Health risk assessment and family history: Toward disease prevention

Abstract This chapter will focus on family history as it related to prevention of autoimmune diseases. Family history offers opportunity for prevention since these relatives are at increased risk due to shared genetics and lifestyle. We will first discuss family history as a construct including difficulties in its verification, psychosocial factors that may influence willingness to participate in prevention strategies, and possible pleiotropic effects on disease presentation and course. We will then discuss how family history may impact primordial, primary, secondary, and tertiary prevention through lifestyle modification and pharmacologic strategies, using rheumatoid arthritis as an example autoimmune disease. We highlight how precision medicine offers the ability to personalize prevention approaches among family members who may be at risk for autoimmune disease.