Pedigree Analysis of Addiction

Pedigree Analysis

I discovered several diseases and traits for which I have a high risk of inheritance, namely chronic lung disease and lung cancer associated with smoking tobacco, hypertension and high cholesterol, an addictive disorder. Each of these illnesses appears more than once in my family pedigree, posing a significant threat to my own health history. Luckily, although I may be predisposed to these adverse health outcomes, their manifestation depends on several behavioral and environmental conditions that are entirely avoidable. The family history pedigree displayed my vulnerabilities and shed light on the importance of cultivating preventive strategies to ameliorate risks and reduce the chances of succumbing to diseases and heritable traits.

At age 30, I am fully responsible and engaged in my own self-care, treatment, and prevention. However, when I was a child, the risk behaviors, social psychologic stressors, and environmental circumstances that made up my health history was determined by my parents; and thus, any attempt at an early intervention targeting the patterns and probability of inheritance was thwarted by familial culture, health beliefs, and the willing to accept medically prescribed lifestyle change to prevention disease and poor health outcomes. I was only five years old when I first had my cholesterol checked and found that my maternal grandfather’s chronic high cholesterol had presented itself in me. The cardiologist charged with my care made it clear to my parents that my condition would get worse if there were mot systemic changes to my lifestyle. Only after the onset of illness and subsequent shocks to the behaviors and norms embodied by patterns of risk, did my family choose to comply with medical assessment and change course for me to avoid any further etiological developments.

This story is important for understanding my family health history, but it also serves as a representational strategy for public health capacity to address the deficit of biomedical knowledge in many communities, as well as the need for epidemiological outreach to promote awareness of risk behaviors and education families on ways they can prevent chronic and infectious disease.

Family history and pedigree analysis are essential components of population health that should not be siloed by institutional practice; but made universally accessible to individuals and communities vested in healthy living and disease prevention. The second-generation pedigree I used to visualize inheritance patterns, agency, and the environment, facilitated my analysis of family health histories as a primary function of self-care. Pedigree analysis aided my interpretations of health, history, and consanguinity in the development of knowledge=based systems to assess risk and evaluate the phylogenetic variance and environmental triggers contributing to etiological inevitabilities.

I did not expect to be shocked, but my completed pedigree exposed the ubiquity of addiction in my family, which, for me, means the risk of developing a substance abuse etiology is highly probably. Or, as is evident in my medical record, the need to critically examine the factors and influences that lead to drug use disorders is imperative to prevent further development of this disease. For public health, identifying variables in etiological research that contribute to addiction disease heritability and analysis of the likely causes and correlates of drug use, can advance epidemiological interests in prevention and treatment of substance abuse disorders. Though it will likely present a challenge for investigators to set aside their quantitative data collection tools and embody holism in understanding the myriad of ways in which individuals cultivate an addictive condition; thus, having enjoyed the gains of pedigree analysis, inquiring minds that learn to see what risk factors can be identified in narrative analysis of addiction from other perspectives, be it emic, etic, or intersubjective. The utility of etiological theories grounded in our observations and participatory experiences of addiction will offer novel insights into the interconnectedness of disease risk, resilience, and vulnerability in development of drug use disorder.