Young People Need To Turn Out For Their Health


This month, we saw historic turnout at the polls for midterm elections with over 114 million ballots cast.  One noteworthy observation regarding voter turnout is record rates of participation by younger voters aged between 18 to 29 years old.  Around 31 percent of people aged 18 to 29 voted in the midterms this year, an increase from 21 percent in 2014, according to a day-after exit poll by Tufts University.

Surely their political engagement counters the criticism that millennials are disengaged and disconnected with society and demonstrates that millennials are fully engaged when issues are relevant to them, their friends, and their families. Why, then, do we not see the same level of passion, engagement and commitment when young adults are asked to consider their health and well-being?

I have had the privilege of being a member of the National Heart, Lung and Blood Institute-funded Coronary Artery Risk Development in Young Adults (CARDIA) study research team. In over 5,000 black and white adults who were initially enrolled when they were 18 to 30 years old and have now been followed for nearly 35 years, we have described the decades-long process by which heart disease develops. We were able to do this because, in the 1980s when these studies began, young adults could be reached at their home telephone numbers. When a university researcher called claiming to be funded by the government, there was a greater degree of trust.

Unfortunately, that openness and that trust has eroded, particularly in younger adults and those who may feel marginalized from our society for any number of valid reasons. However, the results—unanswered phone calls from researchers, no-shows at the research clinic and the absence of an entire group of adults today from research studies, looks like disengagement. Disengagement is a very real public health crisis with consequences that are as dire as any political crisis.

As a public health researcher who has been documenting trends in obesity and heart disease for nearly two decades, a number of frightening patterns have arisen.  One pattern is that three out of every four adults are now overweight or obese and the average age of onset of obesity-related illnesses such as diabetes is falling.  Heart disease and chronic heart failure are developing in middle-age—a time that compromises financial well-being secondary to missed days of work managing illness. The negative implications for caring for growing families and aging parents are obvious.  A frightening harbinger of our future are the children and adolescents who see and feel the impact of these illnesses, but who don’t know how to prevent them because the research studies that have identified risk factors have little relevance to their lives today.

The reason they do not have these answers is related to the second startling pattern that young adults are even more difficult to engage in medical and public health research than their older counterparts. I have led and been a member of many research teams and we are extremely grateful for the retired grandmothers and the reluctant, but willing, grandfathers who donate their time to answer questions about their health and allow us to poke, prod and test them.

Due to their participation, we have identified the major causes of cardiovascular disease in the population. However, our knowledge about the evolution of obesity and cardiovascular disease in young adults is limited to studies that were formed in the 1980s before our social and cultural landscape was dotted with mobile devices, online communications and concerns about safety and privacy.

Young adults certainly have many competing responsibilities, including finishing their education, starting first jobs and building their own families. To saddle them with another responsibility seems unfair.  However, just as participating in our political system is one of our many rights and responsibilities as citizens, participating in our public health system should be, too. Ultimately, the goals of public health are to protect the health of all citizens and promote wellness. The national fervor and debate about health care demonstrate the passion people have for health. We need for young adults to stand together and show up to participate in their health with the same fervor and passion with which they showed up at the polls.

Mercedes Carnethon is the Mary Harris Thompson Professor of Preventive Medicine and Chief of Epidemiology at the Northwestern University Feinberg School of Medicine and a Public Voices Fellow with The OpEd Project.

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  2. First, when young people show up to the polls, they learn within one 4 year election cycle that they were used, lied to, and subsequently forgotten about. So they don’t show back up. There was a lot of momentum behind health care…putting together a health delivery system that takes care of everyone. That is not what they got. They got a huge insurance company and pharma giveaway, and an increased privatization…excuse me, profitization of Medicare and Medicaid.
    Second, there is no remaining mystery why they are becoming sicker. There is no point in doing any further public health research when public health does not have the power to correct the current problems facing that generation. Young people are being filled with massive amounts of corporate garbage masquerading as food on the background of sedentary life fueled by relentless stress, drugs, and generalized consumerism.
    So, lets take CARDIA for instance: what tangible outcomes have been produced because of that research? What can we tell the next generation was accomplished and why should they participate in anything similar?

    • Its hard to ignore the level of institutional codependency that masquerades as our nation’s strategy for healthcare reform. And, we now find out that the treatment of prostate cancer does not change longevity and only serves to aggravate a person’s quality of life while waiting it out.

  3. Professor Carnethon indirectly describes another attribute of our nation’s loss of social cohesion and its associated Social Capital. If you are wondering why the number of mass shootings from 1985-1999 through 2000-2015 increased by 234%, look no more. This is also the same level of worsening in our nation’s maternal mortality incidence during the last thirty years.

    As a reminder, here is a contemporary definition of SOCIAL CAPITAL. It represents:
    .a community’s norms of Trust, Cooperation and Reciprocity that
    .its citizens spontaneously express for resolving the Social Dilemmas
    .they encounter daily within their community’s municipal life
    .WHEN Caring Relationships are persistently nurtured
    .within the social network’s of the community’s citizens,
    .especially the enduring Caring Relationships occurring
    .within the next-door-Neighbor Network of each citizen’s Family.

    Best mass shootings analysis: https://doi.org/10.1002/jip.1491

    Best classic summary of Social Capital issues (Putman):

  4. Well on the bright side voter participation amongst the 18-29 year olds went up by 50%. But in reality 31% is pathetic. If they voted at 65% college, health care, the criminal justice system and the environment would look WAY different. and yes they might take part in clinical research too…so sad

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