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44% of older millennials have a chronic health condition

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As millennials begin to turn 40 in 2021, CNBC Make It has launched Middle-Aged Millennials, a series exploring how the oldest members of this generation have grown into adulthood amid the backdrop of the Great Recession and the Covid-19 pandemic, student loans, stagnant wages and rising costs of living.

Every morning, Kristin Bennett starts her day off by swallowing about 14 different supplements and vitamins designed to help her keep the worst symptoms of her disease at bay. 

Bennett has relapsing-remitting multiple sclerosis, a central nervous system disease she’s been dealing with for about 20 years after being diagnosed in 2001. She just turned 40 last month.

Health conditions like Bennett’s can take a toll, both financially and emotionally. And unfortunately, as the oldest millennials start to hit 40, many are finding themselves coping with chronic health conditions — more so than previous generations, according to some recent research

About 44% of older millennials born between 1981 and 1988 report having been diagnosed with at least one chronic health condition, according to a recent survey conducted by The Harris Poll on behalf of CNBC Make It among over 4,000 U.S. adults, about 830 of whom were between the ages 33 to 40. 

There’s “no question” that some emerging evidence shows many millennials are unhealthier than predicted, says Dr. Georges Benjamin, executive director of the American Public Health Association.

“Hypertension, diabetes and obesity drives a lot of that,” Benjamin says, adding that the obesity epidemic may be one of the root causes of the rise in rates of hypertension, diabetes and even certain types of cancer. Benjamin also says that studies show millennials are far less likely to be smokers, making diseases related to smoking less common. 

Among the older millennials surveyed by CNBC Make It, migraine headaches, major depression and asthma are the three most common ailments. Type 2 diabetes and hypertension round out the top five. 

The prevalence of these diseases not only affects millennials’ health and lifespan, but also their bank accounts. Studies show those with at least one chronic condition spend twice as much on out-of-pocket health-care expenses than those without any medical issues. Those with two concurrent chronic health issues spend five times as much.

Those under 65 with circulatory system diseases, such as high blood pressure and heart conditions, spend more than $1,500 a year on out-of-pocket costs, according to the Kaiser Family Foundation. The average health insurance plan participant without a chronic condition pays just $778 a year out of pocket. 

Over the course of a lifetime, those costs can add up — especially if a patient is diagnosed at a younger age.

Beyond out-of-pocket spending, millennials with a chronic health condition also could see their annual income reduced by as much as $4,500 per person due to medical expenses and even reduced work hours or job loss because of poor health, according to a 2019 report from Moody’s Analytics that analyzed data from Blue Cross Blue Shield Health.

“At the end of the day, if these trends continue, then you’ll have higher health-care costs,” Benjamin says. “You’ll be exchanging the baby boomer generation for a generation with even higher health-care costs just because of normal inflation and the fact these chronic diseases are there.”

Kristin Bennett has been dealing with her MS for almost 20 years.

Source: Kristin Bennett

To help keep her symptoms at bay, Bennett takes about a dozen supplements each morning, as well as other vitamins throughout the day. All told, she spends about $400 a month on more than 20 different vitamins, as well as powdered supplements she adds to drinks and smoothies. Bennett also sees a naturopathic doctor about once a month, a massage therapist when she can and attends physical therapy as needed. Those types of services can typically range from $75 to $150 per session.

But despite all the effort, Bennett started to experience flare-ups in 2018 that have persisted through the coronavirus pandemic, including falls, double vision and even trouble walking and standing for long periods. An avid gardener, one of her more serious falls ended with her hitting her head on a wooden stake after tripping outside of her home in Clinton, Washington. 

Yet Bennett’s health-care costs could be much higher. For eight years after her diagnosis, she was on medications that, without insurance, generally cost patients between $5,000 and $50,000 a year.

When she lost her job in 2009, Bennett spent most of her unemployment benefits paying for COBRA insurance to ensure she had coverage for both her medication and her pregnancy. But Bennett, now a mother of three, couldn’t keep up with the costs and eventually stopped taking prescription medications in favor of a less expensive, more alternative medicine route. 

Getting diagnosed with MS has given Bennett the mindset that anything can completely change at any given moment. “I don’t really know what the future will bring,” she says. “I’m still hoping that I can walk well again, but I also know that might not happen, and I might need a wheelchair someday.”

Declining health is only one piece of the puzzle

While older millennials are experiencing higher rates of chronic health conditions, it may not be strictly due to declining health. The implementation of the Affordable Care Act in 2010, also known as Obamacare, increased access to health-care providers for many Americans. This was especially important for younger Americans, who were given the option to stay on their parents’ health insurance plans until they were 26. 

This helped more college students and recent grads afford and seek out medical care when they needed it. “It is true that we have improved access to care,” Benjamin says. But, “when you improve access to care, then you see more people and you identify more health problems.” 

While that does potentially increase disease rates, it can be a good thing, Benjamin says. Identifying health problems early leads to better long-term outcomes, including longer life spans.

For Brady Dixon, doctors were able to catch his Type 2 diabetes early, when he was only 29. 

Brady Dixon, who lives in Oklahoma City, was diagnosed with Type II diabetes in 2015.

Source: Brady Dixon

Doctors diagnosed Dixon, now 35, with diabetes after a routine health exam for work uncovered critically high blood sugar levels in 2015. Although doctors were able to catch his condition before any real complications arose, diabetes is one of the most expensive chronic diseases to treat in the U.S. today. Those diagnosed with diabetes have an average of $16,750 in annual medical expenditures, $9,600 of which is attributed directly to diabetes, according to 2018 research from the American Diabetes Association.

For Oklahoma-based Dixon, the major costs have been his medication and food. After the first drug prescribed to Dixon left him sick for hours, he switched to another that he tolerated better, but more expensive. A month’s supply of the drug, Trulicity, costs an average of $985 without insurance and $48 with insurance, according to GoodRx.

Dixon earns about $58,000 a year working in IT and spends about $200 more per month on food than he did before his diagnosis. But budgeting for specialty groceries and healthier takeout meals can be challenging, especially with jobs that don’t always pay well and $8,000 in student loans still left to pay off. 

“I learned that food was an under-the-radar cost of having diabetes,” Dixon says. “Yes, if you cook everything at home, it’s not that expensive. But the staples of cheap, easy food — frozen pizza and ramen — are both death to a diabetic.”

More diagnoses could come after the pandemic lifts

As older millennials age, their habits, history and even world events will continue to impact their health. The pandemic will likely result in new shifts in health trends and potentially lead to an influx of diagnoses over the next year, Benjamin says. 

While Covid-19 may not have been as fatal for younger Americans, including older millennials, many of those who contracted the disease experience ongoing symptoms months after recovery. In fact, studies show between 50% and 80% of recovered patients have persistent side effects for up to three months after their initial positive test

Beyond Covid, the pandemic has led to a dramatic decrease in Americans visiting the doctor, Benjamin says. About 70% of physicians surveyed by the American Medical Association reported providing fewer appointments since the crisis started, including both in-person and virtual. Emergency room visits were down 25% in December 2020 and January 2021 compared with a year earlier, according to CDC data

“Because we’ve been sequestered in our homes for a year, people have not gotten the screenings and medical care they need,” Benjamin says. “As people go back to the doctor, we’re going to find cancers that should have been caught earlier, we’re going to find people who didn’t get their immunizations, we’re going to find the diabetes that was not diagnosed because they weren’t at the doctor.”

Increased diagnoses also means that more Americans may be paying higher health-care costs over the short and even long term if the health conditions are chronic.

That’s been the case for Dixon, whose medication and food costs came to a head during the pandemic. He was laid off from his job in IT in March 2020 and on unemployment for six months last year. COBRA would’ve cost about $2,000 a month, so he didn’t sign up. Instead, he stopped taking his medication and tried to get by simply monitoring his sugar levels and diet. 

Last August, Dixon was finally able to secure a contractor IT role that turned into a full-time position in November. When he finally went to see a doctor covered under his new health insurance earlier this year, his sugar levels were critically high to the point where his risk of kidney and eye damage had increased. 

His doctor put him back on Trulicity and added another medication to the routine as well. Thankfully his new job offers decent health insurance, so between that and discount drug programs, Dixon is spending $40 a month out of pocket for his medications. 

Although he’s getting back on track with his career and health, Dixon, who’s still single, can’t help but feel frustrated that he’s not further along in his life. “I expected to own my own home between 25 and 30, and be married with children,” he says. 

“There are two things I think that really messed with the American dream for me. One is my student loans and the other is health problems.”

CNBC Make It will be publishing more stories in the Middle-Aged Millennials series around student loans, employment, wealth, diversity and health. If you’re an older millennial (ages 33 to 40), share your story with us for a chance to be featured in a future installment.

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Portugal hotels face high demand after UK changes quarantine

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Beachgoers sunbathe and swim at a beach in Portimao, Algarve region, Portugal.

NurPhoto | NurPhoto | Getty Images

LONDON — The tables have turned for the Portuguese hotel industry on one announcement. 

The U.K. government said on Friday that from May 17 travelers from England will not need to quarantine when returning from Portugal. They will have to take a Covid PCR test within two days of their arrival in the U.K.— but this is a much simpler process compared to the rules applied to other destinations. 

Though rules might change depending on how the epidemiological situation develops, U.K. tourists were quick to jump on the opportunity to book a vacation abroad.

It’s been “absolute madness in terms of (booking) requests,” Katya Bauval, executive director of sales at the Vila Vita Parc hotel in the Algarve, south of Portugal, told CNBC over the phone.

She said that “bookings literally tripled in demand since Friday.”

Portugal’s largest hotel chain, Pestana, has experienced a similar rush for reservations. “There’s been a very substantial increase in bookings,” Jose Theotonio, CEO of Pestana Hotel Group, told CNBC on Wednesday.

Pestana said demand jumped 250% since Friday and rose by 475% in external booking operators. Consumers are mainly opting for places in the Algarve and Porto Santo, a small island in the archipelago of Madeira.

The preference of consumers is “clearly sunny destinations,” Theotonio said.

This signal from the British government has motivated other bookings.

Jose Theotonio

CEO of Pestana Hotel Group

Portugal also appeared to benefit from the inclusion of relatively few other popular European vacation destinations on the U.K.’s least restricted “green list.”

Spain, Italy and Greece — just to name some of the other competing destinations in the south of Europe — have not yet been added to the U.K.’s top traffic light list. Instead, these countries have been left on the U.K.’s “amber” list, meaning that if U.K. tourists travel to Spain, Italy or Greece they will then be required to self-isolate for 10 days on returning home.

“It was to Portugal’s advantage that Greece, Spain aren’t on the list,” Bauval said.

‘Motivated other bookings’

Portugal has become a hotspot for international visitors in recent years. In 2019, the country welcomed 24.6 million visitors — a 7.9% growth from the previous year, according to the country’s national statistics office.

The U.K. represented the biggest market for tourist stays in Portugal, accounting for 18.8% of the total number of nights in the country. This was followed by Germany, which was 12.3% of the total stays, and Spain, which accounted for 11%.

A woman sunbathes at a beach in Sagres, Algarve region, Portugal on July 29, 2020. Portuguese President Marcelo Rebelo de Sousa has promised to visit the Algarve every week this summer to help the regions struggling tourism sector overcome the effects of the Covid-19 pandemic and the UK governments decision to include mainland Portugal in its travel blacklist. (Photo by Pedro Fiúza/NurPhoto via Getty Images)

NurPhoto | NurPhoto | Getty Images

But the country’s tourism industry came to a complete halt in the wake of the coronavirus. The summer season experienced a later start in 2020 and continued at a much slower pace compared to previous years. Portugal was also forced to introduce a second lockdown at the start of 2021 due to a sharp increase in the number of Covid infections, but the strict measures have now been eased.

“This signal from the British government has motivated other bookings,” Theotonio also said, noting that the recent surge in demand has also come from tourists in Germany, Spain and the domestic market too.

U.S. tourists will take longer to come back

There’s also a common feature in recent hotel bookings: its immediacy. Visitors have mainly been booking a stay for May and June.

This type of booking is “even more important,” according to Theotonio as it reduces the likelihood that people will need to cancel their plans.

Portugal has also attracted many non-EU visitors in recent years. In 2019, there was a jump of 21.3% in the number of stays from American tourists; a 16.8% increase from China; and a rise of 14.9% from Brazil.

But this demand will take longer to come back.

“We feel it will take some time,” Bauval said, explaining how Vila Vita Parc had to shift its focus in the wake of the coronavirus pandemic to attract more Europeans. 

This is despite the announcement from European Commission President Ursula von der Leyen that vaccinated Americans will be able to visit Europe this summer.

“We don’t have illusions,” Theotonio said, expecting only a “gradual” return to pre-pandemic activity levels.

Tourists pull luggage as they walk towards a hotel at Villamoura beach in Villamoura, Algarve region, Portugal.

Bloomberg | Bloomberg | Getty Images

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April’s inflation surge wasn’t as drastic as it looked, but the real test is still ahead

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A woman wears a face mask while shopping for a baby shower gift during the Covid-19 pandemic, at Madison’s Niche boutique in Huntington, New York on April 21, 2021.

Alejandra Villa Loarca | Newsday | Getty Images

There is probably less than meets the eye from the startling inflation pop in April, as goods impacted by a variety of temporary influences pushed core price increases at the quickest pace since the Reagan presidency.

Headline inflation rose by 4.2% from a year ago, while core prices excluding the volatile food and energy sectors got their biggest one-month bump of 0.9% going back to 1981.

At the root of the increases were issues related to the pandemic, both in terms of how aggressive the current recovery is and how bad things were a year ago.

There were factors such as supply chain congestion that added to the pressures. At the same time, an aggressively recovering economy pushed prices for airline tickets (up 10.2% in April), hotels (8.8% higher) and used car prices (up 10%).

While that was happening, the things that drive inflation over longer periods, like housing costs and the price of services, showed increases consistent with where they’ve been over time. Shelter costs broadly increased 0.4% in April while services excluding energy rose 0.5%.

In all, the narrative that the burst in inflation that so many had been forecasting will be transitory likely holds up – at least for now.

“The more persistent categories of inflation (services, and rent specifically) were relatively tame last month, but goods prices surged, as did transportation and travel,” wrote Eric Winograd, senior economist at AllianceBernstein. “None of those moves are likely to be persistent. Over time, that means that the most likely course of events is still for inflation to settle down as the supply side of the economy catches up to the demand side.”

Still, the numbers were jarring.

For headline inflation, it was the fastest year-over-year gain since September 2008, just before the economy fell off a cliff due to the financial crisis. And the Consumer Price Index numbers came the same day AAA reported that gasoline prices eclipsed $3 a gallon nationally for the first time in about seven years.

Federal Reserve officials have repeatedly assured the public that the coming inflation push is largely a result of temporary factors plus distorted comparisons to the economic shutdown of a year ago.

What could change

In the central bank’s thinking, the collective belief that inflation either will stay low or remain high becomes a self-fulfilling prophecy, and it then becomes the Fed’s job to massage policy in whichever direction is desirable.

For at least a decade, collective expectations have been low.

But should readings like Wednesday’s become commonplace, if consumers continue to see stories about sold-out gas stations and car orders delayed by months due to semiconductor shortages or if growth broadly should accelerate even beyond the current lofty expectations, the inflation picture can change in a hurry.

“The fact is that when we factor in all the monetary and fiscal stimulus that’s been delivered (or shortly will be), the Covid crisis seems likely to be a net inflationary event, at least in the near term,” wrote Rick Rieder, chief investment officer of global fixed income at asset management giant BlackRock.

“The risk of overheating in multiple places across the financial and real asset arenas is becoming more and more of a realistic challenge for future policy, as some have suggested, and without an evolution of what heretofore has been policy reacting to emergency economic conditions, the risk from this will only grow,” he added.

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Seychelles most vaccinated nation on Earth but Covid-19 has surged

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A woman holding an umbrella walks in a street in the Seychelles’ capital Victoria.

Valery Sharifulin | TASS | Getty Images

The Seychelles is causing concern for world health experts after a rise of Covid-19 cases among fully vaccinated individuals.

The World Health Organization said Tuesday that it would review coronavirus data from the Seychelles, an archipelago of 115 islands in the Indian Ocean, after the health ministry said more than a third of people who tested positive for Covid-19 in the week to May 8 had been fully vaccinated.

The Seychelles is viewed as having conducted a very successful vaccination rollout so far; it can boast having the highest share of people vaccinated against Covid-19 anywhere in the world, above Israel and the U.K.

The majority of vaccinated people have received China’s Sinopharm vaccine (approved for emergency use by the WHO last Friday) as well as the AstraZeneca shot (known as Covishield locally, a version produced in India). In total, the Seychelles with a population of over 97,000 has recorded just under 8,200 cases and 28 deaths during the pandemic.

On Monday, the Seychelles’ health ministry reported a steep rise in the number of cases. From 120 new cases reported on April 30, a week later over 300 cases per day were recorded on May 7 and May 8, respectively.

Of all the positive cases, the health ministry said 63% had either not been vaccinated or had only received one dose of SinoPharm or Covishield, but 37% of the new infections were in people who had received both doses.

The ministry noted that, of the patients requiring hospital treatment, 80% had not been vaccinated and tended to be people with co-morbidities. It added that “almost all” of the critical and severe cases requiring intensive care treatment had not been vaccinated either. To date, none of the patients who have died with Covid-19 have been fully vaccinated, it said.

While there was a flattening of new cases on May 7 and May 8 (with 317 new cases reported and then 314 cases, respectively), the health ministry said “the rate of transmission remains high and is of concern.”

The situation has certainly alarmed experts, particularly as 60% of the Seychelles’ total population has been fully vaccinated. What’s more, 86% of the Seychelles’ targeted population for vaccination — 70,000 people — have been fully vaccinated to date, ministry data shows.

What the WHO thinks

On Monday, WHO’s Director of Immunization, Vaccines and Biologicals, Dr. Kate O’Brien, said in a briefing that the WHO was in direct communication with the Seychelles’ health ministry and that the situation was a “more complicated situation than the top-line messages.”

“As was noted, the vaccines are highly efficacious against severe cases and deaths. Most of the cases which have occurred are mild cases. However, what is also important is that a substantial fraction, over 80% of the population, has been vaccinated. But as we know … some of the cases that are being reported are occurring either soon after a single dose, or soon after a second dose, or between the first and second doses.”

She said in this specific situation, a very detailed assessment was required “of what the situation is, first of all what the strains are that are circulating in the country, secondly when the cases occur relative to when somebody received doses, third what the severity of the cases is.”

“Only by doing that kind of evaluation can we make an assessment of whether or not these are vaccine failures or whether it is more about the kinds of cases that are occurring, the milder end of cases and then the timing of the cases relative to when individuals received doses. That evaluation is ongoing and we’re supporting and engaging with the country to understand the situation.”

CNBC has contacted the WHO for updated comment on the situation in the Seychelles but is yet to receive a reply.

Vaccine efficacy

The WHO has repeatedly warned that vaccination alone would not be enough to stop the pandemic in its tracks, but would rather be another weapon in the arsenal to fight the virus.

Restrictions on social contact as well as good personal hygiene are still seen as the basis or preventing the spread. Last week, the Seychelles re-imposed restrictions on some social gatherings and public spaces in a bid to curb the spread.

The situation faced by islanders acts as a reminder that no coronavirus vaccine currently in use has been proven to be 100% effective at preventing Covid-19 infection. Still, all the vaccines currently authorized for use by the WHO have proven to be very, if not extremely, effective at preventing serious Covid infections, with cases, hospitalizations and deaths greatly reduced in countries with advanced vaccination programs, like the U.K.

With a third wave of cases and new virus variants having the potential to cause further loss of life and economic destruction, time is of the essence to approve and distribute life-saving vaccines around the world, with the more available, the better.

On Friday, the WHO granted emergency use authorization to the China’s state-owned pharmaceutical firm SinoPharm, a move which could fast-track the shot’s use in WHO’s COVAX scheme, which aims to provide poorer countries with access to vaccines.

The WHO said the addition of the SinoPharm vaccine had “the potential to rapidly accelerate Covid-19 vaccine access for countries seeking to protect health workers and populations at risk.”

It noted that the WHO’s Strategic Advisory Group of Experts on Immunization had completed a review of the vaccine and, on the basis of all available evidence, recommended it for adults 18 years and older, in a two-dose schedule with a spacing of three to four weeks.

“Vaccine efficacy for symptomatic and hospitalized disease was estimated to be 79%, all age groups combined,” it said. However it noted that “few older adults (over 60 years) were enrolled in clinical trials, so efficacy could not be estimated in this age group.”

In March, AstraZeneca released updated clinical trial date which showed its vaccine was 76% effective at preventing against symptomatic Covid-19 infection. Vaccines by PfizerBioNTech and Moderna were found to be around 95% effective.

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