Ask your blood relatives, across three generations, about major conditions, the age each was diagnosed, and the cause and age of death for relatives who have died. Also note ancestry and any genetic test results. Ask one-on-one, accept "I don't know," write it down the same day, and bring it to your doctor.
A family health history works alongside genetic testing. It doesn't replace it, and a negative consumer test doesn't cancel a strong family pattern.
Why holidays are a good time to ask
Most of a family health history lives in other people's memories, not in any one medical chart. Holiday gatherings are one of the few times several generations sit in the same room, and older relatives often remember things nobody wrote down: which great-uncle "had sugar," which grandparent died young of "heart trouble," which aunt had surgery in her thirties and never talked about why.
The idea has an official history. In November 2004 the U.S. Surgeon General and the Department of Health and Human Services launched a family health history campaign timed to Thanksgiving, because that is when families traditionally gather, and public health agencies have used the holiday as Family Health History Day in the years since. Any gathering works just as well. What matters is that the people you need are in one place.
Whose history you need
A complete family health history covers three generations. The CDC lists the core relatives as:
- Parents and siblings, including half-siblings (note which parent you share)
- Your children
- Grandparents
- Aunts and uncles
- Nieces and nephews
Cousins add useful detail too. What counts for genetics is blood relationship. Spouses, in-laws and step-relatives don't share your DNA, but they are often the best memory-keepers in the family, so ask them what they remember about your blood relatives.
What to ask about each relative
You don't need a medical vocabulary. You need a few specific facts for each person, written down as precisely as anyone can remember them.
| Ask about | Why it matters |
|---|---|
| Major conditions: heart disease, stroke, cancer, diabetes, high cholesterol, kidney disease, dementia, mental health conditions, birth differences | Patterns across relatives are what clinicians look for. For cancer, ask which organ it started in, if anyone knows. "Cancer" alone tells a doctor very little. |
| Age at diagnosis | Often the most useful number. The National Cancer Institute lists cancer at a young age, and cancer in several relatives, among the signs that suggest an inherited cancer syndrome. |
| Cause and age of death | A heart attack at 48 means something different from one at 88. The CDC notes that heart disease in family members at age 50 or younger can be a sign of familial hypercholesterolemia. |
| Ethnic background and ancestry | Some variants are more common in particular groups. For example, the National Cancer Institute notes that an FDA-authorized consumer BRCA test looks only at three variants that are common in people of Ashkenazi Jewish descent. |
| Any genetic testing and its result | If a relative already has a confirmed variant, that changes everything for the rest of the family. Ask for the exact gene and variant name, ideally from the report itself. |
| Lifestyle context: smoking, heavy drinking, major exposures | Families share environments and habits as well as genes, so this helps a clinician weigh what a pattern means. |
Uncertain answers are still worth recording. "Grandpa had some kind of stomach cancer in his sixties" is far more useful to a doctor than a blank line.
If heart disease runs young in your family, our guide to genetic testing for familial hypercholesterolemia explains what that pattern can point to.
How to ask without making it awkward
Health is personal, and some families never talk about it. A few habits make the conversation easier.
- Lead with the reason. "My doctor asked about our family history and I realized I don't know much" is honest and low-pressure. So is "I want to write this down so the kids have it."
- Go one-on-one. Don't announce it across the dinner table. Ask while washing dishes, on a walk, or when an older relative is already telling stories.
- Start with stories, not a checklist. "What was Grandma like when you were growing up?" often leads naturally to "she was sick a lot after she turned 60."
- Accept "I don't know" and "I'd rather not." Both are fine answers. You can ask someone else later.
- Be gentle with heavy topics. Mental illness, addiction, pregnancy loss and suicide may come up. Listen more than you ask, and don't push.
- Don't diagnose at the table. If a pattern worries you, save it for a clinician. Telling a cousin "that sounds genetic" can frighten people over something that may not be.
Sometimes these conversations surface something unexpected, like an adoption or a different biological parent. Be kind. It is that relative's story first, and you can decide later, with care, what to write down.
How to record it
Write things down the same day, while the details are fresh. Mark how sure you are, for example "per Aunt Rosa, not confirmed." Where you can, check death certificates or family medical records, which the CDC suggests as a way to fill gaps.
My Family Health Portrait
The free tool from the Surgeon General's Family History Initiative is still available. My Family Health Portrait was created by the National Human Genome Research Institute and is now managed by the National Cancer Institute and hosted on GitHub Pages. You enter your relatives and their conditions, and it produces a family tree drawing and a health history chart you can print or share with relatives and your doctor. The tool says your information is not transmitted to government or other servers. You save your own file and reopen it later to update it.
Old links may be broken. From 2018 the tool was hosted on a CDC knowledge base site, and that site went offline in April 2026. If an older article sends you to a CDC address that no longer loads, use the GitHub Pages address above, which the CDC's own family health history page links to as of October 2026.
A plain spreadsheet or notebook
Paper works fine. Use one row per relative with columns for name, relationship, side of the family, conditions, age at diagnosis, age and cause of death, ancestry, any genetic test results, and how confident you are. Keep it somewhere you'll find it next year, because the CDC recommends updating it over time.
How it fits with genetic testing
A family health history and a genetic test answer different questions, and each covers gaps in the other.
- Family history sees what DNA can't. It captures shared habits and environments, and conditions that don't trace back to any single gene. It's also free.
- Genetic testing sees what family history can't. A variant can pass quietly through relatives who never developed the condition, so a family tree may show nothing.
- A negative consumer result doesn't cancel a strong family history. The National Cancer Institute calls a negative result in someone whose family variant has never been identified an "uninformative negative." It also notes that the consumer BRCA approach misses about 80% of cancer-causing BRCA variants.
If your history shows a strong pattern, the clinical route usually starts with testing the relative who actually had the condition, if they are willing and able. We explain why in which relatives should take a DNA test first. Consumer tests and clinical tests are also built for different jobs. See DTC vs clinical-grade genetic testing for the differences.
Some people still want their own complete genome on file for reference and later reanalysis. That doesn't replace clinical testing ordered by a clinician, but it can sit alongside it.
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Respect your relatives' privacy
When an aunt tells you about her diagnosis, that information is still hers. A few ground rules keep trust intact:
- Ask before sharing anyone's details beyond your own clinician, especially in family group chats.
- Keep health details out of public online family trees.
- Store your file privately. Share it with relatives only if the people in it are comfortable with that.
- If you later learn something with real implications for others, such as a confirmed variant, plan that conversation with care. Our guide to telling relatives about a genetic finding walks through it.
The same principle applies in the other direction. Your own DNA test reveals information about your blood relatives whether or not they agreed to it. We cover that in how one relative's test affects the family.
What to do with what you learn
Take the history to your next appointment. The CDC advises sharing it even if it's incomplete, because it can help your clinician decide which screenings you need and when to start them. One example the CDC gives is that a mother or sister with breast cancer before age 50 may lead to a referral for genetic counseling.
If you see a pattern, such as the same cancer in several relatives, early heart disease, or a known family variant, a genetic counselor can help you sort out what it means and whether testing makes sense. See do you need a genetic counselor. Don't change any medication or screening plan on your own because of what you hear at a holiday table.
Bottom line
Pick one or two older relatives this holiday season and ask about conditions, ages at diagnosis, and causes and ages of death on both sides of the family. Write it down that night, save it in a tool like My Family Health Portrait or a simple spreadsheet, and bring it to your doctor. That alone gives you more to work with than most people have, and a genetic test, if you take one, will mean more alongside it.
Common questions
How many generations should a family health history cover?
Aim for three generations: your parents, siblings and children, then grandparents, aunts, uncles, nieces and nephews. Cousins and great-grandparents are a bonus if anyone remembers.
Is My Family Health Portrait still available?
Yes. As of October 2026 it is free at its NCI-managed GitHub Pages address, and the tool says your entries aren't sent to government or other servers. Its former CDC address went offline in April 2026.
What if I'm adopted or don't know one side of my family?
Record what you do know and tell your clinician which parts are unknown. A gap in the history is useful information on its own when a clinician decides on screening.
Can a DNA test replace a family health history?
No. A DNA test can find variants your family tree doesn't show, but it misses shared environments and many conditions with no single genetic cause. Clinicians use both.
Do I need medical records before I talk to my doctor?
No. Records and death certificates help fill gaps, but the CDC encourages sharing your history even when it's incomplete.
Sources and verification
Checked October 25, 2026: CDC and NHGRI family health history guidance, the live My Family Health Portrait tool and the offline notice on its former CDC host, and NCI's genetic testing fact sheet. We confirmed the Surgeon General's Thanksgiving campaign began in 2004. We could not confirm a federal Family Health History Day campaign for 2026, so we describe it only historically.
- CDC: About Family Health History
- NHGRI: Family Health History for Patients and Families
- My Family Health Portrait (NCI-managed)
- MedlinePlus Genetics: Why is it important to know my family health history?
- National Cancer Institute: Genetic Testing for Inherited Cancer Risk
- CDC: Family Health History and Heart Disease
Medical disclaimer. GenomeTesting.org publishes educational content about genetics and consumer genomic testing. Nothing here is medical advice, a diagnosis, or a substitute for care from a qualified clinician or genetic counsellor. Decisions about testing, treatment, or interpreting your own results should be made with a healthcare professional who can see your full history.
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