Today’s young people are tomorrow’s adults – building the foundations for a healthy life

Much is understood about the importance of a nurturing environment during early childhood, but far less is known about how factors in teenage years shape long term health outcomes. The Health Foundation has started a two-year inquiry to understand the future health prospects of young people.

Our Director of Strategy, Jo Bibby, talks to Julia Unwin, strategic adviser to the inquiry and previously Chief Executive of the Joseph Rowntree Foundation, about why the transition to adulthood is such an important time for determining the future health prospects of young people, and how the inquiry will help.

Jo:          I’m really excited to have you on board with this work Julia. This inquiry came out of the scoping work we did last year to consider the best ways the Health Foundation could add value through our healthy lives work. People told us that by and large the evidence is there about the impact of early years development on long term health outcomes. But we are less clear about the factors that influence people’s lives between the ages of 12–24. How do young people’s experiences as they grow up impact on their ability to build the assets and foundation necessary for a healthy life?

Julia:      Yes there’s definitely a gap in our understanding about what we could be doing to provide the right conditions for young people to help them build the foundations of a healthy life. We’ve made huge progress in some issues that affect young people’s lives, for example smoking and drinking. But the world young people are growing up in at the moment is a very insecure and uncertain one. It’s one which many of us who are older don’t entirely understand. And yet it’s a world that may have long term health impacts.

Jo:          The other thing that came out of our scoping discussions was that when we talk about health, we tend to mainly talk about illness, rather than considering the assets that help a young person to be healthy. I’m talking about social determinants such as their opportunity to work, find secure housing, build effective social networks, good self esteem and so on. So it’s great that with your background you bring a slightly less disease-focused approach.

Julia:      Young people entering adulthood now face completely different issues to their parents’ generation who felt a lot more settled by the age of 25. Such a small percentage of under 25s will become home owners now, let alone have secure tenancies. This is changing the way young people can behave.

Similarly the labour market at all levels is a much more insecure place with far more people working in temporary jobs, or contracting as part of the ‘gig economy’. That brings huge freedom to some people, but we don’t know what it does to their long term prospects for health and wellbeing. 

Jo:          The nature of family life has also changed. The Children’s Society published a really interesting report last year on teenage neglect, looking at the large number of young people living in households where the adults are out at work for very long hours. They spend a lot of time on their own and it’s thought this might be one of the factors contributing to the high levels of anxiety and depression we’re seeing in younger people.

Julia:      Again, we’re more aware of the need to nurture and give attention to children in their early years, but there is a lot of evidence that teenagers are at similar risk if they have that kind of emotional neglect. These are some of the layers of issues we are hoping to uncover as part of the inquiry.

Jo:          I think the on-site visits that you are leading on will really help to drill down into this and complement the big picture work we are already doing. We’re just in the process of selecting our research team so that we can do some quantitative analysis about the social determinants of health for young people. And then there’s the engagement work that’s underway with Kantar and Livity, which is already helping us to build a clearer picture of how young people see their own lives and will frame any subsequent conversations you have.

Julia:      Our hypothesis is that a lot of things may be happening differently in different localities and that young people’s experiences are partly affected by where they live. So we intend to do a number of visits to particular localities to talk in-depth to both young people and to professionals there about what they are experiencing and how they think it affects their health. Is their experience benefiting them and giving them resilience for the future? Or is it actually eroding their capacity to cope with the future? My contention is that growing up in Bradford is rather different from growing up somewhere in the far north of Scotland – in terms of family relationships, jobs, housing, etc.

Jo:          It will be very interesting to see the differences. We will publish creative outputs from this inquiry but what we really want to do is build understanding about what the critical issues are that need some action. And through the events we run to bring together policy and practice perspectives, we will start to highlight the possible opportunities to act.

I think we’re both keen to make sure this isn’t just a conversation between charities and government though. We plan on talking to young people about our findings – helping them to explore the full picture. We hope this will be empowering.

Julia:      Yes definitely. That’s part of what drew me to this work, the very big commitment to engaging with young people and their own views. The risk is that if we just look at it from our perspective we’ll misunderstand what’s going on. Some things might seem like problems when they’re not. Some factors may actually be enabling young people to be more adaptive and more resilient in ways that we don’t yet understand. So many of the recommendations we make will have to come directly from young people.

Jo:          I think there is something really important about people understanding that the experiences young people are having now will have long term consequences for our society. I just don’t think those connections are currently made in people’s minds – we forget that today’s young people are tomorrow’s adults. So even getting that consciousness would be an important first step.

Julia:     Until now we just haven’t done enough thinking about the long term impact of what young people are experiencing. And given how bad we have been as a country at planning for transitions and for change, taking care of our older population for example, this is an opportunity to really plan better for our future generations.