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Investing in the Health and Well-Being of Young Adults Materials from the Report

Young adulthood—ages approximately 18 to 26—is a critical period of development with long-lasting implications for a person’s economic security, health, and well-being. Young adults are key contributors to the nation’s workforce and military services and, since many are parents, to the healthy development of the next generation. Although “millennials” have received attention in the popular media in recent years, young adults are too rarely treated as a distinct population in policy, programs, and research. Instead, they are often grouped with adolescents or, more often, with all adults.

The Institute of Medicine (IOM) and National Research Council (NRC) 2014 report, Investing in the Health and Well-Being of Young Adults, offers federal, state, and local policy makers and program leaders, as well as employers, nonprofit organizations, and other community partners guidance in developing and enhancing policies and programs to improve young adults’ health, safety, and well-being. In addition, the report suggests priorities for research to inform policies and programs for young adults.

A Changed World, Different Pathways

Both today and in the past, the transition to adulthood has reflected the end of trial periods and the beginning of more consequential actions. But today’s world is more global and networked than in previous decades, and it is marked by increased knowledge and information transfer, heightened risks, fairly low social mobility, and greater economic inequality. These changes have placed greater demands on young adults while also providing less latitude for failure.

In previous generations, the path for most young adults was, generally speaking, to graduate from high school, enter college or the work¬force, leave home, find a spouse, and start a family. Today, those pathways are considerably less predictable, often extended, and sometimes significantly more challenging. This presents more choice and opportunity for some young adults and more barriers to others.
Marginalized young adults—such as those aging out of foster care, in the justice system, with disabilities or responsible for young children—are much less likely than other young adults to transition to adulthood successfully. Meeting the needs of marginalized young adults improves their lives and can potentially help them be fully contributing members of society. Absent deliberate action, however, this period of development is likely to magnify inequality, with lasting effects through adulthood.

Find out more about marginalized young adults

Principles to Guide Action

Young adults are resilient and adaptable, and many make remarkable accomplishments, demonstrating and extraordinary capacity for creative insight and innovation. At the same time, however, too many young adults are struggling to find a path to employment, economic security, and well-being. Healthy, productive, skilled young adults are critical to the nation’s workforce, global competitiveness, public safety, and national security. Providing more of the educational, economic, social, and health supports needed by all young adults—particularly those whose background and characteristics put them at risk of experiencing the greatest struggles—will ensure equal opportunity, erase disparities, and enable more young adults to successfully embrace adult roles as healthy workers, parents, and citizens. 

To help achieve this goal, the report offers the following principles to guide action: 

  • Principle 1: Pay specific attention to young adults in research and policy. 
  • Principle 2: Create economic opportunities for young adults. 
  • Principle 3: Allow flexibility in policies and programs for young adults. 
  • Principle 4: Invest in the least advantaged young adults. 
  • Principle 5: Use multigenerational strategies to support young adults and their children. 
  • Principle 6: Empower and engage young adults in policies and programs. 
  • Principle 7: Invest in preventive approaches to improve the health of young adults.

Differentiating Young Adults in Policies and Programs

Three themes emerged from the committee’s review of public and private policies and pro-grams pertaining to young adults in the areas of relationships, education and employment, civic engagement and national services, public health, health care systems, and government programs for marginalized young adults: 

1. Current policies and programs addressing young adults too often are fragmented and uncoordinated. 

2. These policies and programs often are inadequately focused on the specific developmental needs of this population. 

3. The evidence base on interventions, policies, programs, and service designs that are effective for young adults is limited in most areas. 

In response, the report calls for a coordinated effort by the public and private sectors to raise public awareness of the need to improve policies and programs that address the needs of young adults. In addition, it is important to engage young adults themselves in developing policies and programs that affect them. 

The report recommends that federal, state, and local governments and nongovernmental entities that fund programs serving young adults or research affecting the health, safety, or well-being of this population should differentiate young adults from adolescents and older adults whenever permitted by law and programmatically appropriate. This recommendation is not intended to imply the creation of an extensive set of new programs targeted only at young adults. Instead, the committee suggested the adaptation or creation of new policies, programs, and practices only when the evidence indicates that young adults’ specific needs are not being met. See chapter 9 in the report for a discussion of next steps.

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Surprisingly Unhealthy

Contrary to general perception, the report finds that young adults show a worse health profile than both adolescents and adults in their late twenties and thirties. Young adults are currently at the forefront of the obesity epidemic, and this age is also a time of heightened psychological vulnerability and onset of serious mental health disorders. Rapid technological changes, economic challenges, and a prolonged transition to adulthood appear to be contributing to the health problems of young adults by increasing their stress and sedentary habits while making them less likely to participate in work and family roles that tend to decrease risk taking. However, the majority of these health problems are preventable, meaning there are opportunities to intervene and promote lifelong health.

Find out more about young adults and public health


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As young adults face more challenges to their health and safety than is commonly assumed, public health programs and clinical preventive services for this population should be high priorities. Young adults have significantly lower rates of health care system utilization but significantly higher emergency room visit rates compared with those immediately younger and older than them. The ACA and other state-led efforts are notably increasing rates in health insurance coverage for many young adults, but the report says that too little attention has been paid to the specific health needs faced by young adults once they are in the health care delivery system. Expanding coverage is essential for young adults, but it is not enough to improve their health and well-being. 

The report therefore calls for additional actions to improve transitions from pediatric to adult medical and behavioral health care, expand and improve preventive care, and develop evidenced-based interventions for this age group.


Supporting Young Adults, Supporting their Young Children

Although young adults are less likely to be parents today than in the past, many young adults do become parents. Moreover, young people in this age range are more likely to become parents than people in any other age group; indeed, approximately half of all first births are to women aged 26 or younger. While some young parents thrive personally and are able to parent their children effectively, the challenges facing young parents are often great, and the stakes during these years are high, both for them and their young children.
 

The report highlights that investing in young adults has potential benefits for their young children and therefore can complement efforts to support the health, safety, and well-being of the youngest members of society. 

Find out more about young adults as parents



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Disclaimer: Quotations in yellow and green conversation bubbles are from members of a young adult advisory group that met with the IOM/NRC committee to provide input and feedback on the topics of the report. The advisory group members selected came with diverse perspectives and experiences, but their stories and views are not intended to be representative of all young adults or of the IOM, NRC, or the committee.