Increasing Ill Health Among Young Men

Bremberg is senior consultant in child and adolescent health and associate professor in social medicine at the Department of Public Health, Karolinska Institutet. He is the author of the article (in Swedish) Young men’s health in the Nordic countries, which was commissioned by the Nordic Arena for Public Health Issues, a platform for strengthening Nordic public health cooperation and efforts to reduce health disparities among residents of the Nordic countries.

Young men breaking with the trend

In general, the Nordic region has seen a positive development for all groups; however, social health inequalities have escalated over recent years. Even if socioeconomically strong groups have enjoyed the benefits more than others, all groups have still seen improvements. That said, this trend does not apply to young men as a group. In Sweden, development has stagnated for young men in the age group 15-29, for whom health inequity has increased.

– The primary causes of increased ill health among young men are depression, drug-related issues, increases in neck and back pain and higher rates of suicide, self-harm and interpersonal violence. All of these factors impact on socially disadvantaged groups to a greater extent. These increases are most obvious in Sweden.

The impact of the labour market

One underlying factor for the negative development among young men may be the combination of increased demands from the labour market with an education system that has failed to adapt to change:

– The demand for unskilled labour has decreased significantly in the Nordic region while demand for those with a higher education has increased. In all likelihood, this development is due to higher requirements for entry into the labour market, which in turn is related to increased global competition.

A new phase of life

Statistics Sweden, Sweden’s national statistics agency, defines age of establishment as the age at which 75% of the population in a given birth cohort has gainful employment to the extent that they can support themselves. In 1990, the age of establishment was 21 for men and 20 for women. By 2010, this had increased to 26 years for men and 28 years for women. In his report, Bremberg refers to American psychologist Jeffrey Arnett, who has proposed a new phase of life: emerging adulthood:

– This period is defined as between the ages of 19 and 29, when the individual has left upper-secondary education but has yet to establish themselves in their adult role. While for some this period represents enormous freedom, to be used for travel and self-realisation, for young people without a social safety net it is a time marked by uncertainty, worry and unemployment. This phase of life is harder on young men, who generally fare less well in school than their female contemporaries.

Social disparities in mortality

Rates of mortality are higher for men than women in all age groups. These increased mortality rates among men peak between the ages of 20-29 years. According to Bremberg, the marked increase in mortality among this age group warrants an increased focus on men from a public health perspective:

– It is possible that, at this age, the competition to achieve a given social status is more pronounced for men than women and that this leads to greater risk-taking and concomitant higher mortality.

The social disparities in mortality and the increase in social health issues demonstrate the same tendency. In his report, Bremberg states that recent decades appear to have seen a decline in the living conditions that affect health for groups of socially disadvantaged men:

– One Swedish study shows a link between poor performance in school and suicide risk in the age range 15-34 years. This risk was 4.6 times greater among young men in the lower 1/6 in terms of school performance in year nine than among young people who performed well at school. The same study demonstrated an almost six times greater risk of drug problems between the ages of 16 and 35 among the lower 1/6 of students in terms of school performance in year nine.

The conference Health Equity in the Nordic Region was arranged in Stockholm 22-23 November 2018 as a collaboration between the Nordic Welfare Centre and the Ministry of Health and Social Affairs in Sweden, under the auspices of the Swedish chairmanship of the Nordic Council of Ministers. Michael Birkjær was one of the speakers at the conference.