It may not be the meek that inherit the earth but the unhealthy. According to the World Health Organisation (WHO), 81% of young people are not getting enough exercise, 18% are obese and 75% of mental health problems will have emerged by the age of 24.
Generation Z has lit the fuse on a health time bomb with an immediate cost that will increase exponentially across generations. The WHO recognises this as a major driver of investment in adolescent health.
Investments in adolescent health bring a triple dividend of benefits for adolescents now, for their future adult lives, and for the next generation. Their health and well-being are engines of change in the drive to create healthier, more sustainable communities. Investments in adolescent health reduce present and future health costs and enhance social capital.
— World Health Organisation
Science tells us that adolescence offers a unique opportunity for motivating young people to develop healthier lifestyles. Neuroscientists like Dr Frances Jensen state that "the teen brain is nothing short of miraculous" as a "learning machine". However, as Dr Jensen goes on to say, adolescent brains "respond strongly to good things but also negative stimuli". So how do we move them towards the healthful rather than the harmful?
Young people need to feel motivated to make change. Let’s take one example. Data from Troo Life Coach, an AI chatbot for young people which I launched, showed that 57% of young people chose fast/convenience and sugary treats as their preferred foods whilst for 54% fruit and vegetables rank lowest. How do we encourage young people to shift that balance? Scientists from universities in Chicago, Texas, Durham and California concluded that traditional approaches fail on the basis of a poor understanding of adolescent motivation.
We suggest that a critical reason for the failure of past interventions is their overwhelming tendency to rely on the (usually implicit) assumption that adolescents are already motivated by a desire to be healthier in the distant future. Consistent with this assumption, programs have tended to focus on giving participants an appreciation for the health implications of their food choices and/or on teaching them the cognitive skills necessary to pursue the presumed goal of future health. However, this motivational assumption is questionable even for adults, and findings from developmental science suggest it is even less appropriate for adolescents.
— Christopher J. Bryan et al, PNAS 2016 vol 113 no39
So, what is going to make a difference when, as data from TLC suggests, three in five young people may literally "not be in the mood" to make healthier choices?
Again neuroscience may cast some light on how to motivate young people. Dr Juliet Davidow at Harvard notes in her article An Upside to Reward Sensitivity that "adolescents are notorious for engaging in reward-seeking behaviours". Specifically, much research in the behavioural health field suggests that the most successful rewards for motivating adolescents are tied to achieving goals that are immediate, simple and socio-culturally reinforced.
This opens the door to public health approaches based on thinking from behavioural economics that emphasise, as Michael Hallsworth recently published in Nature, "marginal gains that require little or no effort". This reflects early findings, for example, from TLC where young people are nudged towards healthier practices and are rewarded, through a gamified points system, for engagement. Almost four in every five adolescents who tried and were rewarded for using simple stress reduction techniques already available on YouTube, found such approaches were very or fairly useful in helping them manage stress.
Groundbreaking research by Ruttle et al, at the Concordia University and the Centre for Research in Human Development, concluded that "We now have evidence that behavioural problems in children are linked to mental and physical health. Taking a 'wait-and-see' attitude may not be the right approach." Technology offers an unprecedented means to intervene early at scale. Over 75% of young people have a smartphone through which there is an opportunity to screen for ‘danger signs’ as well as to engage them in nudges and rewards for healthier choices.
Hence, it appears that we have the research and the technology at our fingertips to defuse the health time bomb for Generation Z. It seems to carry a low cost, through technology, with approaches that encourage daily marginal change towards lifelong health. Now all it may require is courage from policy makers and health commissioners to put the evidence to work so the healthy may inherit the earth.