Stress Jan 2014

Three-quarters of us are concerned about health care, a fraction fewer than those of us worried about the economy. Underneath stress about healthcare, people are worried about costs and the impact of the Affordable Care Act (ACA).

Say hello to the Healthcare Worry Scale, developed by Chase Communications, a firm focused on marketing and media, largely in the health industry.

Chase found that:

– 93% believe that their health care costs will continue to increase

– 49% say the ACA’s impact is a “major” worry

– 43% say getting a disease, medical condition, or injury that health insurance doesn’t fully cover is a “major” worry.

These top concerns — which center on the cost of health care — surpass peoples’ worries about living longer but sicker (36%), caring for chronic conditions (35%), caring for aging parents (29%), and end of life care (28%).

The survey polled 1,019 online U.S. adults 18 and over in December 2013.

Health Populi’s Hot Points:  I spent time with Julie Chase and Ed Stevens, who led the study for Chase Communications, to dig into these data points and find differences between people by demographics and mindsets. A key finding is that worries about health risks are more concerning to people in lower-income households than people who have more money: most people in homes with under $35K a year were likely to agree that “no matter what I do, I cannot reduce the risk that I will suffer some kind of major illness or medical condition.” This finding gets to a larger issue of self-efficacy and empowerment, which can be mitigated through policies bolstering the social determinants of health – education and literacy (both general and health literacy), access to healthy food, and job creation.

Another demographic difference in health risk-perceptions is among younger people 18-24, who feel less at risk than people over 45. However, younger people do indeed have health risks — they just look different than the risks older people face. The top 5 health risks for people 15-24 according to the Centers for Disease Control (CDC) are road traffic accidents (especially alcohol-related), suicide, poisoning, homicide and some cancers. Once again, helping people get more real about risks in daily life and healthy choices can better inform people to be more engaged about making better health decisions – like purchasing health insurance when you’re young to mitigate risks of high costs due to accidents (this is where high-deductible health plans can be quite useful), and using mobile apps to support good choices. One great example of an app useful for this population is Alcohoot, of which I kicked the proverbial tires at the 2014 Consumer Electronics Show. Alcohoot is a device that connects to a smartphone enabling the user to breathalyze her/himself after drinking — to determine whether it’s safe to drive. (I’ll be writing more on Alcohoot later this week on HealthcareDIY so do stay tuned).

What this first Health Worry Scale illustrates is that Americans are overall more focused on the costs of health care rather than quality of life and living issues like aging well, caregiver stress, and managing chronic conditions. Ironically, it’s engaging in health and healthy behaviors on a daily basis that can help stem non-communicable diseases (diabetes, heart disease, lung disease, and many cancers) which then bolster empowerment and the ability to bend one’s personal health cost curve.

I look forward to tracking Chase’s Health Worry Scale to gauge whether the mass middle’s perceptions shift from cost to quality and life over time. For the time being, given the current debate and media coverage on health care price transparency (like TIME’s Bitter Pill masterpiece and Sunday’s New York Time’s story by Elisabeth Rosenthal on Page A1), cost concerns will be issue #1 for mainstream America.

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