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Issue 6, July 2000, pp.4.

Reports from the Programme conference:
The influence of family patterns of ill-health and early life experiences on behaviour in mid-life
Kate Hunt, Graham Watt and Carol Emslie

The reduction in coronary heart disease (CHD) and in inequalities in CHD is a public health priority. Some of this could be achieved through changes in behavioural risk factors for CHD. However, decisions about such behaviours are complex and take account of many factors, including knowledge about the lives and health experiences of family members. In this study we conducted in-depth interviews with 61 people in their forties to examine whether ideas about 'family histories' of heart disease influenced decisions about health-related behaviours.

The study confirmed the importance of 'heredity' in lay notions of the causes of heart problems. However, while some people saw themselves as definitely 'having' a family history of heart problems, others (in particular men in manual socio-economic groups, i.e. those at highest risk of CHD) were much more ambivalent. People often made a distinction between inherited risk within their family as a whole and for themselves personally. Thus, believing that heart disease 'ran' in the family was not automatically translated into a belief that they themselves were at higher risk, or that they should be particularly careful about health-related behaviours.

The research highlighted some specific ways in which coronary advice is discounted or undermined. Lack of certainty in predicting coronary events at an individual level and the perception of heart disease as a 'good way to go' were two such barriers. Another barrier which people identified was the notion of 'legacies' from their past. Family history, past exposure to tobacco smoke and past diet were commonly mentioned. Thus, some people felt that behavioural change was not sufficient to counteract past experience and exposures.