Americans' top public health concerns

For the poll, Axios and Ipsos surveyed a nationally representative sample of 1,162 U.S. adults from August 11 to August 14, 2023. This poll is the third wave of the Axios-Ipsos American Health Index.

In the latest survey, 26% of respondents said opioids and fentanyl are currently the No. 1 threat to American public health. Other top threats to public health are obesity (23%), access to guns and firearms (20%), and cancer (11%).

In comparison, respondents were much less concerned about unsafe roads or driving, smoking or tobacco products, COVID-19, or alcohol abuse. 

In general, less than half of respondents were familiar with recent public health-related events or milestones when asked. For example, only 25% of respondents said they were familiar with supply chain issues leading to cancer drug shortages, and the same number said they knew about people contracting mosquito-borne malaria in the United States.

There were slight differences in familiarity with certain topics depending on the regions of the respondents. Although 44% of all respondents knew that U.S. drug overdose deaths hit a new high last year, this number increased to 51% among rural respondents, who were also more likely to rank opioids and fentanyl as a top concern.

However, even if respondents were not necessarily aware of these events, they showed concern about their potential impacts. Over 80% of respondents said they cared about supply chain issues affecting cancer drug shortages, as well as the record number of overdose deaths.

In addition, respondents were highly sensitive to economic issues relating to healthcare. Almost 75% of respondents said they somewhat or strongly support capping out-of-pock prescription drug costs at $2,000 a year, and 89% said they somewhat or strongly support insurers covering mental healthcare at the same level as physical care. A similar number (80%) support the government preventing pharmaceutical monopolies.

How Americans currently feel about COVID-19

Over the last few weeks, COVID-19 cases and hospitalizations have been rising again in the United States. In addition, a new omicron subvariant, EG.5.1, is growing in prevalence.

With this increase in cases and hospitalizations, fewer respondents said they believe the pandemic is over, going from 62% in mid-May to 50% in the latest survey. In addition, 46% said this current increase in COVID-19 cases is concerning while 53% said it was not concerning.

In general, most respondents (69%) were not concerned about the risk of COVID-19 to their health, and many are not planning to change their behavior. Eighty-two percent of respondents said they have not taken an at-home COVID-19 test in the past week, and only 15% said they mask in public at least sometimes.

"The concern about rising COVID cases is mixed, but what's more clear is that there's really no behavioral change," said Mallory Newall, VP at Ipsos. "Moreover, the perceived level of risk of contracting COVID remains low — on par with getting a tick or mosquito bite." (Bettelheim, Axios, 8/17; Axios-Ipsos American Health Index, 8/17)

The opioid epidemic is a complex, multi-dimensional public health problem. Use this list of helpful resources on how hospitals and health systems can play a role to treat opioid addiction and prevent further increase in opioid abuse.