America Survey Research Articles

How Age Affects Personal and Social Reactions to COVID-19: Results from the National Understanding America Survey

The pandemic of COVID-19 has had tremendous impact on Americans’ lives including their personal and social behaviors. While everyone is affected in some way by the pandemic, older persons have been far more likely to suffer the most severe health consequences. For this reason, how people have responded to the COVID-19 outbreak may differ by age. Using a nationally representative sample from the Understanding America Study (UAS), we examined differentials in behavioral responses to COVID-19 by age and how they change over time. At the beginning of the pandemic (March, 2020), older people were less likely than younger ones to engage in preventive behaviors. As the pandemic progressed, however, older people have adopted healthy behavioral changes more than younger people, such that about two months after the pandemic started, older people were more likely to comply with suggested and regulated behaviors including practicing better hygiene, quarantining, and social distancing. Even when considering other potential influences on behavioral responses, older age was significantly related to performing more preventive behaviors, and gender, racial/ethnic minority status, perceived risk for infection and dying and political orientation were also found to be related to people’s behavioral responses.

Anti-Asian discrimination and the Asian-white mental health gap during COVID-19

ABSTRACT In this article, we consider how, due to a spike in anti-Asian hate crimes, Asians might face a disproportionate mental health impact of the COVID-19 pandemic. Analyzing data from the University of Southern California’s Center for Economic and Social Research Understanding Coronavirus in America survey, we report several findings. First, since the onset of the pandemic, Asians (Asian Americans in particular) have experienced higher levels of mental disorders than whites. Second, Asian Americans and Asian immigrants are about twice as likely as whites to report having encountered instances of COVID-19-related acute discrimination. Third, experiences of COVID-19-related discrimination increase mental disorders for all Americans. Finally, COVID-19-related discrimination partially explains the disproportionate mental health impact of the pandemic on Asians. In conclusion, we highlight the importance of tackling hate, violence, and discrimination so as to address the disproportionate mental health impacts of COVID-19 on minority populations.

Coronavirus stigmatization and psychological distress among Asians in the United States

ABSTRACT Objectives Coronavirus stigmatization may be disproportionately impacting ethnoracial minority groups in the US. We test three hypotheses: [H1] Asians in the US are more likely to report experiencing coronavirus stigmatization than non-Hispanic Whites; [H2] Coronavirus stigmatization is associated with psychological distress; [H3] Magnitude of association between coronavirus stigmatization and psychological distress is more pronounced among US-born Asians, compared to non-Hispanic Whites. Design We analyzed cross-sectional survey data from the 10–31 March 2020 wave of the Understanding America Survey, a nationally representative survey of adults in the US. Psychological distress was assessed with the PHQ-4. Measures of association were estimated using multiple logistic regression and survey sampling weights. Predicted probabilities were calculated using marginal standardization ( n = 6707). Results [H1] The adjusted predicted probability of experiencing any coronavirus stigma among foreign-born Asians (11.2%, 95% CI: 5.5–17.0%; E-value = 4.52), US-born Asians (10.9%, 95% CI: 5.8–16.0%; E-value = 4.23), Blacks (8.0%, 95% CI: 5.3–10.7%; E-value = 2.92), and Hispanic Whites (7.3%, 95% CI: 4.6–9.9%; E-value = 2.58) was significantly greater than non-Hispanic Whites (4.5%, 95% CI: 3.7–5.4%). [H2] Individuals reporting any coronavirus stigma experience were significantly more likely to exhibit psychological distress (19.9%, 95% CI: 14.6–25.2% vs 10.6%, 9.6–11.6%; E-value = 3.16). [H3] The overall magnitude of association between experience of any coronavirus stigma and psychological distress was not significantly between US-born Asians and non-Hispanic Whites, though we found gender to mask this effect. US-born Asian females who experienced coronavirus stigmatization were more likely to exhibit psychological distress than non-Hispanic white females who experienced coronavirus stigmatization (relative risk (RR): 10.21, 95% CI: 2.69–38.74 vs 1.24, 95% CI: 0.76–2.01; p < 0.01). Conclusion Comprehensive measures around care seeking, public awareness, and disaggregated data collection are needed to address ethnoracial coronavirus stigmatization and its impact on psychological health and well-being.

Gender and Family Ties in Latin American Legislatures

AbstractAre women disproportionately more likely than men to have family ties in politics? We study this question in Latin America, where legacies have been historically common, and we focus specifically on legislatures, where women's representation has increased dramatically in many countries. We hypothesize that, counter to conventional wisdom, women should be no more likely than men to have ties to political families. However, this may vary across legislatures with and without gender quotas. Our empirical analysis uses data from the Parliamentary Elites of Latin America survey. We find more gender similarities than differences in legislators’ patterns of family ties both today and over the past 20 years. We also find that women are more likely to have family ties than men in legislatures without gender quotas, whereas this difference disappears in legislatures with quotas.

The "Efficiency" Effect of Conceptual Referents on the Generation of Happiness: A Cross-National Analysis

This paper analyses how different definitions of happiness affect the individual assessment of subjective wellbeing. Bearing in mind the production theory, we study the impact of definitions of happiness on how efficiently a set of determinants are used and converted into happiness. From a theoretical point of view, we discuss the role of the Conceptual Referent Theory within the affective-cognitive process of personal evaluation of happiness. We use data from the Understanding High Happiness in Latin America survey (2018), which includes a sample of people from Colombia, Costa Rica, Mexico and the USA, to investigate how happiness conceptual referents influence personal assessment using Stochastic Frontier Analysis. This method permits to assess the impact of different definitions of happiness on how a set of standard drivers like income and social relations are used and converted into perceived happiness. To this end, conceptual referents for happiness are treated as (in)efficiency factors. This study shows that the concept of happiness shapes how individuals value the same inputs. “Stoicism”, “virtue” and “enjoyment” emerge as the most efficient referents. Also, we observe that cross-country differences in the level of perceived happiness are associated with differences in the prevalence of conceptual referents. In the USA, where less efficient definitions prevail, people report lower levels of happiness.

Prospective associations between US state-level corruption and individual-level cardiovascular risk factors among middle-aged Americans: The National Longitudinal Survey of Youths 1979.

To estimate the associations between US state-level corruption and risk factors for cardiovascular disease, one of the leading causes of mortality and morbidity in the nation. We used a US nationally-representative sample of middle-aged adults from the National Longitudinal Survey of Youths 1979 and data from the Corruption in America Survey to estimate the associations between state-level illegal (private gains) corruption and legal (political gains) corruption in 2013 and individual-level risks of incident diabetes, hypertension, obesity, and depression between 2014 and 2016. Medium and higher levels of illegal corruption were associated with odds ratios (ORs) of 1.75 (95% CI 1.06-2.88) for incident diabetes and 1.70 (95% CI 1.15-2.51) for incident hypertension, respectively. Furthermore, a higher level of legal corruption was associated with ORs of 1.84 (95% CI 1.08-3.13) for diabetes and 1.58 (95% CI 1.05-2.38) for hypertension. No consistent associations were observed for obesity or depression. Our findings suggest that higher levels of corruption contribute to increased risks of developing diabetes and hypertension. Investing resources into fighting corruption may be means to reduce the national burden of cardiovascular disease.

S0780 Patient-Reported Disease Activity in a Large Sample of Ulcerative Colitis (UC) Patients Using Social Media-Delivered Questionnaires

INTRODUCTION: Therapy for IBD should have dual goals of improving symptoms and mucosal healing. PROs used for approval of UC treatments include number of bowel movements and bloody stools. Research highlights discordance between PROs and mucosal healing. The aim of this cross-sectional survey of UC patients is to understand patient perspectives on UC symptoms and disease burden. We hypothesized that UC patients experience disease activity despite treatment and current PROs fail to capture the full impact of disease on patients' lives. METHODS: IBD In America survey recruited patients via InflammatoryBowelDisease.net and associated social platforms in 2019. Patients self-reported an IBD diagnosis, were 18+, lived in U.S., and participated without monetary incentive. Survey questions addressed diagnosis, symptoms, QoL, treatment, demographics, etc. Survey terms were based on how patients discuss UC in the IBD online community. Remission was defined as “significant reduction of symptoms without an actual cure.” Flare was defined as “temporary intensification of symptoms.” Patients were categorized by disease activity based on number of flares and remission status during the past year. RESULTS: Of 487 patients with UC, mean age 45.6 (SD 16.0); 85% female; 89% moderate to severe; 78% diagnosed in past 5 years; and 51% taking 5ASAs, 37% biologics/JAKs, and 23% immunomodulators. Despite treatment, 46% experienced 15+ symptom days in past month. Fatigue was most frequent complaint (86%) followed by urgency to move bowels (80%), abdominal pain (76%), joint pain (67%), and bloating (66%). Daily pain was experienced by 32%; even patients in remission with no flares experienced pain at least once a month (55%). Difficulty completing daily tasks was reported by 37%, and 27% felt their UC was not controlled despite efforts to manage. 7% reported being in remission (past year) and no symptoms (past month). CONCLUSION: Most UC patients experience frequent symptoms and flares while on treatment. The most common symptoms are not considered in PROs nor addressed with current treatment. A more holistic approach to patient disease is needed.

Characterizing Physician Practice in Nursing Homes Using Claims-Based Measures: Correlation With Nursing Home Administrators' Perceptions.

Heterogeneity in physician practice within nursing homes (NHs) may explain variations in quality. However, data on physician practice organization in NHs are hard to obtain. We characterized NH physician practice using two claims-based measures: (a) concentration of NH care among physicians (measured by Herfindahl-Hirschman index of visits); and (b) physician NH practice specialization (measured by the proportion of a physician's visits to NHs). We examined the relationship between the measures and NH administrator perceptions of physician practice reported in the Shaping Long-Term Care in America (SLTCA) Survey. All 2011 Part B claims from 13,718 physicians who treated Medicare fee-for-service patients in 2,095 NHs in the SLTCA survey were analyzed. The median Herfindahl-Hirschman index was 0.44 (interquartile range [IQR] 0.28-0.70), and the median specialization was 38.1% (IQR 19.9% to 60.9%). NHs with higher physician specialization reported more frequent physician participation in care coordination activities. Claims-based measures could inform the study of NH physician practice.

Does Low-Cost Sexual Gratification Make Men Less Eager to Marry? Pornography Use, Masturbation, Hookup Sex, and Desire to Be Married Among Single Men.

Coinciding with declining rates of marriage and coupled sex in the U.S., some scholars have proposed that the growing availability of "low-cost sexual gratification" or "cheap sex"-sexual activities such as hookups, pornography use, and masturbation that demand little effort or investment-will lead men to find marital commitment less appealing. Using data from two nationally representative surveys of American adults (2012 New Family Structures Study, N = 349; 2014 Relationships in America Survey, N = 1402), the current study tested the thesis that unmarried men's pornography use, masturbation habits, or frequency of recent hookup sex would be associated with a lower likelihood of them finding marriage desirable. This thesis was unsupported. In both surveys, masturbation and hookup sex were not associated with unmarried men wishing to be married, while pornography use was robustly and linearly associated with a higher likelihood of wanting to be married. This association was apparent at both the bivariate level and after taking into account sexual satisfaction, relationship status, beliefs about marriage, and a host of other potential confounds. Findings suggest that, rather than making marriage less desirable, some forms of "low-cost sexual gratification" such as pornography use to predict a comparatively higher desire for marriage. The implications of these findings are considered in light of sex-exchange theories of marital commitment and the large body of previous research connecting pornography use to more liberal, non-monogamous sexual attitudes.

CARES Act: Implications for Retirement Security of American Workers

Many provisions of the Coronavirus Aid, Relief, and Economic Security (CARES) Act were designed to provide relief to those American workers who do not have sufficient emergency savings to weather the current storm. These include increasing defined contribution plan loan limits to the greater of $100,000 or 100 percent of the vested account balance; suspending loan payments due on or before December 31, 2020, and deferring loan payments for up to one year; allowing distributions until December 31, 2020, of the lesser of 100 percent of the vested account balance or $100,000; and allowing repayment of coronavirus-related distributions (CRDs) over a three-year period. The question, however, is as follows: What is the cost of effectively using defined contribution plans as emergency savings vehicles in this way when it comes to the future retirement security of American workers? Using the Employee Benefit Research Institute’s (EBRI’s) Retirement Security Projection Model® (RSPM), we simulate the impact on retirement balances as a multiple of pay at age 65 for scenarios where employees take full advantage of the CARES Act flexibility to access their defined contribution plan. We generally find: • There are limited reductions in projected retirement balances as a multiple of pay at age 65 in scenarios where employees pay back CRDs within the prescribed three-year timeframe or take new loans — even when workers reduce future contributions dollar for dollar in order to repay those loans. • However, we see potentially significant reductions in retirement balances as a multiple of pay at age 65 when employees take full CRDs and fail to pay them back. This is especially true for older age cohorts. • The most catstrophic scenario is one in which workers are provided CARES-Act-like access to withdrawals time and again as various crises occur. In other words, this is a scenario in which policymakers essentially turn defined contribution plans into de facto emergency savings vehicles. In this scenario, the overall median reduction in retirement balances as a multiple of pay at age 65 is 54 percent. • Still, further analysis is warranted. In our preliminary analysis of potential actual aggregate utilization of CARES Act provisions based on employer responses to a Plan Sponsor Council of America (PSCA) survey, we find that reductions were very small. Even in the scenario in which employees fail to pay back CRDs, the aggregate impact — because of low estimated actual implementation and utilization of CARES Act provisions — is estimated to be less than one-half a percent.

1187 What Types Of Organizations Provide Sleep-focused Workplace Health Promotion Programs For Their Employees? An Analysis Of The 2017 CDC Workplace Health In America Survey

Abstract Introduction There has been a rise in workplace health promotion programs (WHPP)’s in the U.S., designed to improve a variety of employee health behaviors such as exercise and nutrition. Yet, relatively few focus on the third pillar of health: Sleep. Methods The CDC collected data from a nationally-representative cohort of companies in 2017. Participants in this Workplace Health in America study completed online surveys reporting the type of WHPP offerings at their worksite and characteristics of their worksite, including occupational field (e.g., agriculture, management, wholesale/retail), workforce size (i.e., small: &amp;lt;100; moderate: 100-499; and large: 500+) and company type (e.g., non-profit, profit-private, profit-public, government). We identified factors associated with an increased likelihood of sleep-focused WHPP using logistic regression adjusted for company size and type. Analyses were weighted for nationally-representative estimates. Results Of the N=2,843 companies that provided information, N=261 (11.74%) reported having a sleep program. Worksites with large workforces (OR=4.8, p&amp;lt;0.0005), for-profit public companies (OR=9.0, p&amp;lt;0.0005), in wholesale/retail (OR=3.8, p&amp;lt;0.0005), and those with employer-subsidized full health insurance (OR=12.7, p&amp;lt;0.0005) were more likely to have a sleep-focused WHPP. Other predictors included more long-standing WHPP programs (6 years, OR=4.4, p&amp;lt;0.0005), the presence of employee health in the company’s mission (OR=4.5, p&amp;lt;0.0005), leadership buy-in (OR=3.5, p=0.007), and an annual health promotion budget &amp;gt;$50,000 (OR=11.3, p&amp;lt;0.0005). Conclusion In general, workplaces with higher budgets, more well-established health promotion programs, and a mission to promote workplace health are more likely to include a sleep program. Also, publicly-traded companies and government were more likely than private companies to have a sleep program. Future research may consider defining barriers among small business and non-profit organizations for implementing sleep-focused workplace health programs. Support T32HL007901

Prevalence of Workplace Health Practices and Policies in Hospitals: Results From the Workplace Health in America Study.

To provide a nationally representative description on the prevalences of policies, practices, programs, and supports relating to worksite wellness in US hospitals. Cross-sectional, self-report of hospitals participating in Workplace Health in America (WHA) survey from November 2016 through September 2017. Hospitals across the United States. Random sample of 338 eligible hospitals participating in the WHA survey. We used previous items from the 2004 National Worksite Health Promotion survey. Key measures included presence of Worksite Health Promotion programs, evidence-based strategies, health screenings, disease management programs, incentives, work-life policies, barriers to health promotion program implementation, and occupational safety and health. Independent variables included hospital characteristics (eg, size). Dependent characteristics included worksite health promotion components. Descriptive statistics and χ2 analyses were used. Eighty-two percent of hospitals offered a wellness programs during the previous year with larger hospitals more likely than smaller hospitals to offer programs (P < .01). Among hospitals with wellness programs, 69% offered nutrition programs, 74% offered physical activity (PA) programs, and 84% had a policy to restrict all tobacco use. Among those with cafeterias or vending machines, 40% had a policy for healthier foods. Only 47% and 25% of hospitals offered lactation support or healthy sleep programs, respectively. Most hospitals offer wellness programs. However, there remain hospitals that do not offer wellness programs. Among those that have wellness programs, most offer supports for nutrition, PA, and tobacco control. Few hospitals offered programs on healthy sleep or lactation support.

Religious Engagement, Civic Skills, and Political Participation in Latin America

AbstractTo what extent has the growth of Evangelicalism in Latin America contributed to political participation across the region? A number of scholars of religion and politics in the United States have suggested that Evangelicalism promotes the development of civic skills necessary for political engagement, while the Catholic Church, due to its hierarchical structure, provides fewer opportunities for skill acquisition. In this paper, we apply this debate to Latin America to test whether civic skills developed in Catholic and Protestant church activities lead to differential participation rates in 18 countries. We utilize the 2014 Pew Religion in Latin America survey to test these effects, and find that Protestant churches do indeed promote skill‐developing activities at higher rates, but that Catholics, when involved, are more likely to translate this religious participation into political action. We conclude that political scientists must better understand the organizational role of religion in promoting political engagement worldwide.

P157 Patient-reported disease activity in a large sample of ulcerative colitis patients using social media-delivered questionnaires

Abstract Background Medical therapy for inflammatory bowel disease (IBD) should have dual goals of improving symptoms and mucosal healing. Patient-reported outcomes (PROs) used for approval of ulcerative colitis (UC) treatments include number of bowel movements and bloody stools.[1] Recent research highlights the discordance between PROs and mucosal healing.[2] The aim of this analysis is to understand patient perspectives on UC symptoms and disease burden based on a cross-sectional survey of UC patients. We hypothesised that UC patients experience disease activity despite treatment and that current PROs fail to capture the full impact of disease activity on patients’ lives. Methods The IBD In America survey recruited patients via InflammatoryBowelDisease.net and associated social platforms in 2019. Patients self-reported an IBD diagnosis, were 18+, lived in U.S., and participated without monetary incentive. Survey questions addressed diagnosis, symptoms, QoL, treatment, demographics, etc. Survey terms were based on how patients discuss UC in the IBD online community. Remission was defined as ‘significant reduction of symptoms without an actual cure.’ Flare was defined as ‘temporary intensification of symptoms.’ Patients were categorised by disease activity based on number of flares and remission status during the past year. Results Of 487 patients diagnosed with UC, mean age was 45.6 (SD 16.0); 85% were female; 89% moderate to severe; 78% diagnosed in past 5 years; and 51% taking 5ASAs, 37% biologics/JAKs, and 23% immunomodulators. Despite treatment, 46% experienced 15+ symptom days in the past month. Fatigue/low energy was most frequent complaint (86%) followed by urgency to move bowels (80%), abdominal pain/cramps (76%), joint pain/inflammation (67%), and bloating (66%). Daily pain was experienced by 32%; even patients in remission with no flares experienced pain at least once a month (55%). Difficulty completing daily tasks was reported by 37%, and 27% felt their UC was not controlled despite efforts to manage it. Only 7% reported being in remission with no flares (past year) and no symptoms (past month). Conclusion Most UC patients experience frequent symptoms and flares while on treatment. The most common and bothersome symptoms are not taken into account in PROs nor addressed with current treatment. A more holistic approach to patient disease is needed. Reference

Pornography and Relationship Quality: Establishing the Dominant Pattern by Examining Pornography Use and 31 Measures of Relationship Quality in 30 National Surveys.

Numerous studies have examined the association between pornography use and various measures of relationship quality. Yet scholars have also pointed out the limitations of many such studies, including inconsistent findings for men and women, non-representative samples, and negatively biased measures that could result in misleading findings. The purpose of this study was to establish a dominant pattern in the association between pornography use and relationship quality in a way that mitigated these issues. Data were taken from 30 nationally representative surveys, which together included 31 measures of relationship quality: 1973-2018 General Social Surveys (1 repeated measure); 2006 Portraits of American Life Study (13 measures); 2012 New Family Structures Study (12 measures); and 2014 Relationships in America Survey (5 measures). This allowed for 57 independent tests examining the association between pornography use and relationship outcomes for married Americans and 29 independent tests for unmarried Americans. Along with bivariate associations, full regression models were estimated with sociodemographic controls and interaction terms for gender. For married and unmarried Americans alike, pornography use was either unassociated or negatively associated with nearly all relationship outcomes. Significant associations were mostly small in magnitude. Conversely, except for one unclear exception, pornography use was never positively associated with relationship quality. Associations were only occasionally moderated by gender, but in inconsistent directions. While this study makes no claims about causality, findings clearly affirmed that, in instances where viewing pornography is associated with relationship quality at all, it is nearly always a signal of poorer relationship quality, for men and women.

«Malleus Maleficarum» сучасного суспільства: передумови і поширеність тортур у ХХІ столітті та політика протидії тортурам

«Malleus Maleficarum» сучасного суспільства: передумови і поширеність тортур у ХХІ столітті та політика протидії тортурам

APA annual stress survey finds 2020 election one major cause

The American Psychological Association (APA) on Nov. 5 released its annual Stress in America survey, which found that the 2020 presidential election has been identified by more than half of U.S. adults as a significant stressor. Additionally, the survey found that stress about health care is on par with stress related to mass shootings.

Use of Treatments for Irritable Bowel Syndrome and Patient Satisfaction Based on the IBS in America Survey

Many treatments for irritable bowel syndrome are available to those with the disease. Satisfaction with these treatments is low, and a need exists for further effective treatments for the condition.

Global Patterns of Adolescent Fruit, Vegetable, Carbonated Soft Drink, and Fast-Food Consumption: A Meta-Analysis of Global School-Based Student Health Surveys.

Adolescence presents an opportunity to influence diet, which impacts present and future health outcomes, yet adolescent diets globally are poorly understood. We generate evidence on adolescent diets globally and explore patterns and trends by subpopulation. We estimated mean frequency of consumption and prevalence of less-than-daily fruit and vegetable consumption, at-least-daily carbonated beverage consumption, and at-least-weekly fast-food consumption among school-going adolescents aged primarily 12 to 17 years from the Global School-based Student Health Surveys in Africa, Asia, Oceania, and Latin America between 2008 and 2015. Random-effects meta-analysis was used to pool estimates globally and by subgroup. On average, adolescents consumed fruit 1.43 (95% confidence interval [CI] 1.26-1.60) times per day, vegetables 1.75 (1.58-1.92) times per day, carbonated soft drinks 0.99 (0.77-1.22) times per day, and fast food 1.05 (0.78-1.32) times per week. Overall, 34.5% (95% CI 29.4-39.7) consumed fruit less than once per day, 20.6% (15.8-25.9) consumed vegetables less than once per day, 42.8% (35.2-50.7) drank carbonated soft drinks at least once per day, and 46.1% (38.6-53.7) consumed fast food at least once per week. Mean daily frequency of fruit consumption was particularly low in South and East Asia (1.30 [1.02-1.58]); carbonated soft drink consumption high in Latin America (1.54 [1.31-1.78]), high-income countries (1.66 [1.29-2.03]), and modern food system typologies (1.44 [0.75-2.12]); and mean weekly fast food consumption high in mixed food system typologies (1.29 [0.88-1.71]). School-going adolescents infrequently consume fruits and vegetables and frequently consume carbonated soft drinks, but there is wide variability by subpopulation.

Fear of mass shootings prevents some from going certain places

A large majority of adults in the United States are stressed by mass shootings, and a third of U.S. adults say that fear of mass shootings stops them from going to certain places and events, according to a new survey on stress and mass shootings by the American Psychological Association (APA). To better understand the impact of mass shootings on stress and health in the aftermath of the recent tragic El Paso and Dayton shootings, the APA commissioned the nationally representative survey. It was conducted online by The Harris Poll between Aug. 8 and 12 among 2,017 adults ages 18 and older who reside in the United States. The survey found that more than three‐quarters of adults (79%) in the United States say they experience stress as a result of the possibility of a mass shooting. Nearly one in three adults (32%) feel they cannot go anywhere without worrying about being a victim of a mass shooting, while just about the same number (33%) say fear prevents them from going to certain places or events. When asked which places they are stressed about the possibility of a mass shooting occurring, adults most commonly say a public event (53%), mall (50%), school or university (42%) or movie theater (38%), with only one in five (21%) saying they never experience stress as a result of the possibility of a mass shooting. Hispanic adults (32%) are more likely than white non‐Hispanic adults (15%) to say they experience stress often or constantly related to the possibility of a mass shooting. The results of this survey come in advance of the findings of the APA's annual Stress in America survey, which will be released this fall.