title: Is there a space for place in family history assessment? Underserved community views on the impact of neighborhood factors on health and prevention.
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.
authors: Department of Bioethics, School of Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH, 44106, USA.
authors: Christopher D
authors: CD
authors: Hartmann
authors: Patricia A
authors: PA
authors: Marshall
authors: Aaron J
authors: AJ
authors: Goldenberg
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease / Q000191:economics / Q000453:epidemiology* / Q000517:prevention & control; D004787:Environmental Pollution / Q000009:adverse effects; D005192:Family Health; D005260:Female; D005523:Food Supply; D020022:Genetic Predisposition to Disease; D054624:Health Status Disparities; D054625:Healthcare Disparities / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D017057:Medically Uninsured / Q000706:statistics & numerical data*; D008875:Middle Aged; D008913:Minority Groups / Q000523:psychology / Q000706:statistics & numerical data; D009820:Ohio / Q000453:epidemiology; D011204:Poverty Areas; D036301:Qualitative Research; D012111:Residence Characteristics; D012449:Safety; D012931:Social Environment; D013315:Stress, Psychological / Q000150:complications* / Q000503:physiopathology; D055815:Young Adult