By MERCEDES CARNETHON PhD
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.