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Is There a Space for Place in Family History Assessment? Underserved Community Views on the Impact of Neighborhood Factors on Health and Prevention

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Abstract

Family health history tools rarely incorporate environmental and neighborhood factors, although the social and physical environments in which people live are recognized as major contributors to chronic diseases. This paper discusses beliefs about neighborhood influences on chronic disease risk among racially and ethnically diverse individuals in low-income communities in Cleveland, Ohio. We report findings from a qualitative study consisting of 121 interviews with White, African American, and Hispanic participants. Results are organized into four major themes: (1) social and economic environment, (2) physical environment, (3) barriers to healthy behaviors, and (4) participants’ views on integrating genetic and non-genetic determinants of health to understand and address disease prevention and management. Findings suggest that integrating environmental factors into family health history assessments would better reflect lay perceptions of disease causation. Results have implications for improving patient-clinician communication and the development of strategies to prevent and manage chronic diseases.

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Acknowledgments

Additional research team members include Sanjur Brooks, Kari Colon-Zimmermann, and Laura Morello, as well as Ash Sehgal and Michele Abraham at the Case Center for Reducing Health Disparities, Case Western Reserve University. We are grateful to members of our Community Advisory Board and Community Partners Network for their support and assistance in developing, executing, and disseminating findings from this study. We are also grateful to Jennifer Hartmann for editorial advice. This study was supported by an NIH grant from the Center for Minority Health and the National Human Genome Research Institute (1RC1HG005789-01). We also acknowledge support from NIH-NHGRI (5P50-HG-003390-07), The Center for Genetic Research Ethics and Law (CGREAL).

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The authors declare that they have no conflicts of interest.

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Authors and Affiliations

  1. Department of Bioethics, School of Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH, 44106, USA

    Christopher D. Hartmann, Patricia A. Marshall & Aaron J. Goldenberg

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  1. Christopher D. Hartmann
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  2. Patricia A. Marshall
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  3. Aaron J. Goldenberg
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Correspondence to Aaron J. Goldenberg.

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Hartmann, C.D., Marshall, P.A. & Goldenberg, A.J. Is There a Space for Place in Family History Assessment? Underserved Community Views on the Impact of Neighborhood Factors on Health and Prevention. J Primary Prevent 36, 119–130 (2015). https://doi.org/10.1007/s10935-015-0384-5

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