I got a
Baby’s brain and an old man’s heart
Took eighteen years to get this far
Don’t always know what I’m talkin’ about
Feels like I’m livin’ in the middle of doubt
‘Cause I’m

Eighteen
I get confused every day
Eighteen
I just don’t know what to say
Eighteen
I gotta get away

— Lyrics from “I’m 18” by Alice Cooper

Very recently, two of my favorite people, Margaret Laws and Susannah Fox, together with Victoria Rideout and others, released a significant new study about teens/young adults and their use of the internet and social media for healthcare queries.  The study, entitled, “Digital Health Practices, Social Media Use, and Mental Well-Being Among Teens and Young Adults in the U.S.,” also studied the connections between self-reported social media use and mental well-being in this age group.  The study included more than 1,300 U.S. teens and young adults, ages 14 to 22, and was conducted in February and March 2018. The final report, which was commissioned by HopeLab, where Margaret is CEO, and The Well Being Trust was released July 31, 2018, and can be found here.

I was very interested to read this study, which I know they have worked on for ages, because in the healthcare world, there is so little information available about teens and young adults.  Considering that this population represents about a quarter of all people in the U.S., it is a pretty significant group worthy of consideration.  Considering that this population represents 33 percent of the people in my house, it is even more relevant!

I was also curious to know whether young people are using the internet for healthcare information. Certainly, most adults do, but when do young people become aware that this is a resource?  The study made it quite clear that young people are pretty savvy about this pretty early, as a vast majority of them reported searching for healthcare-related information.

Some of the key quantitative findings in the study are these:

• 87 percent of all teens and young adults say they have gone online for health information. The top five topics searched are fitness (63 percent), nutrition (52 percent), stress (44 percent), anxiety (42 percent), and depression (39 percent).
• 64 percent say they have used mobile apps related to health, including for fitness, sleep, meditation, and medication reminders. (We took out all the brand names, but tons of respondents named specific apps they love and use.)
• The majority of teens and young adults say they have read, listened to, or watched other people share about their health experiences online, whether in podcasts, TED talks, or YouTube videos.
• One third have successfully connected with health peers online, and 91 percent of them say the experience was helpful.
• One in five report having connected with health providers online, through tools like online messaging, apps, texting, and video chat.
• Females and LGBTQ youth are the most likely to report symptoms of anxiety & depression — and the most likely to be taking action to gather information about emotional well-being.

One of the more sobering findings in the study is in questions 28 and 29, where the respondents are asked about their mental health status over the last two weeks.  The numbers of kids and young adults who report being anxious, stressed, depressed, and otherwise quite distressed is remarkably high. Fifty percent report being nervous, anxious or on edge every single day or at least several days during that time period. About 43 percent say they have had trouble controlling their worrying in that period, 47 percent report having little pleasure doing things over the last two weeks, at least for several of the days and 43 percent report feeling down, depressed or hopeless during that period.  There is more here and it is so sad.

We like to think as kids as carefree and having it easy because they don’t have to, you know, hold down jobs and pay bills and take care of kids.  But the truth is that the data for kids is not far off from what we see for adults.  High levels of depression, anxiety, self-doubt, and despair seem to be the legacy we have left our kids.  Too often adults put that off to social media, suggesting that is the thing that is making kids unhappy. Turns out that this is only one part of the story.

In fact, the study does not suggest that social media is the key ingredient to depression.  It is a very mixed story here, so we need to look far more carefully at how we are pressuring our kids and what we can do about it, including the use of social media for good.  I thought it particularly interesting that the split of people who responded to the prompt “I feel like I always need to show the best version of myself on social media” was 53 percent somewhat/strongly agree and 47 percent somewhat/strongly disagree.  I, too, have held an assumption that one of the reasons that social media causes issues is that it creates extreme pressure to Keep Up with the Joneses or, better yet, One Up the Joneses.  While this is clearly true for some people, the other half report that they don’t feel this pressure.  It would be so interesting to delve into the why’s of this question.  Who is more subject to the peer pressure to be perceived as happy, cool and thriving and who isn’t?  The variables that answer this question would probably tell us a lot about how to properly target mental health treatment for this population. It may well be that depression leads to a more negative view of social media impact and not the other way around.

There is a wealth of information in the study about how young adults can and do find peers on the internet who can help them feel better about themselves.  Susannah Fox has been a longtime proponent of peer-to-peer healthcare and it is pretty clear to me that this is the right population in which to accelerate its use.  Teenagers and young adults are at that special age where their parents are at maximum stupidity (Mark Twain got this so right), so finding others to help them who have gone through what they have experienced and who are worthy of trust by being of a similar age are an essential part of addressing this challenge.

One notable finding in the study is that 69 percent of those surveyed said they strongly or somewhat disagreed with the assertion that they would prefer to interact with other people through social media vs. actual human contact.  I gotta admit, this is a shocker to me.  I have more than once been at the local Starbucks when the high school gets out and watched the kids texting each other while sitting 10 inches away from each other sipping Frappuccinos.  Maybe that is considered actual human contact – I can see you over my straw, but I’m texting anyway.

The study is really worth reading.  It is filled also with interesting free-form quotes from the kids who participated. According to Susannah Fox, “For me, the best part of the report is the “In their own words” sections when we hear from the teens & young adults themselves. They tell a much more nuanced and complex story about how they manage their social media. They’re not all pawns, as some adults would have people believe, but instead curate their feed or go offline when they need a break. And video comes through as a huge opportunity for outreach and education.”

Virtually all digital health products and programs are targeted at adults.  But clearly, there is a large market needing attention here.  I am sure that most VCs would say that kids don’t have decision-making purchase power or the money to spend to make a market, so aren’t a good target, but they are not actually correct. The group covered in this study, measured as “Gen Z” by some researchers (not a perfect match but close), is already on track to become the largest generation of consumers by the year 2020.  They currently account for $29 to $143 billion in direct spending, which isn’t a lot compared to adults, but check this out: 93 percent percent of parents today say their teenage children influence $600 billion of family and household purchases.    If you think the 33 percent of people who are under 50 in my household don’t influence what all of us do, where we all go and what we all buy, you are sorely mistaken. Right as we speak I have a refrigerator that currently houses chocolate milk, golden kiwis and some sort of weird blue ice cream, all of which I paid for and none of which will be consumed by 66 2/3 percent of household members.

I’m delighted to see my friends produce such a great and valuable report and even more excited to see what comes of it.  Since most of us adult will interact with teens and young adults one way or another (by creating them, employing them, or whatever), it is so important that we understand what is making them tick and how we can help them progress to better adjusted adults, or at least those that are better adjusted than we are!