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Talking About the Generations: The Health and Healthcare of Boomers, Gen Xers, Millennials and Gen Zers. Part 3, Millennials

MHE PublicationMHE April 2024
Volume 34

Millennials (1981–1996), burdened by health problems and costly

Third of four parts

In 2019, the baby boomers lost their top spot as the largest living generation. Using U.S. Census Bureau estimates, researchers at the Pew Research Center tallied 72.1 million millennials, a smidgen more than the 71.6 million baby boomers, many of whom are parents of the generation that now outnumber them.

But the power of their numbers is not protecting millennials from a slew of health problems, many of which predate the COVID-19 pandemic and, in some cases, the epidemic seems to have made worse.

The Blue Cross and Blue Shield Association published a report on the health of millennials in 2019. Based on an analysis of 55 million commercially insured millennials (people ages 21 to 36 years old in 2017), the association’s researchers found the group healthy overall. But digging a little deeper, they found a higher prevalence of everything from hyperactivity to Crohn’s disease and ulcerative colitis to major depression among older millennials (people 34 to 36 years old) than among Gen Xers had when they were that age.The researchers also noted steep increases in the prevalence of major depression, hyperactivity and type 2 diabetes among millennials from 2014 to 2017.

A year later, a follow-up report from the association that focused on the behavioral health of millennials found that the prevalence of major depression, alcohol use disorder and substance use disorder had increased in just a year’s time. The report noted that the pandemic and social distancing were associated with increases in drinking, smoking, vaping and nonmedical drug use that was likely to lead to an increase in abuse disorders. According to the report, nearly one-third of millennials had a behavioral health condition and those conditions were associated with an approximate doubling of physical health conditions, including hypertension, type 2 diabetes and coronary
artery disease.

A 2022 UnitedHealthcare white paper on millennials paints a similar picture of a generation burdened by health conditions and related costs. The white paper is based on UnitedHealthcare claims data for 126,000 people from April 2021 through March 2022. The insurer’s analysis found that people with diabetes in the millennial generation had more than double the number of hospital admissions than Gen Xers with the disease, even though Gen Xers are older. The researchers identified the same pattern of greater utilization of some types of healthcare (emergency room visits and hospital admissions)by millennials compared with Gen Xers among those with hypertension and obesity.

UnitedHealthcare’s numbers suggest that the pandemic resulted in a greater increase in behavioral health problems among Gen Zers than among millennials. Still, there are behavioral health hotspots. The report notes that in 2022, 38% of the diagnoses for post-traumatic stress disorder were among millennials when they accounted for just 24% of the
individuals in the database.

Countless articles have been written about the declining birthrate in the U.S., and millennials are currently in the prime reproductive years. Nevertheless, pregnancies are expensive, and they were the single largest clinical cost in the commercially insured population analyzed in the UnitedHealthcare white paper, accounting for 21% of employer per-member, per-month spend, the author said. Employers paid between $17,000 and $27,000 per pregnancy, with costs increasing because of fertility treatments, high-risk pregnancies and other factors, according to the white paper.The white paper says that 9.2% of births were preterm among millennials, which was 0.4 percentage points higher than the proportion among Gen Xers.

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