Inaccuracy of family health information: implications for prevention

There is a conflict between the rest of the family's right to medical confidentiality and the individual's need to know about health risks for which she or he may show increased susceptibility. Research has shown increased risk in the development of a variety of disorders for those with a positive family history. In many cases the familial predisposition appears to interact with alterable environmental factors (e.g., diet). This suggests a need for targeting of preventive efforts at those at highest risk. As success of early detection and prevention programs increase, there will appear an increased need for accurate family health history information as an aid in early identification. Research on accuracy of family health information (Hastrup, Hotchkiss & Johnson, this issue) shows extensive inaccuracy. Implications of inaccurate information for self-directed and public health prevention are described. Research and progress in prevention will likely accelerate, continuing to alter the traditional view from one of the individual with a personal health history to one in which individuals share a familial (genetic + shared environment + similar behavior patterns) risk with others, who may also benefit from preventive programs.