Recent generations show a worrying decline in health compared to their parents

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Recent generations show a worrying decline in health compared to their parents and grandparents when they were the same age, a new national study reveals.

Researchers found that, compared to previous generations, members of Generation X and Generation Y showed poorer physical health, higher levels of unhealthy behaviors such as alcohol use and smoking, and more depression and anxiety.

The results suggest the likelihood of higher levels of diseases and more deaths in younger generations than we have seen in the past, said Hui Zheng, lead author of the study and professor of sociology at The Ohio State University.

“The worsening health profiles we found in Gen X and Gen Y is alarming,” Zheng said.

“If we don’t find a way to slow this trend, we are potentially going to see an expansion of morbidity and mortality rates in the United States as these generations get older.”

Zheng conducted the study with Paola Echave, a graduate student in sociology at Ohio State. The results were published online yesterday (March 18, 2021) in the American Journal of Epidemiology.

The researchers used data from the National Health and Nutrition Examination Survey 1988-2016 (62,833 respondents) and the National Health Interview Survey 1997-2018 (625,221 respondents), both conducted by the National Center for Health Statistics.

To measure physical health, the researchers used eight markers of a condition called metabolic syndrome, a constellation of risk factors for heart disease, stroke, kidney disease and diabetes. Some of the markers include waist circumference, blood pressure, cholesterol level and body mass index (BMI). They also used one marker of chronic inflammation, low urinary albumin, and one additional marker of renal function, creatinine clearance.

The researchers found that the measures of physical health have worsened from the baby boomer generation through Gen X (born 1965-80) and Gen Y (born 1981-99). For whites, increases in metabolic syndrome were the main culprit, while increases in chronic inflammation were seen most in Black Americans, particularly men.

“The declining health trends in recent generations is a shocking finding,” Zheng said. “It suggests we may have a challenging health prospect in the United State in coming years.”

Zheng said it is beyond the scope of the study to comprehensively explain the reasons behind the health decline. But the researchers did check two factors. They found smoking couldn’t explain the decline. Obesity could help explain the increase in metabolic syndrome, but not the increases seen in chronic inflammation.

It wasn’t just the overall health markers that were concerning for some members of the younger generations, Zheng said.

Results showed that levels of anxiety and depression have increased for each generation of whites from the War Babies generation (born 1943-45) through Gen Y.

While levels of these two mental health indicators did increase for Blacks up through the early baby boomers, the rate has been generally flat since then.

Health behaviors also show worrying trends.

The probability of heavy drinking has continuously increased across generations for whites and Black males, especially after late-Gen X (born 1973-80).

For whites and Blacks, the probability of using street drugs peaked at late boomers (born 1956-64), decreased afterward, then rose again for late-Gen X. For Hispanics, it has continuously increased since early-baby boomers.

Surprisingly, results suggest the probability of having ever smoked has continuously increased across generations for all groups.

How can this be true with other research showing a decline in overall cigarette consumption since the 1970s?

“One possibility is that people in older generations are quitting smoking in larger numbers while younger generations are more likely to start smoking,” Zheng said. “But we need further research to see if that is correct.”

Zheng said these results may be just an early warning of what is to come.

“People in Gen X and Gen Y are still relatively young, so we may be underestimating their health problems,” he said. “When they get older and chronic diseases become more prevalent, we’ll have a better view of their health status.”

Zheng noted that the United States has already seen recent decreases in life expectancy and increases in disability and morbidity.

“Our results suggest that without effective policy interventions, these disturbing trends won’t be temporary, but a battle we’ll have to continue to fight.”


Among both children and adults, Quality of Life (QOL) or Health Related Quality of Life (HRQOL) have increasingly been used as health outcome measures [1]. There are various definitions of these concepts in the literature. The World Health Organization defines quality of life (QOL) as “an individual’s perception of their position in life in the context of the cultural and value systems in which they live and in relation to their goals, expectations, standards and concerns” [2].

HRQOL denotes aspects of the quality of life that are related to an individual’s health. It is a multidimensional concept, that involves physical, mental and social components of well-being and functioning as perceived by a person or patient or other observers [3, 4]. HRQOL is often self-reported in questionnaires.

In health promoting interventions, assessment of HRQOL can guide the development of effective intervention strategies [1].

Young people generally report good health, but health is not evenly distributed. Children report better health than adolescents, and boys generally report higher HRQOL, more positive mental health and fewer psychosomatic problems than girls [5,6,7,8]. Moreover, there are socioeconomic differences in health in both children and adults [9, 10].

Previous research has shown that children in families with low socioeconomic position, as well as those with migration background, have lower self-reported health [5, 6]. Poor living standard has also been shown to be associated with increased mental health problems among children [5, 6]. In Sweden, the proportion of 13- and 15-year-old children reporting psychosomatic health problems has doubled since 1985 [6, 11].

Today, more than half of 15-year-old girls and about a third of boys the same age report multiple health complaints [6, 11]. In view of the decline in HRQOL with age, the differences with regard to socioeconomic position and gender, and the recent reports of increased psychosomatic health complaints among adolescents in Sweden, there is an urgent need to find strategies to promote health – including HRQOL – in young people. Increased physical activity (PA) has been recognized as a promising option for increasing HRQOL [12].

Regular physical activity has been associated with psychosocial, physical and cognitive health benefits in both children and adults [13,14,15,16,17]. Previous cross-sectional studies among children have shown that physical activity and, specifically, the amount of moderate-to-vigorous physical activity are positively associated with HRQOL and mental health [18, 19]. The social context of physical activity also matters: for example, involvement in team sports and sports at school has been shown to significantly predict higher self-reported mental health [18, 20,21,22].

The World Health Organization has developed physical activity recommendations for children, constituting of 60 min of daily moderate-to-vigorous physical activity [23]. However, a recent report [24] on a cross-section of Swedish children revealed that few children and adolescents reach recommended levels of physical activity and that physical activity declines during adolescence.

In grade five only 29% of girls and 50% of boys reach recommended level of physical activity [24]. An inactive lifestyle and sedentary behaviour – in particular screen time among adolescents – are associated with poor mental health [25, 26]. Previous research has stressed the importance of promoting physical activity during childhood, since an active lifestyle, including participation in sport early in life, is associated with higher HRQOL, lower incidence of mental health disorders, and a greater likelihood of continuing to be active later in life [26,27,28].

A growing body of research has focused on physical activity interventions in the school context to promote physical activity [29], although the effect of such interventions on HRQOL is unclear. Several studies have therefore recently highlighted the importance of conducting physical activity interventions that include a broader spectrum of children’s environment to promote physical activity and HRQOL [30,31,32,33].

Patterns of physical activity among youth are influenced by individual, contextual, social and cultural factors such as families, the local community and the physical environment [31]. Parents play an important role in facilitating their children’s PA, for example through support, co-participation and encouragement [34].

Therefore, interventions aimed at the family as a whole may be a useful way to promote PA. However, little is known about the effect on such interventions on HRQOL. Additionally, most studies evaluating the effect of physical activity intervention on HRQOL in children have focused on specific groups and there is a scarcity of studies examining the effect within families in general populations.

We hypothesised that there would be an increase in HRQOL after participation in the programme A Healthy Generation and a stronger effect in participants with initial low values of HRQOL. In addition, we expected to see a family correlation in HRQOL, since family correlations have been reported in other health-related outcomes [35, 36].

The overall aim of the current study was to assess HRQOL in children and their parents after participation in the family programme A Healthy Generation. Specific aims were also to evaluate whether the intervention had an effect on a subpopulation with low baseline HRQOL scores, to explore HRQOL in relation to participation, and to evaluate within-family correlations of HRQOL.

reference link : https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-020-08895-z


More information: Hui Zheng et al. Are Recent Cohorts Getting Worse? Trends in U.S. Adult Physiological Status, Mental Health, and Health Behaviors across a Century of Birth Cohorts, American Journal of Epidemiology (2021). DOI: 10.1093/aje/kwab076

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