Highlights of APA Stress in America™: Missing the Health Care Connection

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 released today by the American Psychological Association (APA). Findings from the Stress in America™ survey draw important connections among patient-provider interactions, stress and wellness. Results showed that the U.S. health care system is not meeting specific patient needs related to behavioral health that could aid in the prevention and management of chronic illness. Relatively few Americans (19 percent) report that they describe their health care completely as good quality and fewer describe their health care as focused on educating them about their health (12 percent), prevention of illness (13 percent), lifestyle issues that impact their health (10 percent) or mental health needs (9 percent).

Stress and the Health Care System

While Americans think it is important that health care focuses on issues related to stress and living healthier lifestyles, their experiences do not seem to match up with what they value.

• Thirty-two percent of Americans say it is very/extremely important to talk with their providers about how to manage stress, yet only 17 percent report that these conversations are happening often/always.
• Overall, 53 percent of Americans say they receive little to no support from their health care provider in managing their stress.
• Thirty-five percent of adults say their stress has increased in the past year and 33 percent say that they never discuss ways to manage stress with their health care provider.
• People who do not receive stress or behavioral management support from their health care provider are more likely to say their stress increased in the past year than those who do get support (38 percent with little/no support vs. 29 percent with a lot/great deal of support).

Chronic Illness, Stress and the Health Care System

This year’s survey also finds that people living with chronic illness are less likely to receive health care that is focused on helping them make the lifestyle and behavior changes needed to improve their health. Although those with chronic illness see their health care provider more frequently than the rest of the nation (51 percent of those living with a chronic illness see their health care provider three or more times annually compared with only 17 percent of those without a chronic illness), people living with a chronic illness do not necessarily receive better stress management support.

• Despite more frequent visits, only 25 percent of those with a chronic illness say that their health care provider helps them manage stress a great deal or a lot.
• Forty-one percent of people living with a chronic illness who receive little or no support from their health care provider for stress or behavior management say their stress increased in the past year, compared with 32 percent of people living with a chronic illness who received a great deal or a lot of support from their provider for stress or behavior management.

Impact of Stress

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

• Americans report their mean stress level as a 4.9 on a 10-point scale where 1 means “little or no stress” and 10 means “a great deal of stress,” while they define a healthy level of stress as a 3.6 on the same scale. Twenty percent of Americans report stress levels that are extreme (an 8, 9 or 10 on a 10-point scale).
• The most commonly reported significant sources of stress include money (69 percent), work (65 percent), the economy (61 percent), family responsibilities (57 percent), relationships (56 percent), family health problems (52 percent) and personal health concerns (51 percent).
• Only 17 percent of those with high stress say that they are doing an excellent or very good job of managing their stress, compared with 59 percent of those with low stress and 37 percent of Americans nationwide.

In addition, many Americans are dealing with their stress in unhealthy ways.

• They report lying awake (42 percent), overeating or eating unhealthy foods (36 percent) and skipping meals (27 percent) in the past month due to stress.
• Sedentary behaviors like listening to music (48 percent), reading (40 percent) or watching television or movies for more than two hours per day (34 percent) are strategies used for managing stress.
• Twenty-five percent of Americans report eating to manage stress.
• Thirteen percent report drinking alcohol to manage their stress.

Positively, more people are turning to exercise to manage their stress (52 percent compared with 47 percent in 2011), a healthy strategy to combat stress and its physical health consequences.

Millennials and Stress

Millennials (age 18 to 33) in particular seem to have trouble managing their stress and getting health care that meets their needs. On average, this generation gives its health care lower marks than others across the country.

• Millennials report an average stress level of 5.4 on a 10-point scale compared with the national average of 4.9.
• Forty-nine percent of Millennials do not believe or are not sure that they are doing enough to manage their stress and few say they get stress or behavioral management support from their health care provider (17 percent report that their health care provider supports them a great deal or a lot in managing their stress).