Insights from the Health Information National Trends Survey: What Americans Really Think About Healthcare

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What Americans Really Think About Healthcare: Insights from the Health Information National Trends Survey

American healthcare is a hotly debated issue, with opinions often based more on ideology or anecdote than evidence. But what do Americans actually think about healthcare, and how has their perception changed over time? To answer these questions, we can turn to the Health Information National Trends Survey (HINTS), a biennial survey that collects data on the use, trust, and attitude towards health information and communication technologies among the U.S. adult population. Here are some insights from the latest HINTS (HINTS 5, fielded in 2017), which involved more than 3,000 respondents.

The Affordable Care Act (ACA) is still divisive

Despite numerous attempts to repeal or replace the ACA, also known as Obamacare, it remains a polarizing law. According to HINTS 5, 42% of Americans viewed the ACA as good for the country, while 37% viewed it as bad. This represents a slight improvement from HINTS 4, which showed a 39% to 46% split. Nonetheless, political affiliation strongly influenced the perception of the ACA, with Democrats being much more likely to support it than Republicans.

Lack of affordable healthcare is a major concern

A majority (62%) of Americans cited the cost of healthcare as their top health-related financial concern, followed by health insurance (50%), prescription drugs (46%), and co-pays (34%). The perception of high healthcare costs was consistent across various demographic groups, including age, income, education, and race/ethnicity. In fact, nearly half of uninsured respondents reported avoiding medical care due to the cost, compared to only 12% of insured respondents. For many Americans, access to affordable healthcare is a matter of life and death.

Trust in healthcare providers and institutions is declining

While more than two-thirds of Americans still rated their healthcare as good or excellent, there was a significant decline in trust in healthcare providers and institutions since HINTS 4. For instance, only 45% of Americans trusted their primary doctor to give them the best advice, down from 51%. Similarly, only 34% of Americans trusted health insurance companies, down from 39%, and only 31% trusted the government to provide accurate health information, down from 39%. This erosion of trust is particularly worrisome given the crucial role of healthcare in maintaining public health and well-being.

Digital health has potential but faces challenges

The use of digital health tools, such as health apps, wearable devices, and social media, is growing rapidly, but it also raises concerns about privacy, security, and quality. HINTS 5 showed that about 63% of Americans used the internet to look for health information, while only 17% used health apps and 14% used wearable devices. Furthermore, only 14% of Americans trusted health information shared on social media a lot, while 40% did not trust it much or at all. There were also significant disparities in the use and trust of digital health tools across demographic groups, reflecting the pervasive digital divide in the U.S.

Conclusion: What can we learn from HINTS 5?

The insights from HINTS 5 suggest that Americans are deeply concerned about healthcare affordability, even if they have different opinions on how to address it. Trust in healthcare providers and institutions is declining, which may hinder efforts to promote health literacy and prevention. Digital health has the potential to empower patients and improve health outcomes, but it also requires careful attention to ethical and social issues. Overall, HINTS provides a valuable source of data for policymakers, researchers, and healthcare professionals to understand and respond to the complex and dynamic landscape of American healthcare.

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