Think Tanks
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The King's Fund - How healthy are Gen Z?
The government wants Gen Alpha (born after 2012) to be ‘the healthiest generation of children ever’, but what about Gen Z? While some of Gen Z (currently aged 13–28) are still categorised as children, a large proportion are transitioning into adulthood or are already fully fledged adults. So, were Gen Z any healthier than previous generations? And is there anything the government can learn from the changing health patterns of this generation?
The stats for people aged 16–24 (a common age bracket when it comes to health statistics) suggest some positive long-term shifts in health behaviours and outcomes. These shifts have ultimately led to avoidable mortality in 20–24-year-olds falling over the last 20 years. Many factors have contributed to these shifts, including changing cultural norms and a willingness from a new generation to change their behaviour, which can be observed in England and other countries. Wider environmental pressures have also changed. Gen Z is less likely to have disposable income to spend on unhealthy habits, and the internet and technology have changed how Gen Z access health information and services.
But it’s also notable how many of these shifts are associated with significant national government policy interventions:
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Cervical cancer in women under 30 has fallen rapidly since the rollout of the HPV vaccine to school-aged girls in 2008.
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Rates of teenage pregnancy have halved since Gen Z started becoming teenagers. This shift is often accredited to the national teenage pregnancy strategy which ran between 1999 and 2010.
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Rates of smoking, alcohol consumption and drug usage in younger populations have all fallen (see figure below). This coincides with the introduction of the indoor smoking ban and stricter regulations on smoking and alcohol advertisement.
This should be positive news for the government. It shows that focused national health policy can be an effective lever in shifting the health of a generation.
However, the stats also show some worrying shifts in the health of Gen Z. If the previous government had wanted to make Gen Z the healthiest generation of children, they should have done two things – both of which are good lessons for future children’s health policy.
First, they should have done more to address the wider determinants of health. For example, a key wider determinant of health is poverty and this age group has the highest rate of adults living in relative poverty1. Poverty and deprivation are associated with higher rates of obesity so addressing these wider issues could have helped prevent the steady increase in the proportion of people aged 16–24 that are overweight or obese.
Second, they should have anticipated and adapted to new areas of rising demand for services. New trends specific to Gen Z include a rise in mental health disorders – the proportion of 17–19-year-olds with a probable mental health disorder has more than doubled between 2017 and 2023. Disability rates have risen too: the proportion of people aged 15–24 with a disability more than doubled between 2011 and 2021. Gen Z are now struggling to access support for these conditions because services have not kept up with demand.
Going forward the government also needs to anticipate a changing relationship between younger generations and the NHS. There are signs that Gen Z could become increasingly disengaged with NHS services. For example, people aged 16–35 report poorer experiences than older adults across a range of NHS patient surveys including the GP patient, inpatient, UEC and community mental health surveys. Gen Z are also more likely to use private health care. 42% of 18–24-year-olds reported that they were likely to use private health care in the next year if needed, and an increasing proportion of 20–29-year-olds are using private insurance to pay for procedures. To improve the health of younger generations, the government either needs to re-engage Gen Z with NHS services or health policy needs to increasingly look beyond the NHS to shift health outcomes.
So, Gen Z are a healthier generation in some ways but not others. The government should be reassured that targeted policy interventions can shift the health of a generation. However, the shifts in the health of Gen Z should be a warning. If Gen Alpha are going be the healthiest generation of children ever, the government needs to be ready for the new trends that are emerging in younger generations. They should also use these lessons to help improve the future health of Gen Z, even though many of them are no longer children, as there is no guarantee the positive health behaviours seen in Gen Z will stick long-term into adulthood.
