Adolescent health and Not in Education, Employment or Training (NEET) in young adulthood: Evidence from a UK prospective longitudinal study
Using data from the UK Millennium Cohort Study, this research demonstrates that adolescent health, particularly mental health conditions and their co-occurrence with physical issues like obesity, significantly increases the risk of young people being Not in Education, Employment, or Training (NEET) at age 23, with effects being more pronounced for females and those who are economically inactive.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of a preprint that has not been peer-reviewed. It is not medical advice. Do not make health decisions based on this content. Read full disclaimer
Every society faces a moment when its young people must step from the safety of school into the wider world of work and training. In the United Kingdom, a significant number of these young adults find themselves stuck in a difficult limbo, neither studying nor working. This group is known by the acronym NEET, standing for "not in education, employment, or training." While it is well known that these young people often report poorer health than their peers, the relationship is complex and often goes both ways: poor health can make it harder to find work, and the stress of being out of work can worsen health. For years, researchers have wondered if specific health struggles during the teenage years could predict who would end up in this difficult position later on. Understanding this link is crucial because it shifts the focus from simply managing unemployment to preventing it by supporting young people's well-being before they even leave school.
A new study using data from a massive, long-term project in the UK has begun to untangle these connections. The researchers followed thousands of young people born in the early 2000s, tracking them from infancy into their early twenties. By the time these individuals reached the median age of twenty-three, the team could look back at their health records from age seventeen to see what factors might have foreshadowed their current situation. The study focused on three main areas: mental health conditions, physical health conditions, and daily health behaviors like sleep, exercise, and substance use. The goal was to see which of these teenage experiences were the strongest signals that a young person might struggle to find their footing in the adult world.
The results paint a clear picture: health during adolescence is a powerful predictor of future employment status. Among the thousands of young people studied, about one in eight was NEET at age twenty-three. The data revealed that mental health challenges were the most significant warning signs. Young people who had been diagnosed with autism or attention deficit hyperactivity disorder (ADHD) as teenagers were more than three times as likely to be NEET later on compared to their peers without these diagnoses. A longstanding mental health condition, such as chronic anxiety or depression, more than doubled the risk. The study also found a "dose-response" relationship, meaning that the more mental health conditions a teenager had, the higher their risk of being out of work or education as an adult. Those with three or more conditions faced a risk that was triple that of those with no conditions.
Physical health played a role as well, though it was generally less predictive than mental health. Being obese as a teenager increased the risk of being NEET by about fifty percent, but being merely overweight did not carry the same weight. Interestingly, a physical health condition that interfered with daily life was a stronger predictor than the condition itself. Perhaps most telling was the finding that physical inactivity during the teenage years was a significant risk factor, suggesting that a lack of movement might signal deeper issues with motivation or capacity that carry over into adulthood. When obesity and mental health struggles occurred together, the risk was even higher, effectively doubling the likelihood of being NEET compared to having neither issue.
The study also looked at everyday habits, such as smoking, drinking, and using social media. Surprisingly, many common behaviors like binge drinking or vaping did not show a strong link to future unemployment. However, two behavioral factors stood out: teenagers who reported feeling happier and more connected online than in real life were at higher risk, as were those who reported antisocial behavior. Poor sleep quality and having tried hard drugs also increased the risk. One unexpected finding was that frequent alcohol use among teenagers was actually associated with a lower risk of being NEET, though the researchers caution that this is an unusual result that needs further investigation and does not imply that drinking is beneficial.
When the researchers broke down the results by gender, they found that mental health struggles were a stronger predictor for young women than for young men, even though the overall rates of being NEET were similar for both groups. For men, specific conditions like autism and ADHD were particularly strong predictors. The study also distinguished between those who were actively looking for work and those who had given up and were not looking at all. The health factors studied were much more strongly linked to the group that was economically inactive—those not seeking work—than to those actively trying to find a job. This suggests that poor health may be more likely to cause a young person to disengage from the labor market entirely rather than just making it harder to find a specific job.
The researchers calculated how much of the total problem of youth unemployment could be attributed to these specific health issues. They found that common problems, even if they did not carry the highest individual risk, accounted for a large share of the issue because so many young people experienced them. For instance, self-harm in the past year and physical inactivity were among the top contributors to the overall number of NEET young adults, simply because these issues were widespread. This highlights that while rare, severe conditions like autism carry a high risk for the individual, common issues like psychological distress and lack of physical activity affect the population as a whole in a major way.
Ultimately, this study suggests that the path to being NEET is often paved with health challenges that begin in the teenage years. It indicates that the issue is not just an economic one but a health one, requiring coordinated support across schools, healthcare, and employment services. The findings point toward the need for early, integrated interventions that address mental and physical health together. By identifying and supporting young people who are struggling with these conditions before they leave school, it may be possible to prevent them from falling out of the education and employment systems entirely. The data makes it clear that helping a teenager manage their health is not just about their personal well-being; it is a vital step in helping them build a future where they can work and thrive.
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