By 2014, the under-30 population will become the majority of the workforce, a title once held by baby boomers. During this transition, employers must revisit their strategies for engaging younger populations in health care decision-making and lifestyle improvement.

Although younger workers tend to view themselves as invincible when it comes to their health, the reality is that this age group now faces more health problems than their older counterparts did at the same age: Obesity and activity limitations from chronic conditions plague this group.

Additionally, the under-30 group may have a greater hunger for choices and answers than its older counterparts. Younger employees highly value autonomy, yet at times lack credible information when making their own health decisions.

This year, the National Business Group on Health released a survey of over 1,538 employees, "Employee Attitudes Toward Health Information and Comparative Effectiveness Research." Respondents were age 22-69 and receive their health care benefits through their employer or union. The data reveal several interesting findings specific to the under-30 population.

There are five barriers - and respective solutions - to getting the under-30 employee population more involved in their own health and health care decision-making. It's a worthwhile investment - after all, these workers represent organizations' future success.


1. Family and friends represent top sources for health information.

In early adulthood, social networks not only influence behavior, but can also make or break a health habit. According to our survey, 75% of workers under 30 are more likely to look to friends or family members for health/medical information, compared with 63% of workers aged 40-49. It's important to apply networking techniques to infiltrate this group with accurate and timely health information.

Solutions: Cultivate a social network through social media. Pilot a decision aid with a small group of employees for a limited amount of time (think referral-based shopping sites).


2. Traditional clinical sources of medical and health information are under-utilized.

Only 51% of workers under 30 used the doctor's office for health/medical information, compared with 63% of workers over 30. The under-30 group was also less likely to use pharmacists (33%), medical school websites (35%) or nurse lines (15%) for health information. As this group navigates its way through adulthood, it's important for employers to introduce reputable resources for obtaining information about timely and appropriate care since some younger employees may not be aware of or know how to use these traditional resources.

Solutions: Link to trustworthy websites, like Questions are the Answer ( or Consumer Reports' health website ( Disseminate communication materials with examples of situations that deserve a call to the nurse line.


3. Many trust government agencies to provide information on comparative effectiveness research.

The younger population lacks the skepticism of older people when it comes to government agencies. Fifty-eight percent of workers under 30, compared with 48% of workers aged 30-39, and 38% aged 40-49, are more likely to find government websites (such as the Agency for Healthcare Research and Quality at completely or very trustworthy. Given the under-30 group's inquisitive nature, the employer and health plan must translate government information on comparative effectiveness research into easy, practical methods for daily use. This type of work compares different health care interventions to determine the most effective course of treatment for a patient.

Solutions: Translate CER information. Make the connection on how using CER in decision-making can trim health care costs and improve quality.


4. Money influences treatment decisions.

Not surprisingly, younger employees' health care treatment decisions are driven by what their health plan pays for - 53% of workers under 30 reported having this mindset, compared with 46% of workers aged 30-39. Fortunately, the influence of cost in medical decisions decreases as age increases, presumably due to under-30 workers gradually entering higher-income brackets. Nevertheless, they may still face education loans and other daily expenses not shared by older workers.

Solutions: Promote cost and quality calculators with workers and their families, particularly spouses and partners. Consider an evidence-based plan design.


5. Proactivity is not a priority. The health care "locus of control" (the extent to which individuals believe they can control events that affect them) is low for younger employees. Thirty-eight percent of under-30 workers, versus 30% of workers aged 30-39, are more likely to believe that medicine is too complicated and therefore little can be done but to trust their own physician. Yet only about 20% of those under 30 have discussed scientific evidence with their physician - this number climbs to 32% in the over- 50 population.

Solutions: Create a checklist of questions that employees can ask their physicians; make it accessible through mobile technology. Promote existing sources of on-the-go health information, such as Text4Baby, a free health text messaging service launched by the national Healthy Mothers, Healthy Babies coalition.

Brenna Shebel is an assistant director at the National Business Group on Health. She can be reached at Dannel Dan is a former senior analyst with NBGH.

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