UC Irvine

Knowledge of family health history (FHH) is a key component of genetic counseling practice. As practitioners, it is important to be aware of the factors that can affect a patient's knowledge of their FHH, which can impact the ability to provide accurate risk assessment. In addition, guidelines to determine who is eligible for genetic testing and recommendations for management often incorporate FHH information and applying these guidelines without understanding that some individuals may have limited FHH knowledge leading to inequities in care. This research project was designed to explore these factors by analyzing the relationships between reported knowledge of FHH, reported presence of anxiety and depression within a family, and social determinants of health (SDoH) related to support, relationships, perceived stress, and religion and spirituality. Using the All of Us Research Researcher's Workbench, data was collected from the SDoH, FHH, and Demographics surveys, with sample sizes of 117,023, 184,155, and 410,361 respectively. Analysis revealed significant differences in reported knowledge of FHH in various racial/ethnic backgrounds (p<0.00001) and gender identity (p<0.00001). In three SDoH categories analyzed (support, relationships, and perceived stress) higher average SDoH scores were seen for those who reported higher FHH knowledge (p<0.01). In addition, within all SDoH categories examined participants who reported personal anxiety or depression have lower average SDoH scores compared to those who reported no personal anxiety or depression (p<0.05). Participants who reported a personal history of HTN also had lower SDoH scores in the category of support compared to those who had no personal history (p<0.05), but interestingly had higher SDoH scores for perceived stress (reflecting less reported stress) and for religion and spirituality (p<0.05). The results of this study are valuable in gaining perspective about factors that may be associated with a patient’s knowledge of their FHH. Understanding that patients come to healthcare providers with various levels of FHH knowledge and how certain SDoH factors are associated with FHH knowledge has the potential to improve the ability to provide personalized care for all patients. In addition, it provides information about the importance of taking into account a patient’s FHH knowledge when determining a differential diagnosis, the type of carrier screening to order, or a patient’s eligibility for genetic testing.