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National report puts focus on managing stress to decrease chronic disease

Heather Rudow February 13, 2012


A nationwide report about stress in day-to-day life conducted by the American Psychological Association (APA) reveals that, although average stress levels have decreased slightly over the past year, a substantial number of Americans say their individual stress has actually increased through the years. Not surprisingly, the report also reveals that stress has a domino effect on our health, and experts contend that the only way to properly address these effects is through a change in America’s health care and political system.

The report, “Stress in America: Our Health at Risk,” covers a survey conducted online among 1,226 U.S. residents between August and September of 2011.

“What we found this year is really a good news, bad news story,” said Norman Anderson, CEO and executive vice president of the APA, at an APA-sponsored town hall to discuss the report.

The survey revealed that 22 percent of Americans reported “extreme stress,” which was marked as an 8, 9 or 10 on a 10-point scale, with 1 being “little or no stress” and 10 indicating a “great deal of stress.” The relative good news is that the reported average stress levels decreased slightly from a 5.4 in 2010 to a 5.2 in 2011.

However, Anderson noted, individual levels of stress have increased for some Americans. According to the report, 39 percent of participants said their stress had increased over the past year, while 44 percent said their stress had increased over the past five years.

The report found those at greatest risk for high amounts of stress are individuals with a chronic illness such as depression or obesity (which APA identifies as a chronic illness), and those who take on the role of caregiver for a loved one.

On the stress intensity scale used for the survey, caregivers reported an average stress level of 6.5, whereas the general public reported an average stress level of 5.2. Fifty-five percent of caregivers also reported feeling overwhelmed by the amount of care required by the family member for which they are responsible. The survey revealed that caregivers are more likely than the general public to say they’re doing a poor/fair job of “practicing healthy behaviors, including managing stress (45 percent vs. 39 percent) and getting enough sleep (42 percent vs. 32 percent).” They also appear to manage their stress in ways that are more destructive to their health. The study found that caregivers are twice as likely as other respondents to report smoking as a way to ease their stress (20 percent compared with 10 percent). Caregivers are also more likely than the general population to have a chronic illness — 82 percent compared with 61 percent.

As a press release from APA notes, findings from “Stress in America” revealed that “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.”

APA President Suzanne Bennett Johnson said at the town hall meeting that it will be difficult to significantly decrease stress levels in the United States unless the nation’s health care model also changes. In her view, care systems have not addressed behavioral aspects of getting or living with a chronic illness. “I think our health care system needs to focus more on people and less on disease,” she said.

Katherine Nordal, executive director of APA’s Practice Directorate, said it is important to consider a person’s family dynamics and environment when looking at what stresses that person. “We don’t live in a vacuum,” she reminded the town hall audience.

Anderson, Johnson and Nordal agreed that health care providers should not only ask about patients’ health and behavior, but also about what is happening in their families and personal lives as well.

The three also support a holistic, team-based approach to therapy, in which patients see a primary physician as well as a mental health specialist such as a counselor or psychologist. In addition, they championed community-based programs such as those found at the YMCA as one avenue for helping Americans cope with stress.

“It’s different than going into a hospital and thinking, ‘I’m back in treatment again,’” said Jonathan Lever, vice president of health strategy and innovation for YMCA of the USA. “Many of these programs are group-based, and there is magic among these group programs because people are there to support them.”

Along with trying to change the health care system to become more person-centered, another hurdle mental health professionals face is convincing Americans that high-stress lifestyles are linked to poor health down the road.

As “Stress in America” reports, even though nine in 10 adults think a link exists between stress and the development of a major illnesses such as heart disease, depression or obesity, there is a disconnect when it comes to applying this rationale to themselves: 31 percent believe stress has a “slight or no” impact on their own physical health; 36 percent of Americans also hold the same belief regarding the impact of stress on their mental health.

“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,” Anderson said in a press release. “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.”

Read the entire report here.

Source: American Psychological Association

Heather Rudow is a staff writer for Counseling Today. Email her at hrudow@counseling.org.

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