June 1st, 2012

Stress in America: a chronic condition

Earlier this year, the American Psychological Association (APA) released findings from its 2011 survey Stress in America™: Our Health at Risk. In January, a distinguished panel discussed the findings, identified key areas of concern and offered their thoughts on ways to address stress-related problems.

Susan Dentzer, editor-in-chief of the national peer-reviewed journal Health Affairs, moderated the event, which included panel members Norman B. Anderson, Ph.D., CEO and executive vice president of APA; Suzanne Bennett Johnson, Ph.D., 2012 APA president; Katherine C. Nordal, Ph.D., executive director for professional practice at APA; and Jonathan Lever, JD, Ed.M., vice president of health strategy and innovation at the Y (YMCA).

According to Anderson, the online survey, the first of which was conducted in 2007, polled 1,226 U.S. residents in August and September 2011 and indicates the numbers of individuals experiencing a high degree of stress has decreased, i.e., 5.2 on a 10-point scale vs. 5.4 in 2010. However, half of the respondents noted their individual stress levels had increased; 39 percent reported an increase in the past year, while 44 percent noted an upsurge over the last five years. The survey shows that the highest stress factors include money (75 percent); work (70 percent); the economy (67 percent); relationships (58 percent); and family responsibilities (57 percent). Anderson says, “The types of stress tend to be the same year to year, but there is a cluster around economic factors, interpersonal relationships and family caregivers.”

Anderson explains that team-based care has the potential to make significant changes to the health care system. He promotes a holistic approach in which patients see a primary care physician and a team of professionals including a nurse practitioner, social worker and psychologist who focus on treatment and prevention.

Johnson emphasizes that the “disease model” of treating a problem with drugs or surgery does not address behavioral aspects of illness. “The focus should be more on people, not the diagnosis,” she says. “The health care system needs to be structured to take all demographic risk factors into account.”

The current fiscal structure needs to be overhauled, according to Nordal. “Seventy-five percent of health care dollars are spent on chronic illness,” she says, adding that a biological assessment of diet, nutrition, exercise and family relationships can offer important cues regarding stress and where and how to make appropriate changes. Additionally, she points out that as the population ages and caregivers, as well as those they care for, will continue to get higher rates of chronic illness, increasing the financial burden on the system.

The panel suggested that patient centered medical home and other community-based organizations working together can produce positive results. Lever says that during the last several years, the Y has “moved from a focus on the already fit to health seekers.” He says, “Local Ys have become more involved in chronic disease prevention programs.” APA collaborates with this national organization to run free workshops at local Ys, according to Lever.

“Twenty years ago you couldn’t get anyone to see a link between stress and health,” says Anderson. While strides have been made, the profession has a long way to go and “still needs some targeted education.”

The full report can be accessed at www.stressinamerica.org.

By Phyllis Hanlon

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