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July 25, 2019

DES MOINES, IA – New data from Wellmark Blue Cross and Blue Shield shows Iowa millennials — those born between 1981 and 1996 — are experiencing an increase in the prevalence of health conditions that will reduce their quality of life and life expectancy. In fact, they are less healthy than Generation X during the same period of time in their life.

"The data was startling," said Laura Jackson, Wellmark's chief health officer. "Traditionally, we start to see a decline in health when an individual is in their mid-30s. For millennials it is age 27."

The top-10 health conditions impacting the millennial generation are: depression, substance use disorder, alcohol use disorder, hypertension, hyperactivity, psychotic disorders, Crohn's disease and ulcerative colitis, high cholesterol, tobacco use disorders and Type 2 diabetes. The prevalence rate for these conditions compared to the national average was also revealed.

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Prevalence Rate for Top-10 Conditions of the Millennial Generation (Rate Per 100)

Major depression

  • National 2017 prevalence: 5
  • Iowa 2017 prevalence: 6.3

Substance use disorder

  • National 2017 prevalence: 2
  • Iowa 2017 prevalence: 1.3

Alcohol use disorder

  • National 2017 prevalence: 1.5
  • Iowa 2017 prevalence: 1.5


  • National 2017 prevalence: 8.1
  • Iowa 2017 prevalence: 6.1


  • National 2017 prevalence: 6.8
  • Iowa 2017 prevalence: 5.2

Psychotic disorders

  • National 2017 prevalence: 0.9
  • Iowa 2017 prevalence: 0.6

Crohn's Disease/ulcerative colitis

  • National 2017 prevalence: 1
  • Iowa 2017 prevalence: 0.7

High cholesterol

  • National 2017 prevalence: 6.2
  • Iowa 2017 prevalence: 3.5

Tobacco use disorder

  • National 2017 prevalence: 5.6
  • Iowa 2017 prevalence: 5.4

Type II diabetes

  • National 2017 prevalence: 2.3
  • Iowa 2017 prevalence: 1.6

Most notably, Wellmark's Iowa millennial population has a higher rate of depression than the national average.

"Even though our members born in the millennial generation are healthier than the national average in all other categories, we cannot dismiss the national trend," said Jackson. "There are nearly 73 million millennials in the U.S. today, and it's projected that next year millennials will represent half of the workforce. These health conditions and the impact they have on productivity, absenteeism and heath care costs cannot be ignored. More importantly, we want to help everyone live a long and healthy life."

Millennial health forum uncovers several key themes

As a first step to learn what could be done to reverse this troubling trend, Wellmark and the Greater Des Moines Partnership held an invitation-only forum to address these critical issues. On July 18, professionals from the millennial generation, corporate executives, human resource managers, health care providers, and community leaders engaged in a thoughtful dialogue, and began identifying challenges and solutions to create a future of better health for this generation.

A few highlights of the key takeaways from the forum centered on behavioral health. They included:

  • A stigma around behavioral health conditions still exists. Employees are reluctant to tell their employers they are seeking care. As a result, they delay scheduling appointments or attempt to schedule them outside work hours. One way to bridge this gap is telemedicine. This makes it easier to schedule care when it fits an individual's schedule.
  • Clinician participants also noted that primary care physicians are also changing the way they view behavioral health. They are starting to recognize the link between mental and physical health. Also, an increasing number of primary care doctors are treating behavioral health conditions. This highlights the need for greater education and care coordination between and among behavioral health clinicians and primary care doctors.
  • Many millennials do not "have" a primary care doctor – this was both stated and proven in the data. Instead, they tend to go to urgent care more often because the perception is that primary care doctors are not immediately available or are only open during traditional business hours. This need for immediacy also extends to treatment of behavioral health conditions. For example, Millennials want to see instant results from medications.
  • Millennials also feel they are under constant pressure to meet and exceed expectations in every aspect of their lives, largely fueled by social media. The constant feed of information is impacting their outlook on life both positively and negatively, in some cases leading to social isolation. This pressure could be one reason we see an increase in behavioral health conditions.
  • When it came to the workplace, Millennials put an emphasis on non-health related benefits such as loan/tuition reimbursement, financial planning, work from home/flexible work hours and on-site wellness classes like meditation. They commented that this may help them better manage stress. Additionally, they want their employers to serve a more prominent role in connecting them to health care providers and other health and non-health resources.

"We are grateful for all the input received during this forum," said Jackson. "We are continuing to dig deeper into the feedback to understand these themes and determine solutions that will work best for everyone. We realize how important this work is as we continue to build a future of better health for this generation."

The information gathered at the Wellmark and Greater Des Moines Partnership event will be combined with other listening sessions being held across the country. The Blue Cross Blue Shield Association will debut the information and proposed initiatives to improve millennial health at a national Health of America conference in November of this year.

Community-specific millennial health information is also available for: the Greater Des Moines Region PDF File , Cedar Rapids/Iowa City PDF File , Quad Cities PDF File and Cedar Falls/Waterloo PDF File .