In the United States, once you turn 18, the decision to share or withhold information about your health and your medical decisions is up to you, at least in the eyes of the law, though the reality of the situation is often less cut-and-dried. Under the Affordable Care Act, a person can stay on their parents’ health insurance until they turn 26 years old, a benefit that approximately 7.8 million (approximately one out of four) emerging adults use, according to the Commonwealth Fund, a nonprofit healthcare resource organization. That financial responsibility, along with a healthy dose of parental concern, leads many parents to believe that they should have knowledge and even input into the health decisions of their offspring.
Open Communication Between Parents and Children Can Improve Medical Care
There are many reasons why it’s important for emerging adults to have open communication with their parents about health issues and medical treatment, says Katherine Rafferty, PhD, an associate teaching professor of psychology and communication studies at Iowa State University in Ames and a coauthor of the study. “One clear reason is that we know many health issues have genetic components, meaning that Mom or Dad or the grandparents may have had the same condition. Mental health conditions, such as depression or anxiety, are good examples of that,” says Dr. Rafferty. If there’s open dialogue and conversation between parents and children about their family medical history, not only does that give the EA an awareness of what health issues they might be predisposed to, it can also comfort them to know they aren’t alone in dealing with this issue, she says. “The parent may be able to offer great advice and insights on treatment options or things that may help or exacerbate the condition,” says Rafferty. An awareness of a family history of cancer, for example, will enable the emerging adult to accurately complete a health history for their provider, she says. “This is an important part of getting the appropriate screenings at the right age to help with cancer or disease prevention in general.”
If Parents Are Open About Their Health Issues, Their Children Are More Likely to Reciprocate
The study included a total of 316 emerging adults who were currently enrolled in college. Participants were an average of 20 years old, 33 percent male and 67 percent female, and 89 percent were undergraduate students. Approximately four out of five participants were non-Hispanic white, heterosexual, and from a nuclear family (two parents living with children). The majority of students weren’t financially responsible for their health insurance copay or bills not covered by insurance. Most students did not report a chronic health condition; in the 22 percent who did, anxiety or depression was the most frequently reported condition. Participants completed a survey in which they were asked questions about their health and whether they had shared or withheld health information with either or both parents. To identify what factors may influence openness about health issues, questions about trust, supportiveness, and relationship quality were included. Investigators identified several factors as the biggest influences on whether an emerging adult disclosed health information to a parent. Emerging adults who perceived their parents as being open and respectful were more likely to talk about health issues, and these conversations tended to happen much more frequently with mothers than with fathers. “Relational quality is important, and this is based on the perception of the emerging adult, and so the parent’s perception may be different. If the EA thinks they have a quality relationship, they are more likely to be open and share any health issues,” says Rafferty. “We call this reciprocity. Emerging adults were much more likely to talk to their parents about their health if their parents shared health information with them as they were growing up,” she says. The reverse is true as well — when parents are less open and more private about health-related matters, their children as likely to follow suit, adds Rafferty.
Pressure to Conform to Social ‘Norms’ Makes Young Adults Less Likely to Share
Emerging adults’ willingness to discuss more “charged” health issues, such as ones that relate to sexual behaviors, depended on how much pressure they felt to conform to their parents’ values and desires. Those who wanted to protect a relationship with their father were more likely to conceal private health information from them, particularly if they came from families with “high conformity orientations.” But researchers found that this did not influence an EA’s willingness to talk with their mother about private health issues. “Based on my experiences as a therapist, these findings make sense,” says Allison Young, MD, a psychiatrist and an adjunct professor of psychiatry at the NYU Grossman School of Medicine in New York City who was not involved in the research and who serves as a medical reviewer for Everyday Health. “I worked at New York University at a mental health clinic, and a number of students I saw wanted to seek mental health care when they were in high school but their parents didn’t believe in it, or the student didn’t feel comfortable disclosing to them that they were struggling with a mental health issue,” she says. As a result, these emerging adults waited until they got to college to seek treatment, says Dr. Young. “The strong need to conform to their family’s values was a big theme for many emerging adults that I saw. If a parent didn’t believe that therapy was necessary or effective, the student would typically be reluctant to share with them that they were in therapy,” she says. Further studies that included more ethnically and racially diverse populations would help us know if these findings would hold true in a less homogeneous group, says Young. “In my experience, many of the issues found here about relationships, reciprocity, and conformity seem to hold true for people across cultures,” she says.
Preparing Your Emerging Adult to Advocate for Their Own Health
These findings hold useful information for parents, says Rafferty. “What you model and how you talk about or don’t talk about these things is going to shape how your child approaches conversations about health issues in the future,” she says. To be included in what’s going on in your emerging adult’s life, especially their health issues, foster a quality relationship and share what’s going on with your own health, she says. “This will help equip them to be a knowledgeable and aware health advocate for themselves.” If you’re an emerging adult who grew up in a family that didn’t discuss healthcare topics, be aware of certain habits or patterns you may have picked up from your parents that you can try to overcome, she says. “You may have to be more proactive in getting information about your family’s health history, but it’s still important to do so.”
