factor for cardiovascular disease in middle-aged adults: a prospective study of parents and offspring.JAMA. 2004; 291: 2204-2211https://doi.org/10.1001/jama.291.18.2204
- Tracking of cardiovascular risk factors across generations: family linkage within the population-based HUNT Study, Norway.J Epidemiol Community Health. 2013; 67: 564-570https://doi.org/10.1136/jech-2012-201634
- Hypertension in pregnancy and offspring cardiovascular risk in young adulthood: prospective and sibling studies in the HUNT Study (Nord-Trøndelag Health Study) in Norway.Hypertension. 2017; 69: 591-598https://doi.org/10.1161/HYPERTENSIONAHA.116.08414
Risk functions: FHS primary risk functions. Framingham Heart Study.https://framinghamheartstudy.org/fhs-risk-functions/. Accessed January 10, 2021.
- 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines [published correction appears in Circulation. 2014;129(25)(suppl 2):S74–S75].Circulation. 2014; 129 (suppl 2): S49-S73https://doi.org/10.1161/01.cir.0000437741.48606.98
ASCVD risk estimator plus. American College of Cardiology. http://tools.acc.org/ASCVD-Risk-Estimator-Plus/#!/calculate/estimate/. Accessed January 10, 2021.
- ASCVD risk calculator: pooled cohort risk predicts 10-year risk for a first atherosclerotic cardiovascular disease (ASCVD) event. ClinCalc.2020 (Updated August 6,Accessed January 10, 2021)
- Prediction of coronary heart disease using risk factor categories.Circulation. 1998; 97: 1837-1847https://doi.org/10.1161/01.cir.97.18.1837
- General cardiovascular risk profile for use in primary care: the Framingham Heart Study.Circulation. 2008; 117: 743-753https://doi.org/10.1161/CIRCULATIONAHA.107.699579
- Family history of premature coronary heart disease and risk prediction in the EPIC-Norfolk prospective population study.Heart. 2010; 96: 1985-1989https://doi.org/10.1136/hrt.2010.210740
- Basic vs more complex definitions of family history in the prediction of coronary heart disease: the multi-ethnic study of atherosclerosis.Mayo Clin Proc. 2018; 93: 1213-1223https://doi.org/10.1016/j.mayocp.2018.01.014
- Families of patients with premature coronary heart disease: an obvious but neglected target for primary prevention.BMJ. 2007; 335: 481-485https://doi.org/10.1136/bmj.39253.577859.BE
- Family history and premature coronary heart disease.J Am Board Fam Pract. 1996; 9: 312-318
- A comparison of positive family history definitions for defining risk of future disease [published correction appears in J Chronic Dis. 1987;40(4):369].J Chronic Dis. 1986; 39: 809-821https://doi.org/10.1016/0021-9681(86)90083-4
- Family history of premature coronary heart disease and coronary artery calcification: Multi-Ethnic Study of Atherosclerosis (MESA).Circulation. 2007; 116: 619-626https://doi.org/10.1161/CIRCULATIONAHA.107.688739
- Risk associated with various definitions of family history of coronary heart disease. The Newcastle Family History Study II.Am J Epidemiol. 1998; 147: 1133-1139https://doi.org/10.1093/oxfordjournals.aje.a009411
- Parental history and myocardial infarction risk across the world: the INTERHEART Study.J Am Coll Cardiol. 2011; 57: 619-627https://doi.org/10.1016/j.jacc.2010.07.054
- Breast cancer screening update.Am Fam Physician. 2013; 87 (https://www.aafp.org/afp/2013/0215/p274.html. Accessed January 10, 2021): 274-278
Breast cancer risk assessment tool. National Cancer Institute. https://bcrisktool.cancer.gov/calculator.html. Accessed January 10, 2021.
- Gastric cancer and family history.Korean J Intern Med. 2016; 31: 1042-1053https://doi.org/10.3904/kjim.2016.147
- Colorectal cancer screening and surveillance in individuals at increased risk.Am Fam Physician. 2018; 97: 111-116
- Familial risk for lung cancer.Oncol Lett. 2017; 13: 535-542https://doi.org/10.3892/ol.2016.5518
- Risk for hypertension crosses generations in the community: a multi-generational cohort study.Eur Heart J. 2017; 38: 2300-2308https://doi.org/10.1093/eurheartj/ehx134
- Family history of premature death and risk of early onset cardiovascular disease.J Am Coll Cardiol. 2012; 60: 814-821https://doi.org/10.1016/j.jacc.2012.06.018
- A detailed family history of myocardial infarction and risk of myocardial infarction—a nationwide cohort study.PLoS One. 2015; 10e0125896https://doi.org/10.1371/journal.pone.0125896
- Expanding the definition of a positive family history for early-onset coronary heart disease.Genet Med. 2006; 8: 491-501https://doi.org/10.1097/01.gim.0000232582.91028.03
- Deaths: leading causes for 2017.Natl Vital Stat Rep. 2019; 68 (https://www.cdc.gov/nchs/data/nvsr/nvsr68/nvsr68_06-508.pdf. Accessed January 10, 2021): 1-77
- CDC National Health Report: leading causes of morbidity and mortality and associated behavioral risk and protective factors–United States, 2005-2013.MMWR Morb Mortal Wkly Rep. 2014; 63 (https://www.cdc.gov/mmwr/preview/mmwrhtml/su6304a2.htm. Accessed January 10, 2021): 3-27
Social, behavioral, and biological linkages across the life course. Add Health, The National Longitudinal Study of Adolescent to Adult Health. https://addhealth.cpc.unc.edu/. Accessed January 10, 2021.
- Cohort profile: the National Longitudinal Study of Adolescent to Adult Health (Add Health).Int J Epidemiol. 2019; 48 (1415–1415)https://doi.org/10.1093/ije/dyz115
- Association of cardiovascular risk factors between Hispanic/Latino parents and youth: the Hispanic Community Health Study/Study of Latino Youth.Ann Epidemiol. 2017; 27: 260-268https://doi.org/10.1016/j.annepidem.2017.03.001
- Mortality among the elderly in the Alameda County Study: behavioral and demographic risk factors [published correction appears in Am J Public Health. 1987;77(7):818].Am J Public Health. 1987; 77: 307-312https://doi.org/10.2105/ajph.77.3.307
Populations and vulnerabilities. Centers for Disease Control and Prevention. https://ephtracking.cdc.gov/showPcMain.action. Updated October 21, 2020. Accessed January 10, 2021.
- Determinants of adolescent physical activity and inactivity patterns.Pediatrics. 2000; 105: E83https://doi.org/10.1542/peds.105.6.e83
- Childhood weight affects adult morbidity and mortality.J Nutr. 1998; 128 (suppl): 411S-414Shttps://doi.org/10.1093/jn/128.2.411S
- Childhood obesity and adult morbidities.Am J Clin Nutr. 2010; 91: 1499S-1505Shttps://doi.org/10.3945/ajcn.2010.28701B
- Guidelines for analyzing Add Health data.Add Health, The National Longitudinal Study of Adolescent to Adult Health, Chapel Hill, NC2020 (https://addhealth.cpc.unc.edu/wp-content/uploads/docs/user_guides/GuidelinesforAnalysisofAddHealthData_202004.pdf. Published. Accessed January 10, 2021)
- Effect of adding systematic family history enquiry to cardiovascular disease risk assessment in primary care: a matched-pair, cluster randomized trial.Ann Intern Med. 2012; 156: 253-262https://doi.org/10.7326/0003-4819-156-4-201202210-00002
- Prediction of incident diabetes mellitus in middle-aged adults: the Framingham Offspring Study.Arch Intern Med. 2007; 167: 1068-1074https://doi.org/10.1001/archinte.167.10.1068
- Multiple Chronic conditions in the United States.RAND Corporation, Santa Monica, CA2017https://doi.org/10.7249/tl221 (Published)
Article info
Publication history
Published online: July 03, 2021
Identification
Copyright
© 2021 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
