Health Insurance Costs Placing Stress on Majority of Americans

January 29, 2018 - Sixty-nine percent of Americans with an income of $50,000 a year or more cited the cost of health insurance as a major stressor and 63 percent of Americans with incomes less than $50,000 per year cited insurance costs as a major life stressor, according to a study published by the American Psychological Association (APA).

Two-thirds of adults surveyed by APA said that the cost of health insurance was a major stressor in their lives or a source of stress associated with a loved one, regardless of income.

Americans with annual incomes below $50,000 reported stress about uncertain future healthcare spending (62 percent), healthcare policy and legislation changes (59 percent), the cost of medications (58 percent), and medical bills (57 percent).

Individuals with higher incomes also reported similar healthcare cost-related stressors, but at higher rates. The majority of higher income earners felt stressed about future healthcare spending (65 percent), federal healthcare policy changes (61 percent), the cost of medications (60 percent), and medical bills (60 percent).

APA CEO Arthur C. Evans, Jr., PhD, stated that Americans stress levels are impacted by the chaos associated with healthcare policy debates and rising healthcare costs and have to take additional measures to manage their stress-related health.

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“Given the uncertain fate of our nation's healthcare system, it is not surprising that the majority of adults surveyed expressed concerns about access to healthcare and costs," he said.

"If stress becomes chronic, it can lead to significant health consequences,” Evans continued. “It's important to remember that there are steps that people can take to manage their stress in healthy and productive ways, like exercising, spending time with friends and family and finding ways to get involved in your community, including making your concerns known to policymakers."

Many adults in the US associated their stress to health insurance costs related to their current insurance status, health-related illness, geographic location, age, or ethnicity.

APA found that Americans without health insurance experienced elevated stress levels about healthcare costs over individuals with coverage. On a ten-point scale, uninsured adults reported an average stress level of 5.6 and insured adults reported a stress level of 4.7.

Stress levels may be exacerbated by the presence of at least one chronic condition, APA added. Sixty-two percent of Americans live with a chronic condition with chronic health conditions such as high blood pressure (28 percent) and high cholesterol (27 percent), which may contribute to higher stress levels.

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“Those living with a chronic health condition have a significantly higher average stress level (5.0) than those without a chronic condition (4.4), using the same point scale, where 1 is “little or no stress” and 10 is “a great deal of stress,” APA reported.

Americans living in urban areas also experience a greater deal of stress (5.2) than individuals in suburban (4.5) and rural areas (4.7).

“Americans in urban areas say the cost of health insurance (74 percent), uncertainty about the future when thinking about their own or others’ health (71 percent), having good health insurance (69 percent), changes to healthcare policy from Washington (66 percent) and medical bills (65 percent) are sources of stress,” the APA added.

Conversely, a lower percentage of Americans living in suburban areas reported healthcare cost stressors.  

Sixty-two percent of suburban Americans cited stress with the cost of health insurance, 61 percent reported stress associated with the uncertainty with loved one’s health condition, and 56 percent reported stress from potential changes to healthcare policy from Washington. Suburban Americans also associated stress than urban populations with concerns about having good health insurance (54 percent) and medical bills (52 percent).

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APA additionally found generational differences in healthcare cost stressors: Younger Americans are more likely to experience stress than older Americans about their healthcare costs.

Seventy-two percent of millennials and 71 percent of gen-xers reported health insurance costs as a cause of stress. Sixty-one percent of baby boomers and 51 percent of older adults reported stress due their health insurance costs.

“A lack of access to mental healthcare is a source of stress for 56 percent of millennials and 47 percent of gen-xers, while only 27 percent of boomers and 20 percent of older adults express the same concern,” the APA added.

“More than half of millennials (55 percent) and more than two-fifths of gen-xers (43 percent) report feeling stress related to reproductive healthcare access, while the number is drastically lower for the older generations: One-quarter of baby boomers (25 percent) and only 14 percent of older adults feel stress around this aspect of healthcare.”

Americans within different racial and ethnic groups had varying degrees of healthcare cost concerns, APA found.

Sixty-four percent of Hispanic adults experienced stress when thinking about themselves, their loved ones or people in general losing access to healthcare services. Hispanic adults experienced the highest levels of healthcare cost stress over other racial groups, but large percentages within each group experienced stress. Fifty-six percent of Asian-Americans, 51 percent of African-Americans, 50 percent of Native Americans and 49 percent of whites Americans reported feeling stressed about healthcare concerns.

The APA findings likely reinforce the need for payers to address social health determinants. These determinants can exacerbate healthcare stressors and create socioeconomic healthcare implications, which inhibit individuals from purchasing health insurance and using needed healthcare services.