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Illustration by Chris Philpot

The Millennial Guide to Maintaining Your Health

Generation Y is facing a host of health challenges—and that's before the coronavirus swarmed Colorado. Because informed, consistent maintenance is key, we put together a user's manual to the millennial body to ensure its ready for bumpy roads ahead.

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Millennials. Generation Y. Echo boomers. Whatever you want to call them, Coloradans born between 1981 and 1996 are the largest age demographic in the state, making up 24 percent of our community. With numbers like those, it’s likely you either are a millennial or you care about one, so you have a vested interest in keeping them healthy, something that’s getting more difficult now that they’re 24 to 39 years old. Compounding normal wear and tear is the threat of the novel coronavirus sweeping through the state and nation. Young people—especially those with preexisting conditions—are far from immune. Taking care of oneself is more important now than ever, and that’s where this handbook comes in: Consider it your essential manual for maintaining the model Y. After consulting with physicians, sociologists, and health policy experts we’ve mapped out everything you need to know, from health risks to insurance plans, to keep your millennial machine running smoothly for years to come.

Before We Begin: A Special Report About Millennials and the Coronavirus in Colorado

How (and why) young people were slow to heed warnings about COVID-19, and the scary fact that they’re not as protected from the virus as they thought.

Initial reports of the novel coronavirus in the U.S. suggested those most at risk were older than 60 and those with compromised immune systems. Reports from the Centers for Disease Control and Prevention have since shown that millennials are far from immune. According to data collected in March by the CDC from 49 states, the District of Columbia, and three U.S. territories people age 20 to 44 made up 29 percent of confirmed COVID-19 cases. (Millennials, who are between the ages of 24 and 39, form a sizable chunk of that group.) Twenty percent of everyone hospitalized with coronavirus’ related ailments fell into the same age range. Although the report has some limitations, those numbers show Gen Y isn’t as bulletproof as its members might have thought, especially when you consider that millennials have higher rates of diabetes than Gen Xers did at their age, according to the Blue Cross Blue Shield. (The condition increase a person’s risk of developing a serious illness associated with the coronavirus.)

Early in this pandemic, many young people still appeared to feel invincible, and their actions might well have helped COVID-19 spread. No data exists about which generations have been most lax about avoiding crowds and implementing social distancing practices. The anecdotes, though, don’t make Gen Y and their younger Gen Z cousins look good. When airline prices plummeted in early March, youngsters jumped at a chance to travel on the cheap, NBC News reported. In Boulder, photos of St. Patrick’s Day partiers taken on March 14 show mostly young people. (Just a few days later, the Boulder Daily Camera reported that one of those revelers was diagnosed with COVID-19). On March 21, after Governor Polis recommended keeping gatherings to less than 10, about a dozen 20-somethings were spotted playing spikeball at Cheesman Park; a squad of young Crossfitters powered through burpees at City Park. Mayor Michael Hancock cited actions such as these as part of what motivated his March 23 public health order requiring all residents to remain in their homes except for essential work and shopping excursions.

To be fair, millennials aren’t the only ones behaving irresponsibly. In a survey of 2,000 Americans conducted by Staance, a consumer insights company, 43 percent of baby boomers were afraid they’d catch coronavirus, compared to 53 percent of millennials and 54 percent of Gen Xers. Stories abound about younger generations talking their parents out of going to a concert or begging them not to eat at restaurants (before they closed, that is). But scenes of massive young people’s spring break gatherings have garnered much criticism on social media: #StayTheFuckHome is trending for a reason.

Kimberly Chiew, director of the University of Denver Motivation, Affect, & Cognition (MAC) Lab, has spent much of her career studying how people respond to emotional and motivational influences. She believes part of the reason some have ignored social distancing guidelines could be because we were still early on the curve—that is, the pandemic still seemed far away. “It’s like deciding to watch tv instead of studying for an exam two weeks away,” Chiew says. “People have an inclination to discount consequences that are farther away as opposed to ones that are closer.” Those impacts likely felt even more distant to millennials until stories of young people being hospitalized with COVID-19, like this one, emerged.

Pair that with later-than-ideal warnings and confounding communication from federal officials and it’s a bit easier to understand the inaction. “Public health agencies were suddenly using phrases like social distancing. For most of us, we never heard this phrase before two weeks ago,” Chiew says. “It was less concrete than ‘stay home unless you’re going out to get groceries.’ I think uncertainty potentially played a role in the behaviors we’ve seen.”

Of course, opaque language and human psychology as mitigating factors don’t absolve irresponsible behavior. Plenty of Denverites hastily complied with social distancing recommendations long before Hancock’s stay-at-home order took effect. But determining whether there are more “covidiots,” as Governor Jared Polis posted on Instagram, in Gen Y than other generations does little to help us in our current predicament. COVID-19 is ravaging nursing homes. Hospital staff are at increased risk and running out of supplies. People of all ages are being put on respirators. Colorado can barely keep up with skyrocketing unemployment claims. Rising rates of poor mental health and loneliness among Gen Yers is making the quarantine painful for a generation already besieged by chronic stressors. With so much vulnerability, perhaps the one thing we can do is recognize that to get through this, all of us, no matter what our age, are going to have to pull together—from six feet apart.


Getting To Know The Model Y

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Taking care of yourself, or your millennial, is a lot easier if you understand the parts—and where trouble arises. While the idiosyncrasies of one body can be as quirky as those of a classic car, research* gives us insight into the health habits and risks most common among Gen Y.

Illustration by Chris Philpot

1. According to the Colorado Health Institute, reports of eight or more poor mental health days each month among millennials rose from 12 to 24 percent between 2015 and 2019. Nationally, millennials are dying by suicide and overdose more than Gen Xers did at the same age, according to the Trust for America’s Health and the Well Being Trust. The problem continues in Gen Z, those born between 1997 and 2012: A United Health Foundation report shows Colorado’s teen suicide rates jumped by 58 percent, the highest increase in the nation, from 2016 to 2019.

2. Cigarette smoking nationwide has dropped by 67 percent since the days when boomers lit up on Pan Am flights, according to the American Lung Association. Marijuana use has risen among all ages in Colorado since legalization, but especially for those 25 to 34, potentially setting them up for lung, heart, and memory issues later in life—though more research is needed to confirm this.

3. Despite Coloradans’ healthy lifestyles, 22 percent of those between 25 and 34 reported body mass indices in the obese range in 2018. In 1995, just 9.5 percent of adults in the same age range (Gen Xers) were obese. Carrying too much weight can lead to a number of problems, such as heart disease, high blood pressure, and diabetes. In fact, diabetes rates are higher among millennials than previous generations in Colorado.

4. Nationally, adult binge drinking rates have increased slightly (16.2 percent in 2018 versus 14.1 percent in 1995). But numbers have spiked among young Centennial Staters: 32.2 percent of residents ages 25 to 34 report binge drinking in the past 30 days (compared to 21.6 percent of Gen Xers at the same age), increasing their risk for high blood pressure, stroke, depression, heart and liver disease, and certain cancers.

5. In general, millennials are having less sex than Gen X, baby boomers, and the silent generation did at the same age (perhaps because they’re delaying marriage; a smaller percentage are married at the same age as previous generations). Unplanned pregnancies are also declining across all generations—including millennials.

6. Whether hiking, skiing, or spinning, Coloradans ages 25 to 34 exercise a lot—nearly 88 percent said they’d participated in physical activity in the past month (third in America behind Maine and Vermont’s echo boomers). That number hasn’t changed much since the survey question first appeared in 1996, suggesting Gen X exercised at roughly the same rate even without Instagram’s #fitnessmotivation.

*Unless otherwise noted, all statistics are drawn from data gathered in the Behavioral Risk Factor Surveillance System, a nationwide survey conducted yearly by the Center for Disease Control and Prevention.


Tune Up
Photo courtesy of Getty Images

Gen Y spends, on average, six hours on social media each week, according to a 2016 Nielsen report (one hour less than Gen X). Research has repeatedly shown that anxiety and depression increase with time spent staring at the curated lives of friends and frenemies, so it might be time to take a break. Counterintuitively, some apps make it easier to stop, well, apping: The free Social Fever app alerts you if you spend more than an allotted amount of time on your phone. Forest (free for Android; $1.99 for iPhone) incentivizes unplugging by planting a digital “seed.” If you open an app before the time you set for yourself, your plant stops growing or dies outright.


Under the Hood

While millennials generally display healthier behaviors than previous generations, their bodies are showing early signs of aging. A new theory offers a possible explanation.
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Long before joints stiffen and wrinkles deepen, our bodies record the passage of time in subtler ways. Biomarkers, bits of physiological evidence in our bodies, emerge when we encounter stress. For example, if you see a mountain lion, fight-or-flight hormones like cortisol and adrenaline flood your system. What helps you in that scenario, though, isn’t healthy over time: Prolonged elevations of those hormones have been correlated with suppressed immune system function, hyperglycemia, even heart damage—and chronic stressors such as job insecurity, financial woes, and, now, COVID-19 and the repercussions of a global pandemic, can create the same hormonal response. Just as the buildup of miles wears down your car, that continuous pummeling weathers the body. “Millennials are uniquely exposed to precarious conditions,” says Adam Lippert, a professor of sociology at the University of Colorado Denver. “Their stress response systems are constantly in overdrive in ways previous generations may not have been.” Here’s why.

Job stress is burning them out. Seventy-six percent of millennials report that work is a major stressor, according to the American Psychological Association (APA). While every generation deals with the post-5 p.m. email creep, millennials have likely never known a workplace without it. “That can create an effect of blurring between the office and our home, where we’re never really unplugged from our work,” Lippert says. There’s also the issue of job stability, something 53 percent of Gen Y told the APA is a big worry. Concern over not just keeping a job, but getting enough hours, is particularly pronounced in Colorado, where 46 percent of millennials work in wholesale and retail, leisure and hospitality, or education and health care.

They’re worried about climate change. In 2019, the city of Denver registered 33 ozone warning days. The year before, the Centennial State experienced five of the 20 biggest wildfires in its history, due in part to drought. The average temperature in Colorado has risen by 2.9 degrees since 1970. These factors illustrate just how real the climate crisis is in Colorado. And according to a 2018 nationwide Gallup survey, millennials are likely to be anxious about it—70 percent of Americans ages 18 to 34 report they worry about global warming, a fear the APA says can lead to stress, depression, anxiety, substance abuse, and other risky behaviors, such as smoking.

They’re cash-strapped. Although millennials average less student loan debt than Gen Xers and boomers (millennials owe, on average, $34,504 per borrower; boomers owe $34,703; and Gen Xers lead the pack at $39,584) as well as less credit card debt, finances are still a significant stressor, according to Eli Boone, policy analyst at the Colorado Health Institute. That’s likely because wages, both here and nationally, have stagnated, particularly for low- and middle-wage earners. Meanwhile, home prices in Colorado have risen by more than 200 percent since 1980, and Denver rent hovers around $1,400 for a one-bedroom. Little wonder only 20 percent of millennial renters think they’ll be able to make a 10 percent down payment in the next five years.


Care and Repair

Illustrations by Chris Philpot

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You can’t always avoid stress, but one proven technique for coping with it—and thus keeping your millennial out of the shop—is by building community. Studies have long shown that those without close, supportive friendships struggle with stress more than their connected peers; those with higher levels of loneliness were more likely to develop hypertension, for example. And given that many of Colorado’s millennials are transplants— real estate listing company Commercial Cafe named Denver the number one city for echo boomers to relocate to—it’s understandable that the Mile High City’s millennials might be a little blue. In fact, 76 percent of Denver Gen Yers reported feeling lonely in a 2020 Cigna survey. Given current orders to stay inside to prevent the further spread of the novel coronavirus, finding new friends in the real world will have to wait a little bit longer. When social distancing ceases its reign, though, try one of these methods for meeting new, like-minded people.

For Game Players
One way to make friends? Lock yourself in a room with them. That’s the premise of the Denver Escape Room league hosted by Meet. Play. Chill. You and a team of four (the league places you with a team if you register as an individual) will gain access to four escape rooms in the metro area, where you’ll build camaraderie as you work together to solve the clues. From $80, meetplaychill.com

For the Eco-Conscious
Meet like-minded friends—and soothe your climate anxiety—at the monthly Platte River Cleanup at Confluence Park. Denver Parks and Recreation provides buckets, gloves, and trash pickers for volunteers, who trade them in post-cleanup for brunch catered by Snooze. Free, loveyourriverplatterivercleanu.splashthat.com

For Those Who Just Need to Talk—or Laugh
Group therapy can provide social support and help relieve stress. Dr. Alison Sheesley’s Upstaging Anxiety group workshops, on Sundays at Voodoo Comedy, combine cognitive behavioral therapy and improvisation to help members identify and manage their triggers. From $55 per session (or your mental health copay), comedyistherapy.com

For People Pushing Strollers
Millennial parents living far from home may lack the village new families often need to thrive. The Peanut app can help: Essentially Meetup for moms, Peanut introduces you to potential friends (ones who understand why you’re tired by 8 p.m.) for child-inclusive playdates—like a walk around Washington Park—that don’t require you to find a sitter. Free, peanut-app.io


Tune Up

Some foods can help protect your body from the impacts of time, according to Daniel Linseman, a researcher at the University of Denver’s Knoebel Institute for Healthy Aging. Called “nutraceuticals,” these foods (in moderation) offer a low-risk way to stave off inflammation, a byproduct of aging. So consider making these regular additions to your shopping list: rosemary, parsley, turmeric, eggplant, green tea, bilberries, dark chocolate, and coffee.


So You’re Having A Baby

Photo courtesy of Lumina Images/Stocksy

The boomers had Dr. Spock; Gen X had What To Expect When You’re Expecting. Millennials, currently in prime child-rearing years, have a mess of parenting blogs and judgy chat rooms. To help you sort through the noise, we consulted with the experts to bust baby-centric myths.
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Myth: You’re eating for two; bring on the buffet.
Reality: Studies led by Dr. Dana Dabelea, a professor of epidemiology and pediatrics at the University of Colorado Anschutz Medical Campus, show a mother who is overweight before pregnancy (or who gains too much weight during) can increase the baby’s susceptibility for obesity and type 2 diabetes later in life, though more research is needed to understand why. Excessive weight gain is also associated with gestational diabetes for mom, which sometimes crops up during the second trimester and can cause early labor and increase the likelihood of high blood pressure and preeclampsia during pregnancy, plus an elevated risk of developing type 2 diabetes in the future. Consult an obstetrician about proper caloric intake.

Myth: The internet has all the answers.
Reality: The web panics parents with info overload, says Dr. Tracy Vozar, who directs the Caring For You And Baby Clinic at the University of Denver. “It gives them a sense of, ‘You’re not doing it right,’ ” she says. She tells patients to be mindful of how online communities make them feel. If you’re not finding the emotional support you need, try Parentline Colorado, a new-in-winter-2019 video and phone call system that allows parents to speak with a clinical psychologist (in either English or Spanish)—especially beneficial to those in rural areas. It’s free for the first year and available on an income-based sliding scale afterward. 303-871-7935; gspp.parentline@du.edu

Myth: You need to start saving for your kids’ college tuition before you even have them.
Reality: Actually, you might need to start saving for daycare before you have kids: Colorado has some of the country’s highest infant care costs, at an average of $14,960 per year, as well as some of the lowest availability. “For every three infants who want care, there’s only one slot,” says Erin Mewhinney, director of early care and learning at the Office of Early Childhood. “Once you know you’re pregnant, get on a waiting list.” Start by visiting coloradoshines.com, where the state-run Colorado Shines program issues ratings for childcare centers and resources to make sure you find the best one for your family. Or call 211, and a licensed specialist will help you search.


Extended Warranty

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In 2010, the Patient Protection and Affordable Care Act (ACA) expanded health insurance options for young adults. They’ve taken advantage: Around 30 percent of Coloradans ages 25 to 34 were uninsured 10 years ago, a number that’s fallen to just under 19 percent. Still, millennials nationwide are more likely to report being uninsured than any other generation, according to the Transamerica Center For Health Studies. “Health insurance is typically something young people aren’t used to managing on their own,” says Adam Fox, director of strategic engagement at the nonprofit Colorado Consumer Health Initiative. “There’s a learning curve.” If that sounds familiar, use our chart to begin figuring out what insurance plan makes the most sense for you.

Coverage: Your Parents’ Plan
Who Can Use It? People age 25 and younger
Description: The ACA mandated that U.S. residents can remain on their parents’ health insurance plans until their 26th birthdays. (A Texas lawsuit threatens to overturn the bulk of the ACA, including this provision; Colorado is one of the states defending the law in this case.)
Pros: Stays in place even if you get married, have a child, start or leave school, or don’t live with your parents.
Cons: If you move out of state, you may not be able to access in-network care, and on certain plans, visiting a doctor out of network can be expensive.

Coverage: Connect For Health Colorado
Who Can Use It? People lawfully present in the United States who are also Colorado residents
Description: Created in accordance with the ACA, Colorado’s individual health insurance marketplace has multiple coverage levels. Premiums vary by age and location, but for, say, a 31-year-old woman living in Denver, the cost for a Gold plan (the most thorough coverage) starts around $340 per month. Silver is $312, and Bronze is $245.
Pros: The website allows you to compare plans, and if you buy through the marketplace, you could qualify for a tax credit or other health care cost reductions.
Cons: Some of these plans have high deductibles (ranging from $3,500 to $8,150 for a 31-year-old woman living in Denver).

Coverage: Health First Colorado
Who Can Use It? Coloradans with incomes below a certain percentage of the Federal Poverty Level, starting with single adults making less than $1,385 per month, and people with developmental, intellectual, and physical disabilities
Description: This is Colorado’s Medicaid program, which provides inexpensive (or sometimes free) health care to those who qualify.
Pros: Low or no copays. For example, the copay for an overnight hospital stay ranges from free to $10 per night.
Cons: Doctors are not required to accept Medicaid, though many do; many Medicaid patients complain about longer wait times.

Coverage: Colorado Young Adult Plan
Who Can Use It? Young adults ages 18 to 30
Description: These plans, which can be purchased through Connect for Health Colorado, provide only the minimum coverage required by law.
Pros: Premiums are low, starting around $150 per month.
Cons: Deductibles start at $8,150.

Coverage: Student Health Insurance Plan
Who Can Use It? Undergraduate and graduate students
Description: Most colleges offer health plans that cover basic care.
Pros: Premiums range in price (at the University of Colorado Boulder, it’s $1,874 per semester); deductibles are usually lower than Connect for Health Colorado’s.
Cons: If you see a doctor off-site, you may have to pay extra (contact your college’s health services center to determine whether your doc is in or out of network).

Coverage: Employer-Provided Insurance
Who Can Use It? Most often available to full-time employees
Description: Employers and employees typically share the cost for these group
insurance policies.
Pros: You save money because your company pays for part (or sometimes all) of the monthly premium.
Cons: Plans can change year by year, and if your employer switches to a carrier your doctor doesn’t accept, you may need to find a new physician—or pay out-of-network costs.


Tune Up

Meditation has been shown to reduce inflammation response caused by stress, but you don’t have to be a guru to see the benefit. Start with this breathing exercise recommended by Cierra McNamara, who started Platt Park’s Mayu Meditation Co-Op.

1. Press the right nostril closed and inhale slowly.

2. Close the left nostril and exhale through the right.

3. Inhale through the right nostril (keeping the left one closed).

4. Close the right nostril and exhale through the left.

5. Repeat for three to five cycles.


Rules of the Road

The behaviors of the 1.33 million millennials living in Colorado provide high-tech impacts on the entire state’s health care system.
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Just as the friction of tires wears down roads, millennials’ behaviors have carved new grooves in Colorado’s health care landscape. One that stands out: “Millennials are incredibly enthusiastic about technology,” says Sheana Bull, a professor at the Colorado School of Public Health. “When it comes to adopting new health care tools, they’re the linchpin.”

Nationwide surveys reflect that enthusiasm. Gen Y’s love of health and fitness tracking—28 percent of people ages 18 to 34 use such apps, says Gallup—has launched a wearables industry projected by Allied Market Research to be worth $62.1 billion by 2023. In Colorado alone, companies have made devices to tell you when you may be ovulating (Boulder’s Kindara) and whether you’re lifting the proper amount of weight (Bazifit, also from Boulder). Plus, they’re ditching general practitioners (41 percent haven’t been to the doctor in the past 12 months) for Google, with 43 percent of millennials relying on the internet for health info, compared to 33 percent of boomers.

When they do see a doctor, 23 percent of millennials say they look up online reviews for providers or hospitals. Dr. Erin Beckerman, a physician in Summit County (which boasts the state’s highest concentration of millennials), says many research their symptoms, too.

If millennials had their way, they’d be meeting with Beckerman virtually. They’re three times as likely to have tried “telehealth”—the delivery of health care and information services via remote technologies, which can include video appointments, clinician chat lines, and medication reminders—compared to other generations. As such, they’re helping drive a telehealth boom: Most major insurance providers in the state, such as Anthem, now offer video chats with doctors as a standard choice, and a 2017 law requires Health First Colorado to reimburse telemedicine appointments as if they were in-person visits.

Illustration by Chris Philpot

Millennials aren’t the only reason for that expansion, but their interest in telehealth has played a role, says Dr. Claudia Steiner, executive director of the Kaiser Permanente Colorado Institute for Health Research. In 2016, when Kaiser launched Chat with a Doctor in Colorado, which lets patients message clinicians rather than spend a lunch break in the waiting room, Gen Y used it most readily. Kaiser plans to expand the program to other states due in part to that usage.

Bull has seen millennials’ impact in her work, too. She creates programs that deliver wellness reminders—e.g., heart disease patients may get a text when it’s time to refill their medication. Gen Y often hops on board first. “Anyone can benefit from these tools,” she says, “but millennials are the ones who see the value. They figure out how to use them then teach their parents and grandparents.” It’s a case of digital natives leading their elders down a new road—and toward healthier destinations.

Editor’s note: This article appeared in the April issue of 5280, which went to press before COVID-19 became the biggest story in recent memory. As such, some events and dates listed may now be out of date. For more on how 5280 is shifting coverage during this time, read Editorial Director Geoff Van Dyke’s editor’s note.

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