07:31pm Tuesday 18 February 2020

Latest APA survey reveals deepening concerns about connection between chronic disease and stress

Washington—The American Psychological Association’s (APA) newly released report, Stress in America™: Our Health at Risk, paints a troubling picture of the impact stress has on the health of the country, especially caregivers and people living with a chronic illness such as obesity or depression.

The Stress in America survey, which was conducted online by Harris Interactive on behalf of APA among 1,226 U.S. residents in August and September, showed that many Americans consistently report high levels of stress (22 percent reported extreme stress, an 8, 9 or 10 on a 10-point scale where 1 is little or no stress and 10 is a great deal of stress). While reported average stress levels have dipped slightly since the last survey (5.2 on a 10-point scale vs. 5.4 in 2010) many Americans continue to report that their stress has actually increased over time (39 percent report their stress has increased over the past year and 44 percent say their stress has increased over the past 5 years). Yet stress levels exceed people’s own definition of what is healthy, with the mean rating for stress of 5.2 on a 10-point scale— 1.6 points higher than the stress level Americans reported as healthy.

While 9 in 10 adults believe that stress can contribute to the development of major illnesses, such as heart disease, depression and obesity, a sizeable minority still think that stress has only a slight or no impact on their own physical health (31 percent) and mental health (36 percent). When considered alongside the finding that only 29 percent of adults believe they are doing an excellent or very good job at managing or reducing stress, APA warns that this disconnect is cause for concern.

“America has a choice. We can continue down a well-worn path where stress significantly impacts our physical and mental health, causes undue suffering and drives up health care costs. Or we can get serious about this major public health issue and provide better access to behavioral health care services to help people more effectively manage their stress and  prevent and manage chronic disease,” says psychologist Norman B. Anderson, PhD, APA’s CEO and executive vice president. “Various studies have shown that chronic stress is a major driver of chronic illness, which in turn is a major driver of escalating health care costs in this country. It is critical that the entire health community and policymakers recognize the role of stress and unhealthy behaviors in causing and exacerbating chronic health conditions, and support models of care that help people make positive changes.”

Caregivers Under Fire

Millions of Americans provide care for aging or chronically ill family members at home, and that number is expected to grow as the number of older Americans is likely to double by the year 2030, according to the U.S. Department of Health and Human Services. Findings from the Stress in America survey suggest that we may want to pay particular attention to the impact of these responsibilities on caregivers, who report higher levels of stress, poorer health and a greater tendency to engage in unhealthy behaviors to alleviate their stress than the general public.

Caregivers are not only more likely to report stress than other Americans, they also report it at higher levels. On a scale of 1 to 10 where 1 is little or no stress and 10 is a great deal of stress, the mean level of stress reported by caregivers was 6.5 as compared to 5.2 by the general public. Fifty-five percent of caregivers say they feel overwhelmed by the amount of care their aging or chronically ill family member requires. Caregivers are more likely than those in the general population to say they’re doing a poor/fair job practicing healthy behaviors, including managing stress (45 percent vs. 39 percent) and getting enough sleep (42 percent vs. 32 percent).

The latest data also demonstrate that caregivers are more likely than people in the general public to have a chronic illness (82 percent vs. 61 percent), rate their health as fair or poor (34 percent vs. 20 percent), and point to personal health concerns as a significant source of stress (66 percent vs. 53 percent). In addition, caregivers appear to manage stress in less healthy ways than the general population; for example, caregivers are twice as likely to report smoking to manage their stress (20 percent vs. 10 percent).

Stress Linked to Obesity and Depression

The rate of obesity in the United States remains at epidemic proportions. And according to the Centers for Disease Control and Prevention, 1 in 10 American adults suffers from depression. Findings from Stress in America show that many people who suffer from these conditions say that they are unable to take the necessary steps to reduce their stress and therefore engage in unhealthy behaviors.

On a scale of 1 to 10, people living with depression (6.3) or obesity (6.0) report significantly higher average stress levels than the rest of the population (5.2). Those with depression (33 percent) or who are obese (28 percent) are significantly more likely than the general public (21 percent) to say they do not think they are doing enough to manage their stress. As compared to the general public (11 percent), more people who are obese (34 percent) or depressed (22 percent) report that their disabilities or health issues prevent them from making healthy lifestyle changes. 

“The Stress in America survey continues to show a nation at a crossroads when it comes to stress and health. We are caught in a vicious cycle where our stress exceeds our own definition of what is healthy, and those who are already living with a chronic illness report even higher levels of stress. Yet we’re ill-equipped to make changes to better manage that stress,” says Dr. Anderson. “Given the persistent nature of our stress and the serious physical health consequences associated with it, stress has the potential to become the country’s next public health crisis.”

To read the full report, view the Stress in America: Our Health at Risk town hall event or to download graphics, visit the Stress in America website.

For additional information on stress and lifestyle and behavior, visit APA’s Help Center 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 11 and September 6, 2011, among 1,226 adults aged 18 and older who reside in the U.S. In addition to the 1,226 interviews among the general population, oversamples of 300 caregivers and 1,221 people living with chronic illnesses were also included in the 2011 research. For the purposes of this report, caregivers are defined as adults currently caring for an aging or chronically ill family member. Chronically ill adults are defined as those with at least one of the following conditions: depression, type 2 diabetes, obesity and heart disease. In the report, the adults comprising this group are labeled as “Chronic Illness.” To read the full methodology; visit the Stress in America website.

Additional contact

Scott Rieder, Vanguard Communications, (202) 248-5476

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 154,000 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 psychology as a science, as a profession and as a means of promoting health, education and human welfare.

Harris Interactive is one of the world’s leading custom 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 expertise in a wide range of industries including healthcare, technology, public affairs, energy, telecommunications, financial services, insurance, media, retail, restaurant, and consumer package goods. Serving clients in over 215 countries and territories through our North American, European, and Asian offices and a network of independent market research firms, Harris specializes in delivering research solutions that help us — and our clients — stay ahead of what’s next. For more information, please visit the Harris Interactive website.

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