Stress In America 2013

Health Care System Falls Short on Stress Management

American Psychological Association

APA Survey finds inadequate attention given to behavioral health needs of younger Americans, people with chronic illness

Washington — 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 Stress in America™: Missing the Health Care Connection, which was conducted online by Harris Interactive among 2,020 U.S. adults in August of 2012, 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 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. For example, though 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. In order for our nation to get healthier, lower the 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.”

Americans who receive little or no stress or behavior management support from their health care provider are especially vulnerable. This is a sizeable group, with slightly more than half (53 percent) of Americans saying they receive little or no support for stress management from their providers, and 39 percent saying that 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 to those who do get support from their health care provider (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 provider.

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 Support
Millennials (age 18-33) 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 provider. Only 23 percent think that their health care provider supports 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 to Americans overall, and compared to those who do not have a chronic illness. 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 provider more frequently than those without a chronic illness, people living with a chronic illness do not necessarily receive better stress management support. Half of those with a chronic illness (51 percent) see their health care provider three or more times annually compared with only 17 percent of those without. Despite more frequent visits, only one quarter (25 percent) of those with a chronic illness say that they get “a great deal or a lot” of stress management support from their health care provider. 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.

To read the full Stress in America report or to download graphics, download the full report below.

For additional information on stress, lifestyle and behaviors, visit and read APA’s Mind/Body Health campaign blog Join the conversation about stress on Twitter by following @apahelpcenter and #stressAPA.

The Stress in America survey was conducted online within the United States by Harris Interactive on behalf of the American Psychological Association between August 3 and 31, 2012, among 2,020 adults aged 18 and older who reside in the U.S. The four generations noted in this report are defined as the following: Millennials n=340 (18 – 33 year olds), Generation X n=397 (34 – 47 year olds), Boomers n=1040 (48 – 66 year olds), and Matures n=243 (67 years and older). Among the 2,020 adults surveyed, 1,424 report having been diagnosed with one or more of the following: type 1 diabetes, type 2 diabetes, cancer, heart disease or heart attack, high cholesterol, high blood pressure, overweight, stroke, asthma or other respiratory disease, chronic pain, depression, an anxiety disorder, arthritis, or obesity. This online survey is not based on a probability sample and therefore no estimates of theoretical sampling error can be calculated. To read the full methodology, including the weighting variables, visit

The American Psychological Association, in Washington, D.C., is the largest scientific and professional organization representing psychology in the United States and is the world’s largest association of psychologists. APA’s membership includes more than 137,000 researchers, educators, clinicians, consultants and students. Through its divisions in 54 subfields of psychology and affiliations with 60 state, territorial and Canadian provincial associations, APA works to advance the creation, communication and application of psychological knowledge to benefit society and improve people’s lives.

Harris Interactive is one of the world’s leading market research firms, leveraging research, technology, and business acumen to transform relevant insight into actionable foresight. Known widely for the Harris Poll® and for pioneering innovative research methodologies, Harris offers proprietary solutions in the areas of market and customer insight, corporate brand and reputation strategy, and marketing, advertising, public relations and communications research. Harris possesses expertise in a wide range of industries including health care, technology, public affairs, energy, telecommunications, financial services, insurance, media, retail, restaurant, and consumer package goods. Additionally, Harris has a portfolio of multi-client offerings that complement our custom solutions while maximizing our client’s research investment. Serving clients in more than 196 countries and territories through our North American and European offices, Harris specializes in delivering research solutions that help us – and our clients—stay ahead of what’s next. For more information, please visit


More News