A blog covering the health/care ecosystem and people.

From appointment scheduling to checking in, payment and clinical encounter follow-up, patients now expect digital experiences across the health care continuum….and really great ones, like they get from Amazon and other platforms that earn high net promoter scores. That is the big message from the 2020 Healthcare Consumer Experience Study published by Cedar, based on the input of 1,502 U.S. adults who paid a medical bill between October 2019 and October 2020. The timing of this study coincided with the start of the COVID-19 pandemic in the U.S. through at least seven months of American patients’ experiences in 2020. Two-thirds

Yesterday, IQVIA presented their end-of-year data based on medical claims in the U.S. health care system tracking the ups, downs, and ups of the coronavirus in America. IQVIA has been tracking COVID-19 medical trends globally from early 2020. The plotline of patient encounters for vaccines, prescribed medicines, foregone procedures and diagnostic visits to doctors begs the question: in 2021, will Americans be “sicker,” discovering later-stage cancer diagnoses, higher levels of pain due to delayed hip procedures, and eroded quality of life due to leaky guts? Here are a few snapshots that paint a picture for greater morbidity and potentially more “excess

In the wake of the coronavirus pandemic, women have experienced more than the direct physical, clinical impact of COVID-19: beyond “lives,” women’s livelihoods, financial health and emotional well-being have been hard-hit. This is true on both a global basis as well as in the United States. In that context, last week I engaged in a fascinating conversation with Varsha Rao, CEO of Nurx, to discuss the current state of women and health/care in America, and some thoughts about the future. If you’ve had the TV on sometime since March 2020, one of many millions of people in the U.S. spending

By April 2020, over one million Medicare members were receiving health care via telemedicine. The graph here shows you the hockey-stick growth for virtual care use by older Americans into the second month of the coronavirus pandemic. The COVID-19 public health crisis up-ended all aspects of daily living in America for people of all ages. For older Americans, avoiding the risk of contracting the tricky virus in public, and especially, in health care settings, became Job 1. The pandemic thus nudged older people toward adopting digital lifestyles for daily life, for shopping, for praying, and indeed, for health care. Laurie

The coronavirus pandemic has shifted everything that could “come home,” home. THINK: tele-work, home schooling for both under-18s and college students, home cooking, entertainment, working out, and even prayer. All of this DIY-from-home stuff has been motivated by both mandates to #StayHome and #WorkFromHome by government leaders, as well as consumers seeking refuge from contracting COVID-19. This risk-shift to our homes has led consumers to re-orient their demands for home purchase features. Today, home is ideally defined as a safe place, offering comfort and refuge for families, discovered in the America at Home Study. The Study is a joint project of

The first six months into the coronavirus pandemic shocked the collective system of U.S. consumers for living, learning, laboring, and loving. I absorbed all kinds of data about consumers in the wake of COVID-19 between March and mid-August 2020, culminating in my book, Health Citizenship: How a virus opened hearts and minds, published in September on Kindle and in print in October. In this little primer, I covered the five trends I woven based on all that data-immersion, following up the question I asked at the end of my previous book, HealthConsuming: when and how would Americans claim their health

As the COVID-19 pandemic emerged in the U.S., Americans were already Primed for ecommerce — even in health care. The coronavirus accelerated the digital transformation on people as consumers — and consumers as health consumers. Today, Amazon announced the company’s launch of Amazon Pharmacy. Watch for earth-shaking (negative) impacts on the incumbent pharmacies like CVS, Rite-Aid, Walgreens, as well as discount and ecommerce players such as GoodRx. [Sidebar: as of 10 am this morning, the announcement “sunk” the retail pharmacy stocks, according to TheStreet.com]. Some context: this announcement builds on Amazon’s previous major move into pharmacy with its acquisition of

The COVID-19 pandemic has accelerated health care providers’ and plans’ investment in digital technologies while reducing capital spending on new physical assets, we learn in Building resilience during the COVID-19 pandemic and beyond from the Deloitte Center for Health Solutions. What must be built (or truly re-built), health care leaders believe, is first and foremost trust, followed by financial viability to ensure long-term resilience and sustainability — for the workforce, the organization, the community, and leaders themselves. For this report, Deloitte interviewed 60 health care chief financial officers to gauge their perspectives during the pandemic looking at the future of

Over one-half of Americans would likely use virtual care for their healthcare services, and one in four people would actually prefer a virtual relationship with a primary care physician, according to the fifth annual 2020 Consumer Sentiment Survey from UnitedHealthcare. What a difference a pandemic can make in accelerating patients’ adoption of digital health tools. This survey was conducted in mid-September 2020, and so the results demonstrate U.S. health consumers’ growing digital health “muscles” in the form of demand and confidence in using virtual care. One in four people would consider online options as their first-line to evaluating personal health

Yesterday, the 4th of November 2020, the cable network CNN published a story titled, “Survive election uncertainty with these expert tips on how to cope.” That morning-after-the-Election-night-before followed CNN’s allying on #2020Elections night with the Calm app — a marketing alliance meant to address the real phenomenon of political stress that has been ramping up in the U.S. for several years. I liked Teen Vogue‘s coverage of the story best, and linked it here, but you can also view lenses on the event in: Adweek, Meditation App Calm Was the Most 2020 Brand Partner for CNN’s Election Coverage, whose key

As humans in the Age of the Coronavirus focus on physiological needs, people have intensely focused on hunting-and-gathering food and hygiene products. We will remember memes about toilet tissue stockpiling and re-visiting canned and shelf-stable comfort foods from childhood long after the pandemic. Some people, though, haven’t had easy access to nutritious food in their communities or the ability to engage with ecommerce platforms to order food for delivery. An alliance between ALDI, the value-priced grocer, and Instacart, was forged to address that gap as a key social determinant of health. Food-is-medicine when it comes to managing chronic conditions like

As patients returned to in-person, brick-and-mortar health care settings after the first wave of COVID-19 pandemic, they re-enter the health care system with heightened consumer expectations, according to the Beryl Institute – Ipsos Px Pulse report, Consumer Perspectives on Patient Experience in the U.S. Ipsos conducted the survey research among 1,028 U.S. adults between 23 September and 5 October 2020 — giving consumers many months of living in the context of the coronavirus. This report is a must-read for people involved with patient and consumer health engagement in the U.S. and covers a range of issues. My focus in this

2020 marked the centennial anniversary of the 19th Amendment to the U.S. Constitution, giving women the right to vote. In this auspicious year for women’s voting rights, as COVID-19 emerged in the U.S. in February, women’s labor force participation rate was 58%. Ironic timing indeed: the coronavirus pandemic has been especially harmful to working women’s lives, the Brookings Institution asserted last week in their report in 19A: The Brookings Gender Equality Series. A new study from Tia, the women’s health services platform, looks deeply into COVID-19’s negative impacts on working-age women and how they would advise the next occupant of

In 2020, most Black people, men and women alike, feel it is a bad time to be Black in America. More than twice as many Black men believed that in 2020 compared with 2006. More than four times as many Black women believed that it’s a bad time to be Black in America in 2020 versus 2011, we learn in  The Undefeated Survey on Race and Health from Kaiser Family Foundation (KFF). KFF collaborated with The Undefeated, ESPN’s project that focuses on sports, race, and culture. The Undefeated program was started in May 2016, and has become a thought leader

2020 will be remembered for disruption and dislocation on many fronts; among the major blips in the year will be it remembered as the largest funding year for digital health recorded, according to Rock Health’s report on the 3Q2020 digital health funding. This funding record (“already” before year-end, tallied by the third quarter as Rock Health notes) was driven by “mega”-deals accelerated during the public health crisis of COVID-19. In the third quarter of 2020, some $4 billion was invested in U.S. based digital health start-ups adding up $9.4 billion in 2020….so far. This is $1.2 billion more than two

Financial health is part of peoples’ overall health. As Americans approach November 3, 2020, the day of the real-time U.S. Presidential and down-ballot elections, personal home economics are front-of-mind. Twenty-seven days before the 2020 elections, 7 in 10 Americans say their financial health will influence their votes this year, according  to the doxoINSIGHTS survey which shows personal financial health as a key voter consideration in the Presidential election. Doxo, a consumer payments company, conducted a survey among 1,568 U.S. bill-paying households in late September 2020. The study has a 2% margin of error. U.S. voters facing this year’s election are

The U.S. health care community is collectively embracing the concept of social determinants of health that have become so obvious in understanding the disparities of health outcomes wrought by the coronavirus pandemic. Research from the Harvard Chan School of Public Health conducted with the Robert Wood Johnson Foundation and NPR illustrates the fact that people who are at risk for one social determinant of health tend to be challenged by a bucket of them. The survey research reported in The Impact of Coronavirus on Households With Children, published on 30th September, found that 61% of U.S. households with children had

I have always appreciated Medecision’s mission as expressed in the company’s tagline: “Liberating,” as in “liberate healthcare.” I began collaborating with Medecision as a client several years ago, a couple of years after I heard Todd Park, then Chief Technology Officer in the White House, joyfully assert the phrase, “Data Liberación!” at an early Health 2.0 Conference. Medecision published my blog about health citizenship this week on the company’s Liberate.Health site. The emergence of health citizens in the U.S. — people re-claiming their health, health care, and control of data — is part of liberating health in America. Please check

In January 2020, before we knew how to spell “coronavirus,” millions of consumers were already “Amazon-Primed” for everyday life-flows and consumer behaviors. The pandemic has accelerated consumer trends already in motion early this year when the Consumer Technology Association (CTA) convened the annual CES 2020 in Las Vegas. I covered the event here in Health Populi, as I have for most of the past decade, highlighting the growth of digital health and, this year, the expanding Internet of Healthy Things called-out by Dr. Joseph Kvedar in 2015. What a difference a public health crisis makes, accelerating digital health beyond fitness

The coronavirus pandemic has spawned many side-effects re-shaping consumers’ everyday lives. Among them, more time at home, DIY life-flows, and financial well-being are driving growth of self-care health care. An article in the latest Drug Store News talks about consumers growing more health-conscious, adopting natural, homeopathic products. “It’s about more than washing your hands,” David Salazar explains. “Fending off illness has become a state of mind for many consumers throughout the COVID-19 pandemic.” In feeling dis-empowered in the face of the pandemic – with the first shock of the Great Lockdown and stay-at-home mandates – we’ve taken on more do-it-yourself behaviors, from

On February 4th, 2020, in a hospital in northern California, the first known inpatient diagnosed with COVID-19 died. On March 11th, the World Health Organization called the growing prevalence of the coronavirus a “pandemic.” On May 25th, George Floyd, a 46-year-old Black man, died at the hands of police in Minneapolis. This summer, the Dixie Chicks dropped the “Dixie” from their name, and NASCAR cancelled the confederate flag from their tracks. Today, nearly 200,000 Americans have died due to the novel coronavirus. My new book, Health Citizenship: How a virus opened hearts and minds, launched this week. In it, I

The coronavirus pandemic has revealed deep cracks and inequities in U.S. health care in terms of exposure to COVID-19 and subsequent outcomes, with access to medical care and mortality rates negatively impacting people of color to a greater extent than White Americans. The pandemic has also led to economic decline that, seven weeks before the 2020 elections in America, is top-of-mind for health citizens with the virus-crisis itself receding to second place, according to the Kaiser Family Foundation September 2020 Health Tracking Poll. KFF polled 1,199 U.S. adults 18 years of age and older between August 28 and September 3,

One in two people in the U.S. are concerned that a major health event in their family would lead to bankruptcy, up 5 percent points over the past eighteen months. In a poll conducted with West Health, Gallup found that more younger people are concerned about medical debt risks, along with more non-white adults, published in their study report, 50% in U.S. Fear Bankruptcy Due to Major Health Event. The survey was fielded in July 2020 among 1,007 U.S. adults 18 and older. One of the basic questions in studies like these is whether a consumer could cover a $500

In the U.S., symptoms of depression were three-times greater in April 2020 in the COVID-19 pandemic than in 2017-2018. And rates for depression were even higher among women versus men, along with people earning lower incomes, losing jobs, and having fewer “social resources” — that is, at greater risk of isolation and loneliness. America’s health system should be prepared to deal with a “probable increase” in mental illness after the pandemic, researchers recommend in Prevalence of Depression Symptoms in US Adults Before and During the COVID-19 Pandemic in JAMA Network Open. A multidisciplinary team knowledgeable in medicine, epidemiology, public health,

McKinsey invites us to Meet the next-normal consumer in a recently-published research report describing changing consumer behavior responding to the COVID-19 lockdown and aftermath. The report gives us insights into the next-normal health consumer, which I’ll discuss in today’s post. Note the massive digital shift every person living in a country touched by the coronavirus has experienced, illustrated in the first graphic from the report. Tele-work, tele-education, ecommerce, and streaming entertainment all grew so fast within a matter of a few weeks. And telemedicine, McKinsey points out, was adopted at a rate of ten times growth over 15 days, the

COVID-19 is re-shaping all industries, especially health care. And the pharma industry is challenged along with other health care sectors. In fact, the coronavirus crisis impacts on pharma are especially accelerated based on how the pandemic has affected health care providers, as seen through research from Accenture published in Reinventing Relevance: New Models for Pharma Engagement with Healthcare Providers in a COVID-19 World. For the study, Accenture surveyed 720 health care providers in general practice, oncology, immunology, and cardiology working in China, France, Japan, the United Kingdom, and the U.S., in May and June 2020. Top-line, Accenture points to four

The coronavirus pandemic has revealed many flaws in the U.S. healthcare system, first and foremost the nation’s patchwork public health infrastructure and health inequities in mortality rates due to COVID-19. The Commonwealth Fund‘s biennial report, published as the pandemic continues into and beyond the third quarter of 2020, sheds light on another weakness in U.S. healthcare: the cost of health insurance relative to working Americans’ relatively flat incomes. I explored the details of this study in a post titled Health Insurance Affordability: A Call-to-Action for Healthcare Industry Stakeholders in the Pandemic, published on the Medecision Liberation blog site. The survey

In the midst of the coronavirus pandemic, two certainties emerge in the lives of physicians: they are generating less revenue, and they have adopted more virtual care in practices. The Physicians Foundation surveyed 3,513 physicians in July 2020 on their perspectives on COVID-19 and how the pandemic has impacted practices and patients. This study is part one of three conducted by the Foundation this year, subtitled the “COVID-19 Impact Edition” of the 2020 Survey of America’s Physicians which the Foundation conducts each year. Merritt Hawkins conducted the study on behalf of the Foundation, shifting the focus to the pandemic. This

The pandemic has become a sort of forcing function on all aspects of daily living, include health care. Deloitte’s latest wave of health care consumer market research updates the COVID-19 impacts on the U.S. health care landscape and asks the question in the study report’s title: “Are consumers already living the future of health?” For the general survey of U.S. Health Consumers, Deloitte polled 4,522 U.S. adults 18 and older online in February and March 2020. Deloitte conducted an additional 1,510 interviews with consumers in April to gauge peoples’ perspectives on the pandemic, health and well-being. In the Great Lockdown

The CDC calculated that some 200,000 American lives would be lost to the coronavirus pandemic by Labor Day weekend 2020. Beyond the tragic mortality in the U.S. come morbidity impacts hitting mental health in America, hard. And some people are being hit-harder than others, a report from the Centers for Disease Control details. Overall, 4 in 10 people in the U.S. reported at least one adverse mental or behavioral health symptom in the last week of June 2020. These symptoms included anxiety disorder, depressive disorder, COVID-19 related trauma- or stress-related disorder (TSRD), substance use (either starting or increasing), and serious

While I’m on holiday this week, restoring and re-setting, I’ve been sharing pages from my ABCovid-19 Journal with readers of Health Populi. I created this journal during the early phase of the pandemic in the U.S., as a form of art therapy, creative outlet, and learning. Today is Day 4 of sharing: we consider the letters “P” through “T,” and what I saw in the early coronavirus era. P is for pandemic This “P” was self-evidence in our collective early COVID-19 lexicon. The “P” word was uttered by the Secretary General of the World Health Organization on March 11, confirming

Welcome to Day 2 of my #COVID19 holiday break, welcome to my ABCovid Journal, letters “F” through “J. If you hadn’t tuned into the Health Populi blog yesterday, 10th August 2020, you missed the first five letters of my Age of Corona alphabet, curated in my art journal created in the early weeks of the pandemic. Click the link to back-track and catch up with us… I should explain why I’m sharing this project in the Health Populi blog this week. Last month, long-time colleague and friend Colin Hung interviewed me on the #HITMC broadcast to discuss a lovely recognition

The use of health and wellness services delivered in retail pharmacies is growing, and health consumers’ satisfaction increases with use. That’s the headline for J.D. Power’s 2020 U.S. Pharmacy Study. This is the 12th year of J.D. Power’s U.S. Pharmacy Study, this year based on a survey of 13,378 pharmacy customers who filled a prescription between June 2019 and February 2020. The study assessed four retail prescription drug channels for consumers: brick and mortar chain drug stores, brick and mortar mass merchandisers, supermarket pharmacies, and mail order. The top ranked brands were: For brick and mortar chains, Good Neighbor Pharmacy

Along with the life-threatening impact of the coronavirus on physical health, and the accompanying mental health distress activated by self-distancing comes a third unintended consequence with the pandemic: a hard hit on women’s personal economies. The recession of the pandemic is considered by many economists as a “She-Cession,” a downturn in the economy that’s negatively impacting women more acutely than men. This is markedly different than the Great Recession of 2008, the last major financial crisis: that financial decline was coined a “ManCession,” taking a more significant toll out of more typically men’s jobs like construction and manufacturing where fewer

Pass me the Clorox…tip the UPS driver…love thy grocer. These are our daily life-flows in the Age of COVID-19. Our basic needs are reflected in the new 2020 Axios-Harris Poll, released today. For the past several years, I’ve covered the Harris Poll of companies’ reputation rankings here in Health Populi. Last year, Wegmans, the grocer, ranked #1; Amazon, #2. In the wake of the COVID-19 pandemic, U.S. consumers’ basic needs are emerging as health and hygiene, food, and technology, based on the new Axios-Harris Poll on the top 100 companies. This year’s study was conducted in four waves, with the

The phrase, “burden of health care,” has two usual meanings: one, to do with the massive chronic care burden, and the other, involving costs. There’s a third area of burden in U.S. health care — the onerous patient experience in finding and accessing care, assessed in the 2020 Change Healthcare – Harris Poll Consumer Experience Index. Two in three U.S. consumers feel like “every step of the healthcare process is a chore.” That burdensome patient experience leads to one in two people in America avoiding seeking care, the poll found. That’s not just self-rationing health care due to costs, but due

In the U.S., the use of telehealth services tripled in the past year, as healthcare providers limited patients from in-person visits for care and patients sought to avoid exposure to the coronavirus in medical settings. With this alignment of virtual care supply-and-demand, it is like telehealth will see “permanent usage increases,” according to Parks Associates’ survey report, COVID-19 – Impact on Telehealth Use and Perspectives. Parks Associates fielded this study the second half of May 2020, surveying 5,008 heads-of-broadband households balancing the sample of respondents for age, gender, income, and education. The report reminds us for context that at the

Patients embraced virtual care and communications at very high rates in the first months of the pandemic, and want to continue to use telehealth platforms after the pandemic ends. The new era of virtual care has begun and is here to stay, Accenture expects in its latest look at How COVID-19 will permanently alter patient behavior, a patient survey conducted in May 2020. Accenture polled 2,700 patients around the world, 450 participants each from China, France, Germany, Japan, the U.K., and the U.S. Patients represented one of three conditions, with one-third each managing cardiovascular, immunology/rheumatology, and oncology. Topline, consumers “faced

One in two people in the U.S. say their financial health has been negatively impacted by the COVID-19 pandemic, through job loss, income disruption, or reduced work hours. The 2020 Financial Wellness Census, from Prudential found that one-half of U.S. adults are anxious about their financial future as of May 2020, an increase from 38% in late 2019. Prudential surveyed 3,000 U.S. adults across three generational cohorts: Millennials, Gen X, and Baby Boomers. The economic hit from the pandemic has disproportionately impacted people of color, younger people, women, small business owners, gig workers, and people working in retailer harder than

Advertising Age announced their list of the top 20 brands in 2020 this week. Ad Age’s lens on these was heavily tinted by consumers’ lives coping with the coronavirus pandemic: “The coronavirus has brought new attention to typically boring, decades-old consumer staples, while hastening the rise of digital newcomers that were only just beginning to gain traction pre-pandemic,” Ad Age explains in the introduction to the list of the selected brands. As the editors of the MadMen-and-Women’s most influential industry publication, they explain, “Ad Age chronicles 20 brands that are having a moment.” This moment to them as well as

Within days of the coronavirus pandemic emerging in the U.S., health care providers set up virtual care arrangements to convene with patients. Three months into the COVID-19 crisis, how have patients felt about these telehealth visits? In Patient Perspectives on Virtual Care, Kyruus answers this question based on an online survey of 1,000 patients 18 years of age and older, conducted in May 2020. Each of these health consumers had at least one virtual care visit between February and May 2020. The key findings were that: Engaging in a virtual visit was a new-new thing for 72% of people Patients’

The core business of hospitals is patient care, often baked with teaching and research. But wait — there’s more, asserts the Lown Institute in their approach to ranking America’s Best Hospitals in 2020. The Institute’s methodology for assessing what’s “best” addresses ten pillars. Several of these are the “stick-to-the-knitting” components of the Webster Dictionary definition of hospital work: patient outcomes, clinical outcomes, avoiding overuse, patient safety, and a recent focus, patient satisfaction. Community benefit has been part of a hospital’s life, especially in the not-for-profit world where hospitals must demonstrate goodwill generated for and provided in the neighborhoods in which

“And please…please…please wear a face covering,” Dr. Jerome Adams, the U.S. Surgeon General pleaded on June 30, 2020, during a speech to U.S. Public Health Workers. [You can fast forward to second #42 to hear Dr. Adams’ impassioned plea to his fellow Americans. s Wearing a mask or face covering reminds me of an early economics lesson from Adam Smith: that actions I take that are good for you can be good for me. “In addition to caring about our own well-being, we also naturally care about the well-being of others,” Ryan Patrick Hanley wrote in his assessment of Adam

“Now” is the lowest point in history that most Americans can remember: 7 in 10 people in the U.S. feel this way, up from 56% in 2018 and 2019. Furthermore, 4 in 5 people in the U.S. say the future of America is a significant source of stress, as discussed in Stress in the Time of COVID-19, Volume Two, a report covering a poll of U.S. adults sponsored by the American Psychological Association. APA’s Stress in America research has been one of my annual go-to’s for better understanding U.S. residents through the lens of health consumers and, especially this year

Whether healthcare spending in 2021 increases by double-digits or falls by one-third directly depends on how the coronavirus pandemic will play out over the rest of 2020, based on PwC’s annual report on medical cost trends for 2021. The three cost scenarios are based on assumptions shown in the fine print on the first chart: The medium scenario, a sort of “return to normal” where medical trend could stay even at 6.0%, equal to the 2020 trend. This assumes that healthcare spending recovers by October 2020 as patients return to hospitals and doctors’ offices for regular care patterns. In 2021,

Most U.S. employers worry about workers’ mental health and substance use as employees begin returning to work in the summer of 2020. About 4 in 5 U.S. companies are “very concerned” or “concerned” about employees’ chronic illnesses, acute illnesses, and injuries along with behavioral health issue, based on McKinsey’s annual employer survey which coincided this year with the COVID-19 pandemic. Challenges of opioid use in the workforce remain a concern for two-thirds of U.S. companies, as well. Some 9 in 10 U.S. companies say behavioral health has a negative impact on workforce productivity. In response, 7 in 10 employers are

You’ve heard the one about three characters walking into a bar. A new collaboration between United Airlines, Cleveland Clinic and Clorox reminded me of that scenario, and that in the age of the coronavirus pandemic, collaboration can bolster our health. In the era of COVID-19, people — consumers. patients managing chronic conditions, and caregivers (whether for younger or older loved ones) — are concerned about contracting the virus. In U.S. states where governors mandated shelter-at-home for much of the first half of 2020, millions of people have become conditioned to physically distance, wear face coverings, and #StayHome. In particular, workers

What a difference 90 days makes. I was scheduled to meet with Roy Jakobs, Chief Business Leader of Connected Care at Philips, at HIMSS in Orlando on 9th March 2020. I’d interviewed Roy at CES 2020 in Las Vegas in January to catch up on consumer health developments, and the March meeting was going to cover Philips’ innovations on the hospital and acute care side of the business, as well as to learn more about Roy’s new role as head of Connected Care. HIMSS cancelled the conference just days before it was to commence….due to the great disruption of COVID-19.

The coronavirus pandemic has further opened the kimono of the U.S. healthcare system to Americans: four months into the COVID-19 outbreak, most consumers (62%) of people in the U.S. are more concerned about other people not having access to high quality health care versus themselves. This is a 16 point increase in concern in May 2020 compared with the response to the same question asked in February in a poll conducted by the University of Chicago Harris School of Public Policy and The Associated Press-NORC Center for Public Affairs Research (the AP-NORC Center). The AP-NORC Poll found more of this