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Generation Y: Answering three critical questions about millennials and behavioral health

With today’s technological advances, medical innovations and unprecedented access to information, you might expect millennials, who were born between 1981 and 1996, to be ahead of the curve when it comes to their own health. However, according to a report by the Blue Cross Blue Shield Association (BCBSA), the opposite is true.

Focusing on the 55 million millennial Americans who are commercially insured, the report highlights some alarming trends about millennial health, and behavioral health (including mental health and substance use disorders) in particular. Below, we’ll answer three questions about these trends, including what we’re doing to make a difference.

1. What’s going on?

The good news is that according to the Blue Cross Blue Shield (BCBS) Health Index, millennials as a whole were living at 95 percent of their optimal health. However, a deeper analysis of older millennials, those between the ages of 34 and 36, showed higher prevalence rates compared to Generation X for nearly all of the top 10 health conditions that Millennials face. The takeaway message: By age 35, Millennials are less healthy compared to previous generations, driven by their increased rates of cardiovascular disease, diabetes and behavioral health disorders.

Remarkably, six of the top 10 health conditions impacting Millennials are related to behavioral health, and those rates are continuing to increase. From 2014 to 2017, all of the behavioral health conditions below saw an increase among the millennial population (age 21 to 36):

  • Major depression – 31% increase
  • Hyperactivity – 29% increase
  • Psychotic conditions – 15% increase
  • Substance use disorder – 10% increase
  • Tobacco use disorder – 7% increase
  • Alcohol use disorder – 1% increase

It’s also worth noting that the total adverse health for millennial women is 20 percent worse than for millennial men. For behavioral health conditions, this gap is mainly driven by higher rates of major depression.

2. Why is this happening?

To understand these behavioral health trends, we need to examine how millennials’ thoughts and attitudes about health differ from those in other generations. When BCBSA and other BCBS companies held listening sessions across the country to understand millennials’ health care expectations, needs and challenges, they made several interesting discoveries:

  • Only 49% think their mental health is good or excellent, compared to 56% of Gen Xers and 69% of Baby Boomers. But encouragingly, millennials are more comfortable talking about their mental health, which decreases stigma around accessing behavioral health care.
  • They want seamless care between primary care providers and behavioral health specialists. They believe the mind and body are connected, and seventy-three percent think that mental health counseling needs to change.
  • Financial concerns are impacting whether they seek medical care and affecting their emotional well-being. Fifty-four percent think of their financial status before making health care decisions, 49% feel stressed over the amount of debt they have and 38% have student loan debt that causes them stress.
  • Loneliness is contributing to increases in anxiety and depression. This is in line with a YouGov study that found 30% of millennials report they are often or always lonely.
  • They don’t only want digital health solutions. Millennials want quick and convenient access to care, but they also want to have trusted relationships with their providers.

3. How is Blue Cross NC addressing these challenges?

At Blue Cross and Blue Shield of North Carolina (Blue Cross NC), we believe high-quality health care should be available to all North Carolinians. That’s why we’re taking action to increase access to behavioral health services and improve health overall:

  • Recruiting more behavioral health specialists so that more members can get the affordable care they need, whether via in-person visits or telehealth.
  • Incorporating behavioral health care into primary care, which has shown to be effective in improving access and whole-health outcomes.
  • Collaborating with companies to identify patients with underlying behavioral health conditions early and connect them to the right care.
  • Improving access to substance use treatment by working with Shatterproof, a nonprofit dedicated to ending addiction.

Millennials make up nearly a quarter of the total U.S. population, 30 percent of the voting population and will make up 75 percent of the workforce by 2030, according to research from the Brookings Institution. Because of this, their health status will have major impacts on our society in the years ahead. It is essential that we take steps today to ensure a healthier tomorrow. And all of us at Blue Cross NC will continue to invest in better behavioral health care for all North Carolinians.

authors photo
Kate Hobbs Knutson, MD, MPH
Kate Hobbs Knutson, MD, MPH

Dr. Kate Hobbs Knutson was the chief of behavioral health at Blue Cross NC from 2018 to 2020.

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