Feature

How important do you think it is that your health-care practioner (HCP) discuss the following with you? How often do you and your HCP discuss the following?When it comes to stress management and wellness, there is a gap between what Americans want from their health-care system and what they actually get, according to a new survey by APA.

Findings from Stress in America™: Missing the Health Care Connection, conducted online by Harris Interactive among 2,020 U.S. adults last August, suggest that people are not receiving what they need from their health-care providers to manage stress and address lifestyle and behavior changes to improve their health.

While Americans think health care should focus on issues related to stress and living healthier lifestyles, their experiences do not seem to match up with what they value. For example, although 32 percent of Americans say it is very/extremely important to talk with their health-care providers about stress management, only 17 percent report that these conversations are happening often or always.

"When people receive professional help to manage stress and make healthy behavior changes, they do better at achieving their health goals," says APA CEO Norman B. Anderson, PhD. "Unfortunately, our country's health system often neglects psychological and behavioral factors that are essential to managing stress and chronic diseases."

To improve Americans' health, lower their rates of chronic illnesses and lower health-care costs, "we need to improve how we view and treat stress and unhealthy behaviors that are contributing to the high incidence of disease in the U.S.," said Anderson.

Americans who receive little or no stress or behavior management support from their health-care providers are especially vulnerable. Slightly more than half (53 percent) of those surveyed said they receive little or no support for stress management from their providers, and 39 percent said they have little or no behavior management support.

The same respondents were more likely to indicate that their stress increased in the past year compared with those who do get support from their health-care providers (38 percent with little/no support vs. 29 percent with a lot/great deal of support). The situation appears to be worse for the 20 percent of Americans who report experiencing extreme stress (an 8, 9 or 10 on a 10-point scale).

More than two-thirds of U.S. adults with high stress (69 percent) say their stress has increased in the past year, yet 33 percent of U.S. adults say that they never discuss ways to manage stress with their health-care providers.

Survey findings also show that Americans struggle to keep their stress to levels they believe are healthy. Even though average stress levels across the country appear to be declining (4.9 on a 10-point scale vs. 5.2 in 2011), stress levels continue to surpass what Americans define as a healthy level of stress (3.6 on a 10-point scale).

And for many Americans, stress is on the rise — 35 percent of Americans say their stress increased this past year.

Millennials challenged by stress and lack of support

Millennials (ages 18 to 33) in particular seem to have trouble managing their stress and getting health care that meets their needs. The Stress in America survey found Millennials reporting an average stress level of 5.4 on a 10-point scale, exceeding the national average (4.9). This generation also gives its health care lower marks than Americans across the country: Millennials are less likely than people nationwide to give their health care an "A" grade (25 percent vs. 31 percent).

Nearly half of Millennials (49 percent) do not believe or are not sure that they are doing enough to manage their stress, and few say they get stress or behavior management support from their health-care providers. Only 23 percent think that their health-care providers support them a "lot or a great deal" in their desire to make healthy lifestyle and behavior changes, and just 17 percent say the same about their health-care providers' support for stress management.

The connection between chronic illness and stress

The Stress in America survey found that U.S. adults with a chronic illness seem to lack support for stress and behavior management when compared with Americans overall, and compared with people who do not have chronic illnesses. Americans with a chronic illness are less likely than those without a chronic illness to say they are doing enough to manage their stress (59 percent vs. 66 percent).

And for those with a chronic illness who say they get little or no stress management or behavioral support from their health-care provider, stress is on the rise — 41 percent said their stress increased in the past year compared with 35 percent of Americans overall.

Although Americans living with a chronic illness see their health-care providers more frequently than those without a chronic illness, they do not necessarily receive better stress management support. Half of those with a chronic illness (51 percent) see their health-care providers three or more times a year, compared with only 17 percent of those without such conditions. Despite more frequent visits, only one quarter of those with chronic illnesses say that they get "a great deal or a lot" of stress-management support from their health-care providers. But those who say that their health-care provider supports them a great deal or a lot for stress or behavior management fare much better than those who do not receive such support. Sixty-eight percent of the former group report they are doing enough to manage stress. This compares to only 54 percent who say they receive little or no support.

Read the full Stress in America report.

Sophie Bethune is director of public relations for APA's Practice Directorate.