family health history essay examples

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• Why is it important to know my family health history?

A family health history is a record of health information about a person and his or her close relatives. A complete record includes information from three generations of relatives, including children, brothers and sisters, parents, aunts and uncles, nieces and nephews, grandparents, and cousins.

Families have similar genetic backgrounds, and often similar environments and lifestyles. Together, these factors can give clues to conditions that may run in a family . By noticing patterns of disorders among relatives, healthcare professionals can determine whether an individual, family members, or future generations may be at an increased risk of developing a particular condition.

A family health history can identify people with a higher-than-usual chance of having common disorders, such as heart disease, high blood pressure , stroke, certain cancers, and type 2 diabetes. These complex disorders are influenced by a combination of genetic factors, environmental conditions, and lifestyle choices. A family history also can provide information about the risk of rarer conditions caused by variants (mutations) in a single gene, such as cystic fibrosis and sickle cell disease .

While a family health history provides information about the risk of specific health concerns, having relatives with a condition does not mean that an individual will definitely develop that condition. On the other hand, a person with no family history of a disorder may still be at risk of developing the disorder.

Knowing one’s family health history allows a person to take steps to reduce his or her risk. For people at an increased risk of certain cancers, healthcare professionals may recommend more frequent screening (such as mammography or colonoscopy) starting at an earlier age. Healthcare providers may also encourage regular checkups or testing for people with a condition that runs in their family. Additionally, lifestyle changes such as adopting a healthier diet, getting regular exercise, and quitting smoking help many people lower their chances of developing heart disease and other common illnesses.

The easiest way to get information about family health history is to talk to relatives about their health. Have they had any health problems, and when did they occur? A family gathering could be a good time to discuss these issues. Additionally, obtaining medical records and other documents (such as obituaries and death certificates) can help complete a family health history. It is important to keep this information up-to-date and to share it with a healthcare professional regularly.

Topics in the Inheriting Genetic Conditions chapter

• What does it mean if a disorder seems to run in my family?
• What are the different ways a genetic condition can be inherited?
• If a genetic disorder runs in my family, what are the chances that my children will have the condition?
• What are reduced penetrance and variable expressivity?
• What do geneticists mean by anticipation?
• What are genomic imprinting and uniparental disomy?
• Are chromosomal disorders inherited?
• Why are some genetic conditions more common in particular ethnic groups?
• What is heritability?

Other chapters in Help Me Understand Genetics

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Family health history

From the worksheet provided a lot of information is readily available regarding various conditions that are genetic that could cause death to a linear group of family members. In this case, however, I identify that my Maternal Great-Grandmother died of natural causes at age 97.  Therefore, such information shows that in my family line most of the hereditary diseases such as asthma among others are not available since they have not been transferred to my maternal grandmother nor my mother. On the other hand, my paternal grandfather died of natural causes at 96. In this case, therefore, it is apparent that my great-grandfathers died of natural deaths that would not raise any alarm on their next generation (Kaur, 2014). As such, my grandparents have led a healthy life tile late life ages. They would succumb to death on natural causes especially that they were old and fragile not only to foreign diseases but also any other foreign material that would harm their physical or spiritual beings.

Given that I am from humble backgrounds it means that my grandparents had to work all their lives past the retirement years more so because even at these odd ages they were not assured of their livelihoods. Further, they were not well educated which meant that they had to work the small jobs in the society to meet their needs. As such, they never had the time to complain nor visit hospitals for health checkups. Therefore, they worked and hoped that they were never sick of any ailment that was either temporary or genetic.   As such, it was notable that my parents have both grown in health without any diseases apart from the normal ones. Nonetheless, given that my grandparents had everything within their disposal, it meant that my father grew up feeding and living as he whatsoever wanted. As such he turned out obese and a tobacco addict.

As such the conditions of the old man are highly transferable to me and my kids as these traits might have never appeared as all my fore parents were actively involved in hard jobs that burnt all the fats and sugars that lead to diabetes and heart diseases (Maradiegue, 2013). As a result, it remains imperative to watch the diet I practice because unbalanced diet could result in obesity, diabetes, and eventual heart disease. I believe substituting proteins and fats that are usually from junk, and fast foods would become a huge step towards fighting obesity and diabetes. Additionally, observing a diet of vegetables, fibers and fruits would be beneficial to maintaining a healthy body that would fight any other foreign diseases. Further, it is essential to factor in physical exercises frequently. In so doing, the body is in a position to burn out excessive fats that normally accumulate in the body. These fats lead to veins vasoconstriction; a condition that highly contributes to hypertension and eventual stroke (Kaur, 2014). Nonetheless, I have established that my family lineage is a healthy one that requires minimal attention of watching diet and observing physical exercise to avoid development of fatal conditions like diabetes and hypertension.

• Kaur, J. (2014). Family history: a vital predictor of cardiovascular health.  International Journal Of Health ,  2 (1), 287.
• Maradiegue, A. (2013). Central American mothers report family history of depression and alcohol abuse as a predictor of teenage health risk behaviors.  Journal Of The American Academy Of Nurse Practitioners ,  22 (10), 540-547.
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Family Health History. Nursing Practice Essay

Spirituality in nursing, success plan, reference list.

Family health history is very important as it provides information that can be used for health risk assessment. Providing information about one’s racial background helps the doctors assess the potential diseases and health conditions associated with the region of origin and adaptability patterns associated with the racial origin. Family health history also enable us access health care whenever we need it and therefore better manage our health care. Family health history improves efficiency in the diagnosis process and hence influences the health care that we receive. However, the question is the significance of the number of uncles and aunties in acquiring health care.

A few members of my family have been diagnosed with Coronary Artery Disease. One of my uncles occasionally experiences heart failure and has always been hospitalized to seek treatment so as to normalize his heartbeat. Coronary artery disease is also known to cause a condition known as angina which occurs when an area in the heart does not receive enough oxygen-rich blood flow due blockage of the heart muscles leading to pain in the chest, shoulders, back, arms, jaw as well as the neck (Baan, 2011). I was diagnosed with angina while I was 10 years old and although I have received treatment, it has never completely gone away. Similar conditions are also experienced by my father.

According to Thomas, (1993), human beings are biological, psychological and also spiritual, therefore nursing care should also include spiritual care. The spiritual domain of patients is very important since some patients are always more concerned with their spiritual being than their physical nature. Therefore holistic assessment that includes assessment of spirituality helps create and maintain a bond with the patient and hence reduce distress in the patient. Effective assessment of a patient’s spirituality involves asking him or her about his or her concept of deity as well as his or her source of hope as well as strength. It will also involve asking the patient about his or her perception towards the significance of religious as well as ritual practices. Finally, it is also important to understand the patient’s belief on the relationship between his or her illness and his or her spiritual belief.

Some patients experience anxiety as well as guilt when they are about to die as they back-flash on their unfulfilled expectations, therefore to effectively help the patient overcome this, it is important to help the patient understand that the unfulfilled expectations are meaningless. This would help the patient accept him or herself regardless of his or her past thereby relieving his or her spiritual pain. For a nurse to gain more knowledge in spirituality, he or she must first be comfortable with matters of spirituality and must also develop his or her communication skills; and finally, should also be able to show empathy (Conrad, 1985).

In these particular areas where I have not been able to become competent, I have to gain the necessary skills through practical orientation programs and consistent training in the skills and procedures. This would enable me acquire evidence-based skills in nursing. I also plan to gain the skills by consulting the current evidence-based literature which includes nursing and health care journals, books as well as monographs (D’Amico, & Barbarito, 2007).

Baan, J. (2011). Coronary artery disease , 22(1). Web.

Conrad, N.L. (1985). Spiritual support for the dying . Nursing Clinics of North America, 20 (2): 415-427. New York: Oxford University Press.

D’Amico, D., & Barbarito, C. (2007). Health and physical assessment in nursing . Upper Saddle River, New Jersey: Pearson Education.

Thomas, P. (1993). Spiritual care outline, gerontology and palliative care . Melbourne, NSW: School of Nursing and Human Movement, Australian Catholic University.

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Knowing and recording your family health history

• Genetic Testing

By Mayo Clinic Health System staff

People are spending more time at home due to the COVID-19 pandemic and taking the opportunity to virtually connect with family members. In addition to learning a new recipe they have tried or the movies they have watched, you may want to virtually discuss your family health history.

Benefits of family health history

Many health conditions have a genetic link. Outlining your family health history can help you and your health care providers understand if you have an increased risk for developing certain conditions that are present in your family. If you are at risk, you may be able to take preventive measures to decrease your risk or undergo genetic testing to clarify your risk.

Genes versus environment

Your genes play a role in nearly all areas of your health. A gene is like an instruction manual for your body that tells your body how to function, develop and stay healthy. You have around 20,000 genes in your body. Some health conditions are almost completely determined by your genes, meaning having a specific harmful gene change ― called a mutation or pathogenic variant, like a spelling error within the instruction manual ― will cause you to develop a genetic condition. These genetic conditions are not something you would have caught or developed purely because of your environment.

However, your genes usually don't determine anything with complete certainty. Your family health history and genes do not make up your fate, and your environment still plays a role. Your environment may include factors you can't change, like your biological sex and age, as well as factors you can control, such as diet, physical activity level, and exposures to cigarette smoke and other chemicals. Multifactorial inheritance is when your genetic makeup and environment play a role in determining your risk for particular conditions. Many common conditions, such as autoimmune diseases, cancer and mental health conditions, like anxiety and depression, are considered multifactorial.

It may help to think of it with a metaphor. Imagine you are born with a cup for a particular health condition, like a cancer cup. If your cup overflows, you develop cancer. Some people are born with an empty cup, meaning those people have a genetically low risk for cancer. However, risk factors get added to your cup over time, such as age, and exposures to chemicals or radiation. Eventually, your cup may overflow, and you may develop cancer. Conversely, some people are born with a fairly full cup, meaning they are at risk from birth due to genetic risk factors they inherited. Yet, if they minimize the amount of risk factors being added to their cups over their lifetime, they may never develop cancer.

While you can't change your genes, you can control some aspects of your environment, such as diet, physical activity level and tobacco use. You have some control over how much goes into your various health cups over time. That's why it's still so important to live a healthy life, regardless of your personal and family health history.

Who to talk with

Generally, you should try to get information about:

• First-degree relatives  — Parents, full siblings, children
• Second-degree relatives  — Half-siblings, grandparents, aunts and uncles, nieces and nephews, grandchildren
• Third-degree relatives  — First cousins, great-aunts and great-uncles, great-grandparents, great-grandchildren, half-aunts and half-uncles

It still may help to gather information from as many relatives as you can, but the more distantly related a person is, the less his or her health history is expected to affect you.

Both your mother's and father's side of your family are relevant for you, regardless of your biological sex or whether you more closely resemble one side of the family more than the other.

Many people find it challenging to capture a complete health history due to adoption, estrangement or simply a lack of details known or willing to be shared in the family. It's OK to simply record the information that you can gather and know that it can be updated if more information becomes available in the future.

What to ask about

In general, you should try to gather information about whether relatives are living, their current age or age at which they passed away, and their medical history. Relevant details about health history include any medical conditions they have had and at what age they were diagnosed. For example, you can ask if they have had major health concerns, have ongoing or chronic health concerns, see a specialist for any medical conditions or are taking medication for health conditions.

Some specific conditions to note include:

• Birth defects, such as spina bifida, cleft palate or heart defects
• Cancer, tumors or polyps, noting specifically what organ or part of the body was affected
• Heart conditions or abnormalities
• Infertility, multiple pregnancy losses (generally three or more), or babies who were stillborn or who passed away in infancy
• Kidney disease
• Learning problems, intellectual disabilities or developmental delays
• Mental illness or mental health conditions, such as depression, anxiety, bipolar disorder or schizophrenia
• Unique spots or patterns on their skin, such as cafe au lait spots, shagreen patches or many lumps and bumps under the skin
• Very tall or very short stature, compared to the rest of the family
• Vision or hearing loss at a young age or with no apparent cause
• Unexpected deaths due to known or unknown medical conditions
• Other unexplained medical conditions
• Any known genetic or chromosomal conditions, such as cystic fibrosis, muscular dystrophy, Huntington's disease or Down syndrome
• Genetic testing or genetic counseling

It's also helpful to know about your relatives' environmental risk factors, too, such as history of tobacco use, alcohol abuse, drug abuse, obesity or exposure to radiation or chemicals.

You can record the information you gather in many formats, such as this example of a family health history form  from Mayo Clinic. Also, if you have relatives who have visited with a genetic counselor before, they may have already had a pedigree constructed — a visual representation of the family health history, like a family tree. It may help to ask if they'd be willing to share their pedigree, as this can save you a lot of time and work when gathering family history details.

Gathering information from relatives who have passed away

Sometimes gathering health information can be challenging if a relative has passed away. It's common for that person's diagnosis to be uncertain. For example, sometimes a cancer diagnosis will be labeled as a "female cancer," making relatives unsure if this was cervical, uterine, ovarian or breast cancer. It also is common to call any cancer of the gastrointestinal tract a "stomach cancer," although cancers of the stomach, small intestine, colon and pancreas differ from each other. Knowing the specific details about your relative's history is important in providing an accurate risk assessment for you, so you may need to dig a little deeper to get the accurate details.

Relatives' health records are the most helpful tool in getting these details, but they can be difficult to obtain. If no one has a hard copy of the decedent's records, the family may need to work with the health care institution to access the records. Sometimes records can be released to the decedent's personal representative or other authorized parties. In addition to health records, obituaries, death certificates, information from relatives and autopsy reports can help.

After you have gathered your family health history, you should discuss it with your primary care provider who will determine what, if any, next steps are needed. If you have specific family history concerns you would like to address, you can ask for a referral to meet with a genetic counselor for further discussion. If you are seeing a genetic counselor, it is important that you bring your family health history along to the appointment so your family history can be discussed in detail.

Discrimination protection

Some people are concerned that information in a family health history can be used against them. The Genetic Information Nondiscrimination Act of 2008 is a federal law that protects people from genetic discrimination, specifically in the setting of health insurance and employment. This means your genetic information cannot be used against you when it comes to health insurance and employment.

Genetic information includes family health history genetic testing results, use of genetic services, such as genetic counseling, and participating in genetic research. Under the act, your family health history and genetic testing results cannot be considered a preexisting condition. It is important to know that there are some exceptions to the act, and it does not have protections in place for life insurance, long-term care insurance or disability insurance.

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Example Of Family Health History Essay

Type of paper: Essay

Topic: Health , Medicine , Family , Life , Parents , History , Diabetes , Father

Published: 02/27/2020

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In the contemporary society, medical problems can arise in a person’s life due to factors such as the foods we eat or the environment we are exposed to. Knowing your family history is important since it will enable you to know your risk factors and predict with a high level of accuracy the kinds of diseases that you are likely to develop in the future. I’m the 8th born in a family of 6 boys and 4 girls. I have been enthusiastic to learn the history of my life since I believe it is of absolute importance in envisaging my life too. Though genetics does play a part, poor diet, lifestyle choices and lack of exercise have an implication in one’s life. My family has a history of various issues. For instance, my father suffers from asthma and tuberculosis which he inherited from my grandfather. Additionally, he has a case of mild diabetes which he believes that it came from his grandfather. My older brother and I both agonize from stress. I solely believe that this is the origin of my continuous headaches and heartburn that have adversely affected my concentration in class. My father had been working as a painter for the last 40 years until recently when he retired due to the age factor. He is currently 75 years and has been suffering from the diseases for the last 49 years. In the twilight of his 50s, he was diagnosed with diabetes having symptoms like extreme fatigue, irritability, unusual hunger and thirst and frequent urination. He now has to monitor his blood levels or else things will get out of hand. My 4 younger brothers both suffer from diabetes and asthma. Apparently, they inherited it from my father. In addition to this, they also have thyroid disease and obesity. My father was confident enough to accrue their condition to their lifestyles. They have been known to be frequent consumers of fatty and sugary foods. Personally, I was recently screened for diabetes but no traces of it were found. Additionally, my cholesterol level was found to be at the normal healthy rate. However, it has been established that I have developed heart murmur, and the physician ascertained that it started naturally and could, therefore, not be stopped. Currently, my mother is 72 years and has been working as an accountant for the last 50 years. On my maternal side, high blood pressure is very common. It is a genomic attribute that has been passed down from generation to generation. It is now a common illness for my family since my grandmother, mother, all my sisters and aunts have the disease. Though it has unsympathetically affected her performance in the workplace, she still struggles with the job since she needs income to cater for the adversities associated with old age. Additionally, one of my sisters has a Whitecoat Hypertension which is particularly fascinating. It commonly occurs when she visits the doctor and its symptoms include dizziness, panting and fainting. My mother admitted having the same condition during her childhood. Analyzing my family health history has enabled me to gain a clear understanding of the turbulent divorce between my parents. It, however, informs that efforts must be directed towards containing these conditions and maintaining a pristine image in the eyes of others. The different problems engraving my family should not hamper my performance in college but should prepare me adequately to handle the challenges of future life. Additionally, it informs me on the lifestyle that will enable me to live beyond 80 years that is the current lifespan of my family members.

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Original research

How is family health history discussed in routine primary healthcare a qualitative study of archived family doctor consultations, sara filoche.

1 Department of Obstetrics, Gynaecology and Women’s Health, University of Otago, Wellington, New Zealand

Maria H Stubbe

2 Department of Primary Health Care and General Practice, University of Otago, Wellington, New Zealand

Rebecca Grainger

3 Department of Medicine, University of Otago, Wellington, New Zealand

Bridget Robson

4 Te Rōpū Rangahau Hauora a Eru Pōmare, Department of Public Health, University of Otago, Wellington, New Zealand

Karyn Paringatai

5 Te Tumu, School of Māori, Pacific and Indigenous Studies, University of Otago, Dunedin, New Zealand

Phil Wilcox

6 Department of Mathematics and Statistics, University of Otago, Dunedin, New Zealand

Regina Jefferies

Anthony dowell, associated data.

No additional data available.

Family health history underpins genetic medicine. Our study aimed to explore language and patterns of communication relating to family health history observed in interactions between general practitioners (GPs) and their patients within routine primary care consultations.

Secondary analysis of patient and GP routine consultation data (n=252).

Participants

Consultations that included ‘family health history’ were eligible for inclusion (n=58).

Primary outcomes

A qualitative inductive analysis of the interactions from consultation transcripts.

46/58 conversations about family health history were initiated by the GP. Most discussions around family history lasted for between approximately 1 to 2 min. Patients were invited to share family health history through one of two ways: non-specific enquiry (eg, by asking the patient about ‘anything that runs in the family ’ ); or specific enquiry where they were asked if they had a ‘strong family history ’ in relation to a particular condition, for example, breast cancer. Patients often responded to either approach with a simple no, but fuller negative responses also occurred regularly and typically included an account of some kind (eg, explaining family relationships/dynamics which impeded or prevented the accessibility of information).

Conclusions

Family health history is regarded as a genetic test and is embedded in the sociocultural norms of the patient from whom information is being sought. Our findings highlight that it is more complex than asking simply if ‘anything’ runs in the family. As the collection of family health history is expected to be more routine, it will be important to also consider it from sociocultural perspectives in order to help mitigate any inequities in how family history is collected, and therefore used (or not) in a person’s healthcare. Orientating an enquiry away from ‘anything’ and asking more specific details about particular conditions may help facilitate the dialogue.

Strengths and limitations of this study

• The patient cohort was Euro-centric, and not fully reflective of the ethnic population of New Zealand (where the study was carried out).
• The extent to which the family health history information had been previously shared/documented was not ascertainable.
• The study draws on range of routinely collected consultation studies with different purposes, and hence cover a wide range of general practitioner contexts, without specifically having a focus on family history.

Introduction

Family health history has been described as the first genetic test. 1 A family health history is defined as ‘ a record of health information about a person and his or her close relatives. A complete record includes information from three generations of relatives, including children, brothers and sisters, parents, aunts and uncles, nieces and nephews, grandparents, and cousins.’ (National Institutes of Health, Genetics Home Reference). Such a detailed family health history is regarded as one of the most useful tools for risk assessment for common chronic diseases. 2 It is estimated that the relative risks and ORs for various cancers, stroke, type 2 diabetes and cardiovascular diseases is twice that for people with an affected first degree relative, and more than four times greater for many of these diseases if there is more than one affected first-degree relative. 2 3 The value of health records from relatives has been recently demonstrated in research aimed at providing accurate predictions of disease risk: Truong et al showed that including health information from first-degree relatives of those with both genomic and health records, had similar accuracies in polygenic risk scores with 44-fold larger population samples consisting of only genomic data and health information. 4 Several professional organisations have recently made recommendations that general practitioners (GPs) routinely, and opportunistically, collect family health history for three generations. 2 5 However, current evidence would indicate that there may be barriers to achieving this level of information, and approach to its collection, as family health history is widely reported as being both poorly and infrequently collected. 6 7 Reported barriers to the collection of family health information include: poor reimbursement, provider’s lack of time and expertise, lack of guidelines and adequate tools and limited functionality of electronic health information systems to capture and interpret data and unreliability of information provided by patients. 8 9 The potential to improve healthcare by being able to act on family health history information is thus not being fully realised. This is important as access to genetic and genomic testing becomes easier and cheaper, available direct to the public and knowledge of family health history is imperative in wisely using this testing and interpretation of results. 1 10 11

The exploration of the practice of collection of family health history has tended to focus on the practical side, that is, to garner better understandings around the barriers and facilitators to its collection, and the validation and implementation of tools to collect family health history. 2 11 12 How family health history is actually discussed in routine primary healthcare consultations has received less attention, and to our knowledge this is first study to observe conversations about family health history in routine primary care consultations. The aim of our study was to explore language and patterns of communication relating to family health history observed in interactions between GPs and their patients within routine primary care consultations.

Materials and methods

Data source.

Consultation data were sourced from the Applied Research on Communication in Health (ARCH) Corpus at the University of Otago, Wellington, New Zealand, 13 and have been previously described. 14 The Corpus houses a digitally stored collection of patient/practitioner consultation data that includes 458 videorecorded consultations, verbatim transcripts and selected medical notes. 15

Identification of family health history consultations

The consultations analysed in this paper were derived from five different studies that comprise the ARCH Corpus; in none of these was family health history the focus ( table 1 ). At the time of this study, the Corpus included 252 patient–GP consultations involving 36 GPs, collected between 2004 and 2018. The ARCH Corpus includes a Microsoft Access database populated with metadata including full demographic information about every participant, research site information and free-text content logs of each consultation. The logs were prepared by a research nurse according to a standard template and include information about the main topics discussed, outcomes of the consultation (including prescriptions and referrals) and a minute by minute summary of key events and content. The logs thus capture any complaint or topic mentioned incidentally in a consultation, in addition to the main presenting complaint(s). The database and logs link electronically to full verbatim transcripts (including time measurements in minutes) and the original audio and videorecordings to facilitate subsequent more detailed analysis, but the latter cannot be queried directly via the database. 15

Overview of the study and number of patient–GP consultations where family health history was discussed

GP, general practitioner.

A query was run on the Microsoft Access database of the logs of each GP consultation in the Corpus using the keyword ‘family health history’ ( table 1 ). The term ‘family health history’ was present in the logs of 71/252 individual patient consultations with GPs. Further review of the transcripts was undertaken and the consultations were excluded if family health history was not discussed. Additional terms were also included at this time to identify if family health history was mentioned in another context and included ‘family history’; ‘family’; ‘whānau’ (family); ‘inherited’; and ‘condition’. It is possible that not all relevant consultations in the Corpus were identified; however, the purpose was to collate a relevant dataset adequate for the purpose of undertaking a descriptive qualitative analysis, and not to investigate the frequency of occurrence of family health history.

Patient and public involvement

Patients were not involved in any aspects of the study design, including plans for dissemination of the research findings. As part of the original consenting process, they would have been advised on the length of the time required to participate in the research.

Data analysis

Themes were derived iteratively using a qualitative inductive approach based on the verbatim transcripts of interactions between patients and GPs. 16 Our overarching aim was to report on the emerging range of issues and communication styles without pre-conceived assumptions. SF (health services researcher) read all of the transcripts (n=71) several times and identified the conversation sequences that related to family health history, including the time in the consultation that it was first mentioned. A subsample of transcripts were read by RJ (GP and health services researcher). Twelve initial inductive themes were derived ( table 2 ) that formed the coding frame, the transcripts were then reread and new codes emerged as preliminary themes. These themes were mapped across all of the transcripts, reread and recoded until no further themes emerged and the final themes derived ( table 2 ). Where additional clarity or interpretive information was required, the videorecording of the consultation was reviewed. Initial interpretations of the themes were shared with the team and discussed in detail discussion between SF and RJ. MHS, a researcher with experience in interactional sociolinguistics contributed to an additional round of discussion and interpretation. The themes were discussed and agreed by consensus with all of the authors. The sociodemographic information of the 71 patients was reviewed after the first round of analysis and self-identified ethnicity reported in table 3 analysis by ethnicity was not undertaken.

Thematic structure

Self-reported ethnicity of patients who participated in the original studies

Fifty-eight out of a possible 252 (23%) patient–GP consultations involved at least one mention of family health history. Since most patients came to the consultation with more than one reason for their visit, the resultant interaction between the GP and the patient was a dynamic exchange of information, often covering several points of discussion. The length of each individual consultation ranged from 6 to 37 min duration. Sharing or updating family health history was never the presenting reason for the consultation. In the 58 consultations, 46 conversations about family health history were initiated by the GP. Most discussions around family history lasted for between 1 and 2 min. Two overarching themes were developed from the transcripts that described how family history was raised, and then subsequently discussed, in the consultation—non-specific and specific enquiry; and one theme which related to the situational context, multitasking ( table 2 ).

How family health history is raised in the consultation

The topic of family health history was presented initially to the patient in one of two ways, through a line of non-specific enquiry or through a specific context ( table 4 ). Patients often responded to either approach with a simple ‘no’, but fuller negative responses also occurred regularly and typically included an account of some kind—for example, that the patient was unable to be certain or to provide the requested information (eg, explaining family relationships/dynamics which impeded or prevented their access to information).

Supporting quotes

ARCH, Applied Research on Communication in Health.

Non-specific enquiry

A non-specific line of enquiry was initiated through prompt questions that were tilted towards a ‘no’ answer, typically asking the patient if there was ‘anything that runs in the family’ or if there was ‘anything in the family we should know about? ’ .

The introduction of the topic through this form of non-specific enquiry, while sufficient to initially engage the patient, elicited two opposite types of responses, one where the patient disclosed very little or one where the patient disclosed a significant amount of information.

Where patients responded by not disclosing any information, this often ended any further discussion about family history, with no further details being drawn out by the GP. Following this, the direction of the consultation tended to change abruptly into a different topic, as illustrated by the following interaction:

GP: … and anything that runs in your family at all on either your mum or dad’s side?

PT: No not that I know of

GP: Fine, and have you ever had a smear test?

(ARCH:TS GP08-17)

Those patients who responded positively to the initial response to the prompt to share ‘anything’ or discuss ‘any’ history did so by presenting a picture of family health that had personal meaning to them, and at the same time oriented to the doctor’s agenda by highlighting aspects that were clinically relevant. For example:

GP: I’ve got your details and medication, any history of

PT: Parents are in the seventies and still alive

PT: Apparently my grandmother ended her life in the gas oven at home so I guess she would have lived a long life if she hadn’t of done that

PT: Grandfather on the other side was an alcoholic so that sort of explains why he’s dead

PT: The other set of parents are fine

GP: And the other grandparents

PT: Oh grandparents? One died on the operating table and um, he was sixty odd, and my grandmother would have been in her seventies as well I think’

At this point of the consultation, the GP changed to a more specific line of enquiry (inferably following a checklist) by asking about the occurrence of specific health conditions, and it followed as:

GP: Anyone had diabetes in the family?

GP: And high blood pressure?

GP: Um alcoholism it was your mother’s father or your father’s father?

PT: Oh my mother’s father grandfather, but it’s all largely hearsay

GP: Any significant mental illness?

PT: No, we seem to be pretty straight up

GP: And familial degenerative disease, which I don’t actually understand what that means, so we’ll leave that blank

PT: Once again they’re all seventy they’re not in the mental asylums and they’re living in their own homes without nursing and wheelchairs so that’s pretty good

(ARCH:IS-GP02-08)

In this interaction initially it appeared that the patient wasn’t going to share family health history information by stating ‘Parents are in the seventies and still alive ’, which suggests that they felt this was sufficient in describing a picture of family health. However, they went on to share more details, despite being prompted initially by a non-specific line of enquiry, with the patient disclosing that alcohol misuse and mental health conditions did exist in their family. Of note is that while this patient disclosed that a relative died by suicide, and that there was alcohol misuse, they did not appear to attribute this to poor mental health, instead discounting the reliability of the information passed down, by saying it was ‘hearsay’. After several specific questions about the occurrence of particular health conditions, the GP ended the enquiry by saying ‘ And familial degenerative disease, which I don’t actually understand what that means, so we’ll leave that blank ’ to which the patient augmented their initial response by stating ‘Once again they’re all seventy they’re not in the mental asylums and they’re living in their own homes without nursing and wheelchairs so that’s pretty good ’ , at which point the discussion changed topic. A more extended dialogue about family health was not established.

A more specific enquiry through context: highlighting the unknown

In comparison, more specific lines of enquiry were evident when the GP was wanting to establish the occurrence of a particular condition, which in this cohort was mainly about the occurrence of heart disease, diabetes, cancers and/or the existence of allergic reactions to particular medications ( table 4 ). This line of enquiry was frequently premised by asking the patient if there was a ‘strong family history’ of a particular condition; although the adjective ‘strong’ was never defined nor questioned by any of the patients. With a more specific enquiry, the patient was often asked to think about more than one condition ( table 4 ), for example when this patient was seeking a repeat prescription for hormonal contraceptive:

GP: You or your family have never had any sort of blood clot or thrombosis or a stroke or blood pressure is there a strong family history of breast cancer at all?

PT: No, not that I know of

GP: No, fine, fine.

PT: I live with my father so I don’t really know much about my mother’s side of the family

GP: Yeah okay. And have you had any medical problems in the past?

(ARCH:TS-GP08-07)

Exploring this interaction further, the use of the words ‘never’ or ‘any’ in the first three-part question orientated the response to a negative, and the doctor left no space for a response, continuing straight on to the next question, suggesting this was a request for confirmation rather than a question seeking specific information. In all cases, as we see in the response to the doctor’s second question here, a more specific line of enquiry placed an onus of recall on the patient, as with a non-specific line of enquiry, but had the additional effect of orientating the patient to wanting to be as accurate as possible. In this example, we see the patient added ‘not that I know of’ and an explanation as to why they do not know all or some of the answer (at that given time). Estranged family relationships were frequently reported to account for why patients did know about the occurrence of specific health conditions. As exemplified by another patient disclosing:

GP: Yep so um well—apart from that is there anything that runs in your family that might trigger it thyroid problems or auto-immune problems or nothing else?

PT: Nothing that I know of um I mean I don’t know my father that well but um, I’ve kind of asked him a few questions but he’s had nothing he’s only just got heart disease and stuff like that

(ARCH:TS-GP10-16)

Where patients indicated that they did not know (much) about their family health history, there was no indication that they would have been able to ascertain a more detailed family history if they knew they were going to be asked about it, nor did any patient say in the consultation that they would attempt to find out more. Once an estranged family had been raised by the patient, the GPs made no more enquiries to establish familial inheritance/occurrence, and the consultation was refocused to the individuals’ health history.

Multi-tasking

In reviewing the video recordings, the GP could often be observed multitasking during the consultation (eg, looking at or adding to the electronic medical record, undertaking a physical examination), including at the time while asking the patient about their family health history. The patient was also expected to multitask, from having to think about answering more than one line of enquiry, and having to undertake tasks at the same time. The following excerpt exemplifies such an interaction:

GP: I will need your height and weight please as well, and do you have a family history of heart attacks or strokes? Without shoes please

PT: Um my mum she had a minor heart attack but she died um it’ll be three years this year

PT: Um from cancer

GP: Mm what kind of cancer?

PT: Um they’re not really sure

GP: Stand here please

PT: Cos they don’t know where it started

GP: Sometimes has that, okay, that’s perfect

PT: Oh okay, what height am I?

GP: One fifty six

(ARCH:DS-DP32-08)

This consultation commenced with a ‘so’ to which the patient explained the reason for their visit. Within 1 min the GP had turned their back to the patient, and started typing. Two minutes into the consultation, the GP started experiencing problems with the computer (data entry) and said to the patient ‘ahhh don’t you hate computers?’. The patient in this instance did not appear relaxed, they were wringing their hands and swinging their legs under the chair. The topic of family history was raised approximately 5 min into the 13 min consultation, where the patient was given a statement of intent—that their height and weight would need to be taken, asked a question—about their family history, and an instruction—to remove their shoes. In response to the doctor’s question about family history of heart attack or stroke, the patient disclosed that her mother had died 3 years ago. At this point the GP was not making eye contact with the patient, and during the explanation of what her mother had died from the patient was given another instruction to go and stand in a particular place. While family health history information was able to be shared, because it was done in a context of multitasking, it appeared to create a perfunctory transaction, rather than a discussion.

This paper reviewed how family history was discussed in a sample of archived primary healthcare consultations. To our knowledge, this study is the first to observe conversations about family health history in routine primary care consultations. The majority (46/58) of conversations about family health history were initiated by the GP. Most of these family history discussions lasted approximately 1–2 min. Patients were invited to share family health history through one of two ways; non-specific enquiry such as asking ‘anything that runs in the family? ’ , or in relation to a specific condition where patients were asked if they had a ‘strong family history ’ of a particular condition, like breast cancer. The majority of patients responded to either approach by replying ‘no’ or premising the negative reply by explaining family relationships or dynamics which would impede or prevent access to such information. Of note is constraints of primary care consultations on family health history taking. ‘Multitasking’, and computer use also appeared to have an influence on how family history taking played out. These aspects have been noted in other areas of primary care performance and, once understood, strategies can be put in place to mitigate their impact. 17

Sharing of family history information with family members and health-professionals is influenced by the sociocultural norms of the family it pertains to and the purpose for which the information is being sought. 18–21 There are multiple meanings of ‘family’ and varying beliefs about what ‘health’ (and illness) means. 19 20 Furthermore there are different reasons for collecting family health history information, for example, to establish genetic risk to identify which patients need referral for specialist genetics assessments 21 ; to establish the prevalence of complex chronic diseases 3 ; or to establish family systems genogram 21 or potentially for all of the aforementioned reasons. However, if this is not established prior to the enquiry being made, the healthcare interaction may result in misaligned communication because there has been an assumed shared understanding of what is meant by ‘family health history’. 20 22 This was frequently observed in our study. While no patient questioned why family health history was being enquired about, there was no indication given by the GPs as to why it was being asked about. It is not possible to ascertain whether indicating the purpose of the enquiry would have resulted in more aligned discussions and this warrants further investigation.

As part of realising the use of family health history more routinely, there is an emerging expectation that people will collect their family health information through the use of online family health history tools. 2 12 23 In 2010, the US Surgeon General suggested that Thanksgiving Day be also called ‘Family Health Day’ because families often get together, providing an opportunity to discuss and collect family health history from several family members. 24 In parallel the US Surgeon General released a free online tool for the collection of family health history. 25 The use of family health history tools has been shown to improve the detection of inherited conditions and cancer in research studies. 2 However, there are considerations for the use of such tools in routine practice. As with other family health history tools, this tool reflects a narrow biomedical definition of the family 20 which raises questions about the relevance and potential acceptability of such tools for many families, including for those observed in our study. Multiple approaches that incorporate both social and biological/medical elements are likely to result in more equitable access to and greater benefit from family history information in healthcare.

In our study, enquiring about family health history lasted between 1 and 2 min. A ‘full’ family history includes three generations of relatives, health problems with age of onset for each family member, and age of each relative at death with cause has been estimated to take up to 30 min. 26 Dedicated consultations for the collection and documentation of family health history have been proposed as potential solutions to these system level constraints. 2 However, this approach could potentially create inequities in access to (and therefore benefit from) family history collection for those people who are unable to pay for and/or attend additional consultations.

In previous studies, GPs have reported that the information that patients do provide about their family history is unreliable. 8 27 28 Our study demonstrates that the way GPs enquire about family health history may also contribute to the amount and type of information that is gathered. Another study exploring how GPs could meet patients unmet needs in acute care consultation found that changing the orientation of the enquiry by using the question ‘Is there something else you want to address in the visit today?’ led to significantly more unmet needs being eliminated than when GPs used the question ‘Is there anything else you want to address in the visit today?’ 29 Although the paper reports an randomised controlled trial that was conducted in the context of eliciting additional concerns, but its relevance extends beyond this topic—the key point is that choosing ‘anything’ rather than ‘something’ in asking the question signals that that the expected answer is ‘no’. Hence this finding is relevant to history taking as well as problem presentation. It would be worth exploring if such attention to linguistics would help improve the collection of family health history. In a further study, when patients were asked to consider family health history, the addition of ‘extended’ to family health history yielded patients reporting positive family history for 8 of 11 medical conditions. 26 In our data, the abrupt shift in consultation topic after a negative initial response to family history is indicative of many interactions in primary care where there are competing demands in a checklist driven consulting environment. 30 With increasing expectations that family health history is collected, such communication devices may help to enhance interactions and obtain more relevant information

A limitation of this study is that the patient cohort was Euro-centric, and not fully reflective of the ethnic diversity of New Zealand (where the study was carried out). We have not undertaken any analysis by ethnicity, and this is warranted in future research. It was also not possible to ascertain the extent to which the family health history information that was shared was taken into account in any clinical decision making by the GP. Nor was it possible to ascertain whether other healthcare practitioners had had prior discussions with patients about their family history, or if this information had been collected and recorded elsewhere in the patient records. A strength of this study is that these examples are taken from a range of routinely collected consultation studies with different purposes, without a specific focus on family history, and hence cover a wide range of GP contexts.

This study has highlighted areas where inequities may arise with existing methods of routine collection of family health history. The opportunistic enquiry into family health history is more complex than asking if ‘anything runs in the family’ and, with attention to linguistic devices and acknowledgement of patient social and cultural norms, there is an opportunity to expand history taking to the point at which the history can become an effective genomic tool.

Supplementary Material

Acknowledgments.

The authors thank Jo Hilder and Rachel Tester for helping to develop the search strategy and data retrieval, and the GPs and patients who generously contributed their data to the ARCH Corpus of Health interactions. This research was funded by the University of Otago, Aotearoa New Zealand.

Twitter: @chttr, @drbeckyg

Contributors: SF conceived the idea, led the analysis and drafted all versions of the manuscript. MHS contributed to the study design, analysis and manuscript preparation. RG contributed to the study design, analysis and manuscript preparation. BR contributed to the study design, analysis and manuscript preparation. KP contributed to the study design, analysis and manuscript preparation. PW contributed to the study design, analysis and manuscript preparation. RJ contributed to the study design, analysis and manuscript preparation. AD contributed to the study design, analysis and manuscript preparation.

Funding: This work was supported by The University of Otago Research Grant. Award/Grant number is not applicable.

Competing interests: None declared.

Patient and public involvement: Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

Provenance and peer review: Not commissioned; externally peer reviewed.

Data availability statement

Ethics statements, patient consent for publication.

Not required.

Ethics approval

The collection of all Corpus data and guidelines for subsequent use have been approved by the New Zealand Health and Disability Ethics Committee and University of Otago Human Ethics Committee (Health). Ethics approval for this study was given by the University of Otago Human Ethics Committee (Health) (H19/022).

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Family Health, Essay Example

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Introduction

This paper examines the concept of family health for American families. Examination of the basic family structure is followed by a look at the typical health systems available in the USA today. This includes the barriers to obtaining good healthcare and the role of nursing as it applies to families.  It addresses the question of whether the USA Government is doing enough to support the healthcare sector and what may be done to improve deficiencies?

Family Structure

The early post-war depiction of the American family circa 1950’s was that of a dutiful husband at work with a wife who raised and looked after the children at home.  This profile has now changed in modern day America and become more complex.  Large families of the pre-war era are on the wane and the modest family structure is based upon two children supported by working parents. In addition, owing high divorce rates we are also seeing more single parents and this has placed more financial pressures, particularly on single moms.  The cost of high medical insurance has become an issue for the poorer and disadvantaged family units.

It is estimated that some 47 million residents of the USA are without health insurance.  As employees continue to try and shift the burden to individuals, the trend is set to increase.  As such, this creates a vicious circle where the average Americans continue to struggle with escalating health costs and adequate coverage.  The most successful of all the health care programs, i.e. Medicare is under increasing attack for lack about the service provision.  This particularly impacting the over 65 group that rely on Medicare for health support.  The question posed then is – are  all individuals entitled to healthcare?

Reasons Supporting Automatic Healthcare Entitlement

The number of uninsured American citizens has increased to over 45 million people.  The escalating costs of health coverage has  made health care become unaffordable for both individuals and businesses in the USA.  Companies already facing tough economic conditions are pushing back by transferring the cost from the companies to individuals.  It is considered that a centralized medical database would be easier for doctors and nurses to administer.  By the introduction of free medical services.  Patients are more likely to practice preventative medicine and inquire about potential problems more expensive medical tree becomes a necessity.  Also, those patients with pre-existing conditions should be able to get health coverage.

The USA is the only industrialized nation that is not guaranteeing health care is an automatic entitlement of its citizenship.  United States spends at least 40% more per capita on healthcare than any other country with universal healthcare system.  It has been estimated that a single payer universal health care system would save between hundred to $200 billion in one year alone.  These figures, even after factoring in all the uninsured and increasing health care benefits.  The cost of health care in Canada as a percent of GNP has reduced since 1971, when the system was first implemented.  In the US costs of increased despite having a stronger economy in Canada.

America cannot afford to have its working populace unable to afford adequate health coverage.  America already has the highest levels of obesity, diabetes, cancer and heart disease in the world.  As such, the American people paid the price for this with sickness, time off work, lost income and loss leisure time with family and friends.  As such universal healthcare is the only viable means of ensuring everybody is treated in an equitable manner and afforded human rights proper medical coverage.  Those countries with universal health coverage have demonstrated more concerned about human welfare and conservative citizens.

It is considered that there is a moral obligation to provide a citizen with universal health coverage.  The single universal health care system is the health care payment system and not be considered a free care system.  Polls in the USA have indicated that between 60 to 75% of Americans like to see a universal healthcare system adopted.  The current situation of the US healthcare system is ranked as the lowest of any industrialized nation.

Current Health System Assessment

Medicare –  Essentially,  Medicare provides health insurance cover for the 65+ age group and for those under 65 with certain disabilities.  In addition people of any age with Kidney or renal problems.  (Medicare.gov, 2012).

Medicaid – his is essentially a State and Federal partnership that provides for medical insurance coverage for the low income groups, older people, those with disabilities and certain disadvantaged groups. (Healthcare.gov, 2012)

Non Insured – These are groups of people that do not have medical insurance cover i.e. Medicare or Medicaid.  This includes many illegal immigrants, mentally retarded people, those essentially living outside of the state or federal systems.

Retirement Plans – Specific medical insurance plans offered as part of retirement packages.  These are mainly offered to retiring Executives and often are premium rate insurance policies offering extended health and superior coverage.

Indemnity Plans – These allow you the flexibility of choosing any hospital or Doctor that you wish and are often on a fee for service basis. Policies vary and you need to read the fee provision applicable to the policy.

Barriers in the Health System

The author laments on the poor state of the US healthcare provision.  In 1966 the US was on the verge of improving universal health insurance for children with the ultimate end goal of an inclusive system for all. The Clinton Administration set out an ambitious reform plan but this was badly flawed and it never really got off the ground.  Today there remains a similar crisis and there seems little room for optimism of reforms in the near future. As such there seems little hope for the 44 million Americans without health insurance. Public opinion polls have indicated that health care reform remains high on the agenda.  Without the reformation of the health care system the entire structure is in risk of collapse. With the baby boomers reaching old age it will impose a severe strain on the current health system in the US.  The government needs to commit to a universal coverage for all Americans now. (Southby, R.F., 2004)

There are many different representational points of view as to whether individuals are automatically entitled to healthcare.  On the one hand, many consider that healthcare is a human right and should be provided to all citizens regardless of race, creed or monetary status.  The other viewpoint is that health care is a privilege and should be earnt by responsible citizens through contribution to society.  This has been defined as those people who are employed and pay taxes or contribute financially to society in some other form.  In the United Kingdom and Canada the concept of a universal health system was decided by the electorate.  Perhaps ultimately in the United States, a similar situation will take place i.e., the people will decide on the most suitable system to be adopted moving forward.  (Woolhandler, S. 1991)

The arguments against adoption of the Universal healthcare system are equally convincing.  The concept of government intervention and running a state health system as opposed to the more entrepreneurial approach of the private sector is a persuasive argument.  In the United Kingdom, the national health service — NHS, has been the subject of considerable criticism in terms of sustaining good medical practice and retention of key staff i.e., consultants, doctors and nurses many of which departed to the private sector of the US healthcare system, where they received higher remuneration and improved medical facilities.  The NHS has also been the victim of financial cuts from UK government spending policies.  It is this argument that the anti-lobby put forward in terms of nationalizing the US healthcare system.

Role of Nursing in Family Care

The scope of the family nurse is defined under the auspices of ‘ The American Nurses Association Public Health Nurses Scope and Standards of Practice ’.  The Registered Nurse (RN) works under the supervision of the Care Manager and part of an interdisciplinary team designed to provide  healthcare and support for those families in need of medical support.  The RN becomes the lead contact person and in the front line for dealing with the family related issues.  This often means adopting the role of an advocate in terms of dealing with face-to-face issues, conducting interviews and completing regular health monitoring and checkup needs.

The Family Nurse has an important role to play in terms of getting the family to understand the beliefs and value systems of good medical practice. A considerable effort is spent on preventative care policies and promotion of positive health and wellbeing.  As such the RN is responsible for helping families with quality of life issues.  The Family Nurse can deal with most routine issues but equally is important in routing to the Doctors / Hospital where more intervention is required.  (Linn, L.S. 1976)

Healthcare.gpv. (2012, 8 22). Medicaid Benefits . Retrieved from Healthcare.gov: http://www.healthcare.gov/using-insurance/low-cost-care/medicaid/

Linn, L. S. (1976). Patient Acceptance of the Family Nurse Practitioner. Medical Care Vol 4(6) , 357-364.

Medicare.gov. (2012, 8 22). Medicare Benefits . Retrieved from Medicare.gov: http://www.medicare.gov/navigation/medicare-basics/medicare-benefits/medicare-benefits-overview.aspx?AspxAutoDetectCookieSupport=1

R.F., S. (2004). Where do we go from here: is there any real hope for health care reform. Journal of law medicine and ethics , 442-445.

Steffie Woolhandler, M. M. (1991). The Deteriorating Administrative Efficiency of the U.S. Health Care System. New England Journal of Medicine , 1253-1258.

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Family Health History Genogram Assessment

Introduction, genogram assessment, risk assessment.

The analysis of family history by health care professionals is discussed as an appropriate way to determine diseases and conditions which are typical of this family. The focus on three generations in one family is appropriate for such an analysis. In order to prepare a genogram diagram and a family health history table for the client’s family, it is necessary to interview the client and learn about conditions from which his relatives suffer from the focus on genetic conditions and diseases which could lead to death. It is also important to follow certain rules while conducting the family health history assessment and asking the client about personal details (Bennett, 2004). The purpose of this case study is to conduct the genogram assessment with reference to the collected data, identify health risks for younger family generations, propose interventions, and determine the benefits of such assessments.

A specific tool proposed by the Surgeon General allows for creating a genogram diagram and a family health history table in order to reflect conditions, including genetic diseases, which “run” in a concrete family. After evaluating the received data, it is possible to conclude that the greatest health risks to the client’s and younger family members’ health care associated with such diseases as osteoporosis for females and hypertension for both females and males (“Core principles,” 2011). In addition, it is also necessary to control cholesterol levels. To recognize these chronic medical conditions which are often associated with genetic factors, it is important to analyze how many family members suffer or suffered from these diseases with the focus on the age of disease onset.

Thus, osteoporosis is observed in three female family members (the maternal grandmother, mother, and maternal aunt). The disease began to progress when the women were aged 50-59 years. While focusing on the causes of osteoporosis as a loss of bone density, it is possible to state that these causes are in the combination of genetic and environmental factors. Therefore, osteoporosis affects females of the same family who live in similar environments. Furthermore, during the determined period, the maternal grandmother and mother also began to suffer from increased cholesterol. Hypertension is observed in four family members, including the paternal grandfather, maternal grandmother, maternal uncle, and father. The disease was diagnosed when the family members were aged 40-49 years. It is possible to state that genetic factors and specifics of a lifestyle can influence the increase in blood pressure. Therefore, in this family, risks of developing hypertension in all members older than 40 years are high because of similar genetic patterns, environments, and followed lifestyles.

To address the identified risks and contribute to preventing the development of symptoms of osteoporosis in female family members and hypertension in all family members, it is necessary to propose two counseling interventions. The first intervention is based on modifying the family’s diet and eating habits. The purpose of this intervention is to decrease the risks of osteoporosis and increased blood pressure and cholesterol. Females in the discussed family tend to suffer from postmenopausal osteoporosis, and the diet for this condition should include products with high levels of calcium and vitamin D (Kanis et al., 2013). Thus, the focus is on consuming milk products, cheese, green vegetables, and salmon. The diet to avoid high blood pressure and cholesterol levels should not include saturated fats. It is important to eat vegetables and fruits, whole grains, and fish. The consumption of alcohol, high-calorie products, caffeine, and salt is not recommended to prevent the development of undesired conditions.

The second intervention is associated with changes in lifestyle habits, including smoking, alcohol consumption, and exercising. The family members should modify their lifestyles in order to avoid the development of diseases which “run” in their family. The focus is on exercising for females to improve their bones’ mass and density. Each training session should last 30 minutes, and the recommended number of sessions is two-three per week (Kanis et al., 2013). All family members should avoid smoking and alcohol consumption to prevent effects on their bones and changes in blood pressure. The focus is also on self-monitoring with reference to the movements and falls control, the consumption of medications, and monitoring of cholesterol levels and blood pressure.

The assessment of a family health history with the help of the proposed diagram and table is important to identify certain diseases or conditions which are typical of several members in one family. The assessment provides individuals with opportunities to prevent the development of certain conditions with the help of following recommendations developed by health care providers and nurses. The appropriate screening of health conditions is important to identify risks and create a management plan. As a result, it is possible to expect that certain conditions will not develop in other generations because of the actions taken. For this family, the recommendations to follow include changes in their diet with the focus on modifications for females and males, as well as changes in the lifestyles with the focus on exercising, self-monitoring, and quitting unhealthy habits.

Bennett, R. (2004). Is a universal family history tool feasible? The Genetic Family History in Practice, 2 . Web.

Core principles in family history . (2011). Web.

Kanis, J. A., McCloskey, E. V., Johansson, H., Cooper, C., Rizzoli, R., & Reginster, J. Y. (2013). European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporosis International , 24 (1), 23-57.

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• Family Health History
• Family Health History Tools and Resources
• Family Health History and Pregnancy
• Family Health History and Your Child
• Family Health History for Adults
• Family Health History Resources for Health Professionals and Researchers
• MFHP Algorithms
• Genomics and Your Health
• About Cascade Testing
• Hereditary Breast and Ovarian Cancer
• Hereditary Colorectal (Colon) Cancer
• Heart Disease, Family Health History, and Familial Hypercholesterolemia
• Public Health Genomics at CDC

What to know

If you have a family health history of a chronic disease such as cancer, heart disease, or diabetes, you are more likely to get that disease yourself. Knowing your family health history risk can help you—if you act on it. Share your family health history with your healthcare provider, who can help you take steps to prevent disease and catch it early if it develops. Finding disease early can often mean better health in the long run.

Knowing and acting on your family health history can be an important part of staying healthy. Family health history can help your healthcare provider decide what screening tests and other interventions you need and when. For example, if you have a parent or sibling diagnosed with breast cancer before age 50, your healthcare provider might refer you for cancer genetic counseling .

Whether you know a lot about your family health history or only a little, take time to talk to your family about their health histories. It might not be easy. Your family members might not be used to talking about their diseases or might not want to talk. But starting the conversation is important. Remember, you're asking not just for your own health, but for the health of everyone in your family.

If you have a medical condition, such as cancer , heart disease , or diabetes , be sure to let your family members know about your diagnosis. If you have had genetic testing done, share your results with your family members. If you are one of the older members of your family, you may know more about diseases and health conditions in your family, especially in relatives who are no longer living. Be sure to share this information with your younger relatives so that you may all benefit from knowing this family health history information.

Collect and share your family health history

Are you ready to collect your family health history but don’t know where to start? Here’s how!

Talk to your family. Write down the names of your close blood relatives from both sides of the family: parents, siblings, half-siblings, grandparents, aunts, uncles, nieces, and nephews. Talk to these family members about what conditions they have or had, and at what age the conditions were first diagnosed. You might think you know about all of the conditions in your parents or siblings, but you might find out more information if you ask.

Ask questions. To find out about your risk for chronic diseases , ask your relatives about which of these diseases they have had and when they were diagnosed. Questions can include

• Do you have any chronic diseases, such as heart disease or diabetes, or health conditions such as high blood pressure or high cholesterol?
• Have you had any other serious diseases, such as cancer or stroke? What type of cancer?
• How old were you when each of these diseases and health conditions were diagnosed? (If your relative doesn’t remember the exact age, knowing the approximate age is still useful.)
• What is our family’s ancestry? From what countries did our ancestors come to the United States?
• What were the cause and age of death for relatives who have died?

Record the information and update it whenever you learn new family health history information . My Family Health Portrait , a free web-based tool, is helpful in organizing the information in your family health history. My Family Health Portrait allows you to share this information easily with your healthcare provider and other family members.

Share family health history information with your healthcare provider. If you are concerned about diseases that are common in your family, talk with your healthcare provider at your next visit. Even if you don't know all of your family health history information, share what you do know. Family health history information, even if incomplete, can help your healthcare provider decide which screening tests you need and when those tests should start.

Share your medical and family health history with your family members. If you have a medical condition, such as cancer, heart disease, or diabetes, be sure to let your family members know about your diagnosis. If you have had genetic testing done, share your results with your family members. If you are one of the older members of your family, you may know more about diseases and health conditions in your family, especially in relatives who are no longer living. Be sure to share this information with your younger relatives so that you may all benefit from knowing this family health history information.

Act on your family health history

Having a family health history of a disease doesn't mean that you or your family members will definitely get it. Knowing about your family health history of a disease can motivate you to take steps to lower your chances of getting the disease. You can’t change your family health history, but you can change unhealthy behaviors, such as smoking, not exercising or being active, and poor eating habits.

Talk with your healthcare provider about steps that you can take, including whether you should consider early screening for the disease. If you have a family health history of disease, you may have the most to gain from lifestyle changes and screening tests.

What you can do if you have a family health history of

• Colorectal cancer : If you have a mother, father, sister, brother, or other close family member who had colorectal cancer before age 50 or have multiple close family members with colorectal cancer, talk to your healthcare provider about whether you should have screening starting at a younger age, being done more frequently, and using colonoscopy only instead of other tests. In some cases, your healthcare provider may recommend that you have genetic counseling, and a genetic counselor may recommend genetic testing based on your family health history.
• Breast or ovarian cancer : If you have a parent, sibling, or child with breast cancer, follow current recommendations and start getting mammograms at age 40. If your relative was diagnosed with breast cancer before age 50, if you have a close relative with ovarian cancer, or if you have a male relative with breast cancer, your healthcare provider might refer you for cancer genetic counseling to find out if genetic testing is right for you. In some cases, your healthcare provider might recommend taking tamoxifen, raloxifene, or aromatase inhibitors, drugs that can decrease risk of developing breast cancer in some women.
• Heart disease : If you have a family health history of heart disease, you can take steps to lower your chances of getting heart disease . These steps can include eating a healthy diet, being physically active, maintaining a healthy weight, not smoking, limiting your alcohol use, having any screening tests that your healthcare provider recommends, and, in some cases, taking medication. If you or a family member has low density lipoprotein (LDL) cholesterol levels over 190 mg/dL (or over 160 mg/dL in children), talk to your healthcare provider about getting checked for familial hypercholesterolemia (FH), especially if you have a family health history of early heart disease or heart attacks. If you have FH, you might need to take additional steps to maintain your health.
• Diabetes : If your mother, father, brother, or sister has type 2 diabetes, you and your other family members could have prediabetes and are more likely to get type 2 diabetes. While most people with type 2 diabetes are older adults, more and more children, teens, and young adults are developing type 2 diabetes. But there are important steps you and your children can take to prevent type 2 diabetes and reverse prediabetes if you have it. Take this test to find out if you or your family members could have prediabetes. Ask your healthcare provider whether you need earlier screening for diabetes. Find out more about the National Diabetes Prevention Program 's lifestyle change program and how to find a program near you .
• Osteoporosis : This is a medical condition where bones become weak and are more likely to break. A family health history of osteoporosis is one of a number of factors that make you more likely to develop osteoporosis. For example, if you are a white woman whose mother or father fractured a hip, talk to your healthcare provider about screening for osteoporosis earlier (at about age 55, compared with age 65 for most women).
• Hereditary Hemochromatosis : Hereditary hemochromatosis is a disorder in which the body can build up too much iron and can lead to serious liver damage and other problems. If you have a family member, especially a brother or sister, with hemochromatosis, you may be more likely to develop the condition yourself. Talk to your healthcare provider about testing for hemochromatosis and whether you should take steps to lower the amount of iron in your body.

Learn how collecting your family health history can help prevent disease or find it early.

For Everyone

Public health.

family history-Nursing Paper Examples

• January 11, 2024
• Nursing Paper Examples

Response 1 (family history-Nursing Paper Examples)

Excellent post! I agree that collecting family history is instrumental in identifying risk factors for diseases the rum among family members. Besides risk identification, family history should be combined with physical assessment during health promotion to improve early detection and disease prevention. Family history is an effective screening tool that ensures that moderate-risk or high-risk people benefit from more targeted interventions (Chigonda, 2022) (family history-Nursing Paper Examples).

A DNP-prepared nurse can incorporate genetics and genomics into their practice by encouraging individuals or families to maintain their family history and share the information with various health providers. The nurse can also record, track, and update patients’ family histories, such as children’s immunization schedules to improve the quality of care toward mitigating diseases in the families (family history-Nursing Paper Examples).

Chigonda, R. L. (2022). A Systematic Review on Evolving the Bowel Cancer Screening Programme in England: Targeted Screening for Individuals with First-Degree Family History of Bowel Cancer. https://orcid.org/0000-0001-7022-1560

Great post! Your discussion is informative and fascinating. I agree that incorporating family history in physical assessment during health promotions allows healthcare professionals to devise informed treatment plans for patients, leading to improved care quality and positive health outcomes. Family history should comprise behavioral and environmental factors influencing various family members (Prom-Wormley et al., 2021) (family history-Nursing Paper Examples).

For instance, chronic multifactorial diseases such as diabetes and cardiovascular conditions may have genetic influence and behavioral and environmental factors within the family unit. In this case, DNP-prepared nurses can integrate genetics and genomics by encouraging their patients to adopt healthy lifestyles such as healthy eating and physical activity to reduce the risks of developing the conditions even though they are genetically predisposed (family history-Nursing Paper Examples).

Prom-Wormley, E. C., Clifford, J. S., Bourdon, J. L., Barr, P., Blondino, C., Ball, K. M., … & Newbille, C. (2021). Developing community-based health education strategies with family history: assessing the association between community resident family history and interest in health education.  Social Science & Medicine ,  271 , 112160. https://doi.org/10.1016/j.socscimed.2019.02.011

Great post! Your discussion is educative and engaging. I support your claims that family history is one of the fundamental tools for all healthcare professionals to determine the inheritance pattern of different disorders among families. It aids in determining differential diagnoses, identifying necessary genetic tests, and devising individualized care plans for different patients (family history-Nursing Paper Examples).

In addition, family history is a vital clinical tool that guides disease management by considering genetics among individuals while acknowledging their effects from environments shared by a family unit (Li et al., 2012). The tool improves physical assessment and health promotion by developing awareness and genetics-related health information for different conditions across diverse populations. Therefore, DNP nurses can integrate genetics and genomics into their practice by ordering genetic tests and providing pre- and post-genetic test counseling to improve patient health outcomes (family history-Nursing Paper Examples).

Li, M., Zhao, S., Young, C. M., Foster, M., Wang, J. H. Y., Tseng, T. S., … & Chen, L. S. (2021). Family health history–based interventions: A systematic review of the literature.  American Journal of Preventive Medicine ,  61 (3), 445-454. https://doi.org/10.1016/j.amepre.2021.03.022

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Home — Essay Samples — Life — Family History — An Overview Of My Family History

An Overview of My Family History

• Categories: About Myself Family History Who Am I

About this sample

Words: 723 |

Updated: 1 December, 2023

Words: 723 | Pages: 2 | 4 min read

Works Cited

• The Holocaust Encyclopedia. (2022). United States Holocaust Memorial Museum. Retrieved from https://encyclopedia.ushmm.org/
• Protestantism. (2023). Encyclopedia Britannica. Retrieved from https://www.britannica.com/topic/Protestantism
• Janette Smith's Life Story: A Journey of Faith and Family. (n.d.). Personal memoir.
• Assembly of God. (n.d.). ReligionFacts. Retrieved from https://www.religionfacts.com/assembly-god
• The Woman's Hospital of Texas. (n.d.). Retrieved from https://www.texaschildrens.org/locations/womans-hospital-texas
• NASA's Space Shuttle Columbia Disaster: STS-107. (2023). NASA. Retrieved from https://www.nasa.gov/columbia/home/STS-107.html
• Hurricane Katrina. (n.d.). National Geographic. Retrieved from https://www.nationalgeographic.org/article/hurricane-katrina/

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