Americans stressed by health care, mass shootings, politics
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* Kim Krisberg

Health care, gun violence and the upcoming presidential election are big sources of stress for Americans.

In the 13th annual “Stress in America” report, released in November by the American Psychological Association, 69% of adults surveyed said health care is a significant source of stress, while 71% tapped mass shootings as a significant source of stress, up from 62% in 2018.

Sixty-two percent of respondents said the current political climate is a source of stress.

Overall, the report found that stress levels have not changed significantly over the past few years, but the proportion of Americans experiencing stress over specific issues has gone up in the last year. The report is based on a survey of more than 3,600 U.S. adults and conducted between Aug. 1 and Sept. 3, 2019.

“The average person may not have much understanding of mental illness, but almost all of us universally understand the idea of stress,” said Lynn Bufka, PhD, associate executive director for practice research and policy at the American Psychological Association. “This is a good way to talk to the public about mental well-being, because it’s something we all experience.”

The report found that among adults who say they feel stress about health care at least sometimes, 64% said the cost of care is a cause of stress. People with private health insurance coverage were more likely to report such stress than those with public insurance. Nearly 2 in 5 adults said their families struggled to pay for health care.

Stress about health care varied by age, race and ethnicity, with younger adults more likely to express such concerns than older adults, and Hispanics more worried about paying for and accessing health care than other groups. LGBT adults were much more likely to worry about accessing health care than their heterosexual counterparts, at 73% versus 51%, respectively.

On gun violence, Hispanic adults were the mostly likely to cite mass shootings as a significant source of stress in both 2018 and 2019, following by black adults. However, Asian adults reported the biggest increase in mass shooting-related stress, with 62% citing the events as significant sources of stress in 2018 compared to 77% tapping the issue in 2019.

Other sources of stress highlighted in the report include climate change, changing abortion laws, discrimination and immigration. In particular, the proportion of adults who cited climate change as a significant source of stress rose from 51% in 2018 to 56% in 2019. Americans living at or below the poverty line were more likely to be stressed about changing abortion laws than those with higher incomes. Immigration-related stress was most common among Hispanic adults, followed by Asian, American Indian, black and white adults.

On discrimination, the number of adults who named it as a source of stress continued to rise. According to the report, 25% of adults said discrimination was a significant source of stress of 2019, compared to 24% in 2018, 21% in 2017 and 20% in 2016. Most of the people of color surveyed, or 63%, as well as a majority of LGBT adults, at 64%, said that discrimination hindered them from living a full and productive life.

On a more positive note, nearly three-quarters of adults surveyed also felt hopeful about their futures.

“We know stress is a risk factor for so many other health conditions, like heart disease, cancer and obesity,” Bufka told *The Nation’s Health.* “So helping people develop an arsenal of skills (to cope with stress) early on could have a positive effect on overall well-being.”

She noted while stress is a normal feeling and has its own positive benefits — such as pushing people to prepare for big events in their lives — it is important to recognize when stress begins to interfere with quality of life, relationships and well-being.

“When those things start happening, it may be really helpful to seek professional help,” Bufka said.

For a copy of “Stress in America,” visit [www.apa.org](http://www.apa.org).

*   Copyright The Nation’s Health, American Public Health Association