Concerning Trends in the Mental Health of Emerging Adults: 2011 to 2022

Abstract Importance: There is a critical need to understand changes in the mental health of emerging adults. This study focused on identifying when and among who changes in the quality of life of US adults occurred between 2011 and 2022. Objective: To identify changes in mental and physical health-related quality of life among adults by age cohort in the United States between 2011 and 2022. Design: This was a survey-based observational study that included annual cohorts of more than 400,000 adults living in the United States between 2011 and 2022. Data was sourced from the US Centers for Disease Control and Prevention Behavioral Risk Factor Surveillance System, a national telephone-based health survey. Setting: This study leveraged a large population-based sample living in the United States. The sample includes data from all 50 US states, the District of Columbia and three US territories. Participants: Data were weighted based on age, sex, ethnicity, geographic regions within states, marital status, education level, home ownership, and type of phone ownership to represent the United States population. Main Outcome(s) and Measure(s) : The primary measures included the CDC Healthy Days items, which measure the number of mentally and physically unhealthy days experienced by survey respondents in the previous 30 days. Results : The annual sample size ranged from N=438,693 to N=506,467. An 82% increase in the number of mentally unhealthy days was observed among adults aged 18-24 between 2011 (M=4.19, 95% CI 4.03-4.35) and 2022 (M=7.61, 95% CI = 7.41-7.82), with evidence of smaller but increasing rates among adults through mid-life. Minimal changes in physically unhealthy days were observed for all age groups over the same period. Conclusions and Relevance: This study identified a clear need to address the mechanisms underlying a dramatic increase in mentally unhealthy days among young adults, which is also becoming increasingly common in mid-life. Special attention should be paid to the role social media plays in the way people perceive, interpret, and cope with stressors or traumatic events.