Susannah Fox posed an excellent question during a recent Master Class on participatory medicine at Medicine X that went something like this:

How do we adapt to a shifting landscape of polling where people expect a more participatory approach?

The translation is, “How do we connect with young people that increasingly have more control over who calls them and do not see an apparent need to participate in polling research.”

In my humble opinion, Millennials have often been poorly characterized. Employers read that they were given a lot of trophies as kids and expect a lot of feedback and praise. I believe the truth is a lot more textured than that.

I would argue that Millennials (young adults born after about 1982) are a Frontier Generation. What does that mean?

A frontier is an untamed and unsettled world. A Frontier Generation is the first group of people to arrive on the scene. The U.S. western frontier may have closed in 1890, but the virtual frontier of the Internet opened in the 1980’s and Millennials are the first to be online for most of their lives.

Being the first to arrive on a frontier means that there is almost no distance between “what you want to do” and “doing it”. If you see a problem, you band together to find a solution. If MySpace isn’t meeting your needs, you create your own alternative (Facebook) and people are free to flock to it. Who settled the Facebook Frontier? Millennials. They have imprinted on a virtual world that seems to always get better, is filled with innumerable choices, and where they are constantly in the driver seat.

At the opposite end would be Establishment Generations. They grow up in a world where things are orderly, and have not largely been disrupted for quite some time. They learn in their youth that it is futile to try to change things, not just because it’s really hard, but because it will make life worse for you. People will think that you’re crazy for challenging an establishment that –most people are convinced — was set up for the betterment of society.

The most long lived Establishment society I’ve encountered is Japan. They have many, many cultural rules and norms that have been fostered for thousands of years. The frontiers of Japan have been closed for centuries. Interestingly, while other ancient countries have seen massive disruptions (being colonized, fighting for independence, etc.), Japan’s history is far more static. They’ve largely always been independent (people could argue they lost that after WWII, I would respectfully disagree). The difference is amazing. One example is the way they park in Japan:

Flickr by andydoro

Notice how all the cars in a row face the same direction. Notice how each car is neatly parked within its lines, anyone who’s been to Japan can relate to this. Now behold American parking:

Flickr by corporatemonkey

If you want to connect with young people, it helps to understand their world.

Expectations of the World:
Frontier Generation: Changeable, engaging, with transparent exchange (i.e. What value do you want, and what do you offer in return?).
Establishment Generation: Emphasizes peace and stability, one-way, opaque (e.g. “fill out this form and don’t ask why — it’s for the greater good.”).