Feeling Worse

Why don't Americans feel as good as they once did? The percentage of adults aged 18 or older who say they are in "excellent" or "very good" health fell from 59 to 54 percent between 1995 and 2005, according to the government's Behavioral Risk Factor Surveillance System.

The aging of the population explains some of the decline, since older Americans are less likely to report being in tip-top shape. But an examination of the data by age group reveals young adults to be the ones with the biggest decline in health status. The percentage of 25-to-34-year-olds who say they are in excellent or very good health fell by nearly 8 percentage points between 1995 and 2005—from 70 to 62 percent. In contrast, among people aged 65 or older, the percentage reporting excellent or very good health fell by less than 1 percentage point, declining from 37.2 to 36.5 percent during those years.

Every demographic segment was less likely to report being in excellent or very good health in 2005 than in 1995, but some recorded bigger declines than others. By race and Hispanic origin, Hispanics experienced the sharpest drop in health status—down an eyebrow raising 17 percentage points. By income group, those in the middle saw the biggest decline in health status. The percentage reporting excellent or very good health fell by 11 to 12 percentage points for those with household incomes ranging from $15,000 to $49,999. By education, high school graduates and those with only some college experienced a larger decline in health status than those without a high school diploma or a college degree.

One possible explanation for our worsening health status is the decline in health insurance coverage. The groups experiencing the biggest losses in health insurance coverage are also the groups with the biggest declines in health status. The percentage of people aged 25 to 34 without health insurance grew from 23 to 26 percent between 1995 and 2005—the biggest increase among age groups, according to the Census Bureau. This is also the age group reporting the biggest decline in health status. The only age group with universal health insurance coverage—people aged 65 or older—experienced the smallest change in health status during those years. Likewise Hispanics, the group most likely to be without health insurance, saw the biggest decline in health status. Middle-income groups—with incomes too high to qualify for Medicaid (the government's health insurance program for the poor) and too poor to afford employer-provided or private health insurance—also experienced the biggest declines in self-reported health status.

If the lack of health insurance is behind Americans' growing unease about their health, then we're likely to feel even worse in the years ahead as health insurance costs climb and coverage falls.