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Differences between Generations

2. Nice to Know:

Clinicians encounter patients of different ages and there are systematic cultural differences between the generations. Having a basic understanding of these differences will help you in understanding some consistent patterns in the attitudes and expectations of your patients.

Note: the range of birth years shown below is very rough. You will find different ranges for the various generation groups.

Inter-war years "veteran" generation (born c.1918-1940)
  Attitudes. Growing up in the great depression fostered a sense of fatalism and powerlessness. Their parents spoke of the great war and all of the death and destruction that brought. People expected little and held onto any job they could find; forces beyond their control affected their destiny, and then the second world war came. Friends died in large numbers. Men were away at war so delayed marriage until after the conflict, leading to the baby boom.
Baby boomers (born 1946 – c.1964 (19 year span)

Circumstances. Many of the parents of the boomers had worked for the war effort, and were independent, strong-willed and used to hardship.  When the war ended, couples made up for the delay in child-bearing; there were an average of four children per couple in Canada during this era. The economy recovered slowly from the war, but young families wanted to consume, to have a car, home appliances, etc., that had not been available in the 1930s. 

The large numbers of baby boomers therefore grew up in an era of optimism and rising aspirations: people could have things and do things and travel. Because of the growth in the economy, jobs were relatively easy to get in the 1960s and 1970s. But then the large numbers of boomers caused difficulty when the job market fell in the 1980s and into the 90s. This also led to subsequent generations having difficulty in finding a job as the boomers were blocking them. Their sheer numbers have turned boomers into a powerful economic, cultural, and political force.

Attitudes. The boomers' world was shaped by television, the anxiety of the Cold War, the cautious optimism of a growth economy.  In 1950, 8% of American homes had a t.v.; by 1958, it was 83%. Boomers on average gained more education than their parents.

As your patients. Many boomers now have care duties for aging parents; they may feel sandwiched between obligations to their parents and to their children. Because of mobility, siblings may not live close to each other so there are often problems over sharing care responsibility for aging parents. Many women suffer work-life conflict.

Be aware of the "clubhouse sandwich" — those caring for elderly parents and also for their own children aged 20-something who have returned home. The "open-faced sandwich" are single parent families in which the mother (typically) is caring for her children and for an elderly parent.

Generation X (born c. 1964 – 1974, 11 years)  Also called the Baby Bust

Circumstances. The Boomer parents, more educated, chose to focus on career and to have fewer kids: birth rates fell 15%. But the boomer parents ensured their kids were well educated. Even more deception, then, when the economy declined during the early 1980s and the children of the boom faced unemployment, downsizing and restructuring in the work environment. They had also to compete with the large number of boomers still blocking potential jobs. 

Attitudes. These educated children of the boomers faced low starting salaries. Interest rates were very high, making home purchase difficult: Cynicism! This was the first generation to develop strong computer skills. But the fragility of their work situation meant that they were worried about work security, so tended to put in long hours. They want a raise, a promotion, career development, and respect.

As your patients. Because of initial uncertainties, many have decided to delay having children to establish their career. So, you will find older women with fewer children. Often parents are remarkably unschooled in child-rearing.

They often feel little commitment to their employer and are likely to change jobs often; many report high levels of job stress and are tired. But they are caught: they have to stay, even if their job is awful, because they have young children and older parents and depend on the financial security the job offers. They may feel trapped by the boomer generation which is blocking the good jobs. They want benefits such as vision and dental care, and a good pension plan. Many are also finally in their career ascendancy.

Generation Y (born c. 1974 – 1997, 23 year span)  Also called the Nexus Generation or the  Millennials

Circumstances. These are the echo of the boomers, who began having babies in the 1970s. They are the next generation of workers in our society, but there are half as many as we ideally require. As Linda Duxbury humorously noted, for them (compared to their parents)

  • Bottle caps have always been screw top and plastic;
  • They have never heard of Atari;
  • They have never owned a record player, never played a vinyl album and do not understand the expression, “You sound like a broken record”;
  • They have never used a slide rule or a typewriter.
  • Most have never seen a black and white television set with only 13 channels, no cable or remote control;
  • Their helicopter parents hovered around to help their kids; tended to get far too involved in what their children were doing;
  • In job interviews have been described as "suggesting 10 ways to fix the company's web site" without realizing this may not be the best time to make that comment;

Attitudes. Technologically skilled. They look online to see what’s on at the movies (Boomers look in the paper).  Boomers watch the news on t.v. whereas the Millennials have an RSS feed to their iPod.  Boomers may view content on the Web; Gen Y changes content on the web. As Duxbury noted, they want fun, challenging, interesting, and exciting work with flexibility and balance. Employees in this group do not want a boss: rather, they want a coach, a mentor, someone who listens to their concerns. What will happen if the organization does not deliver? The 20-year-old employee will leave – immediately. They may expect salary raises that are unreasonable; would prefer stable long-term employment but don't expect it. Money is not a concern for many in this group as they have no responsibility for others (they're unlikely to get married until age 29, on average, and they do not have their first child until age 31). They can move back in with their parents if necessary.

As your patients. Brought up by parents who praised them for participation more than for performance and winning, so may not expect to struggle with a health problem. Entertained by video games rather than conversation at dinner table, so may expect immediate gratification and may lack social skills. Used to informal knowledge transfer rather than formal training courses.

Next generation (born c. 1998 – present), also called generation Z
  For them, the internet is not technology: it’s a normal part of life.  XML replaces HTML: merely viewing the web becomes changing it.

3. Additional Information:

Nerd's Corner:

The journalist Jan Wong has made some interesting observations on similar issues in China.  In discussing the one-child policy, she notes:

"There are now 650 million Chinese born after the Cultural Revolution.  They have no memory of Chairman Mao, ration coupons or collectivism.  And they got scant help from their disillusioned parents, who had squandered their own youth on a Maoist dream.  That had only made them doubly determined to give their one and onlies everything they never had.  Parents of the Lost Generation indulging kids of the Me Generation ...

"Without an ideology to anchor the country, callousness reigned supreme ... Decades of cradle-to-grave collectivism had left everyone convinced that it was better to receive than to give.  Political campaigns had obliterated religious beliefs.  And a decade of Cultural Revolution cruelty, followed by two decades of me-first capitalism, had wiped out the last vestiges of empathy.

"China was becoming a selfish society.  It had no soup kitchens or homeless shelters, no Salvation Army-style charities ...

"For generations, the big, extended family defined each person's place in the hierarchy.  Chinese had no clue how to raise an only child ... In the summer, I saw grandmothers chasing after their grandchildren on the side-walk, bowl and spoon in hand, begging them to take another bite.  In a land of scarcity, love was expressed through food.  Child obesity, unheard of a decade ago, became so common that hospitals in Beijing held "fat reduction camps" ... Pampered onlies were growing up to be strong-willed, spoiled, self-centered types who reminded me of, well, Americans.  When you have a nation of little emperors, you can't have a nation of little slaves, and maybe, just maybe, China will get democracy.  With its one-child policy, the Communist Party may have unwittingly sown the seeds of its own destruction."

Jan Wong, Jan Wong's China, Doubleday Canada, 1999. Excerpts taken from pages 284-314

Link: William J Schroer's take on generations