In the span of just a few years, America has ricocheted from a pandemic to a mental health crisis, from record profits in the healthcare industry to heightened frustration among patients. Insurance premiums are climbing, hospital systems are consolidating, and burnout is pushing providers out of the field faster than new ones can replace them. These pressures have collided with political battles over coverage and cost, and even the recent government shutdown left many people wondering what parts of the system they could reliably count on.
And now it is January, the month when millions of people decide this will be the year they finally get healthier. They set goals, make plans, and try to take better care of themselves. But those resolutions unfold inside a system that often feels unpredictable, expensive, and harder to navigate than it should be. Civic Pulse data gives us a clear look at that reality.
Views on Our Health
To understand the full story, we start with how people feel in their own bodies and what they see when they step into the healthcare system. The good news is that most Americans say their health is at least okay. About half rate their health as good or excellent, while only a small share describe it as poor. The rest live in that familiar middle ground where you are not unwell, but you are also not thriving.
Access also looks surprisingly functional on paper. About 72% say it is easy for them to get the care they need, whether somewhat or very easy. And 66% say the quality of their available care is good or excellent. If this were the whole picture, you might assume the system is steady and reliable.
But people’s lived experiences tell a different story. Even those in good health talk about uncertainty: long waits for appointments, rushed visits, opaque billing, and the sense that the quality of care depends too much on luck and geography. Beneath it all is a steady worry that the system won’t be there when they truly need it. And more than anything, they talk about cost. That tension comes into sharp focus when we look at access by financial comfort.
And unmistakable in the data: people notice how the healthcare system treats them as consumers, not patients. In the open responses, one person put it bluntly: “Quit trying to make so much money from healthcare.” Another said they would trust the system more “if the CEOs did not get millions in bonuses.” Others wished for “a system that is less concerned with money and more with actual health.” These quotes reflect a sense that the system’s motivations are misaligned with people’s needs.
The Price Tag Is the Crisis
Money has become the first filter through which people interpret their health. Nearly half of Americans do not feel confident they could afford the care they would need if they or a family member became seriously ill. That includes people with insurance. It includes people who say their health is good. It includes people who otherwise feel stable.
So it tracks that when we asked people which health policy issue should be the nation’s top priority, 54% chose lowering healthcare costs. Nothing else came close. Not mental health, not insurance expansion, not reproductive rights, not opioids, not pandemic preparedness. Cost dominates everything.
This financial fear affects how people approach every decision. When we ask about barriers to staying healthy 20% of people directly mention affordability. When you read what they say, cost influences when they seek care, how long they wait, whether they fill prescriptions, and how they plan for the future.
But the cost crisis is not limited to hospitals or insurance. A third of people who cited affordability as their top barrier specifically mentioned food costs. Women, particularly those over 30, were far more likely to name groceries as a hurdle. This expands the picture of “healthcare costs” to something much broader: people feel financially squeezed not just when they’re sick, but when they try to stay well.
Trust Is Fractured
The third part of the story is about trust: who people listen to, who they ignore, and how they navigate an information environment that feels increasingly chaotic.
When it comes to guidance on something as basic as childhood vaccines, people scatter across a wide range of sources. Doctors are still the anchor, with 52% turning to their pediatrician or primary care provider. Pharmacists come next at 21%. Friends and family follow at 20%. Institutional public health sources like the CDC, WHO, or local health departments draw only 15–19%. And 7% turn to social media or influencers. The sharpest contrast appears once you break the data out by education level a clear shift in how much weight people place on expert opinions.
But across the board, over the last year “messages around vaccines, pregnancy, and women’s health” decreased trust in public health institutions for 38% of people (up to 44% for college graduates) and increased trust for only 8%.
The open responses show a deeper rupture: people increasingly see trust as something earned through relationships, not institutions. Two-thirds say they rely most on a healthcare professional—usually their own doctor—for guidance. Only 8% say they primarily trust public health institutions, and nearly as many say they trust “no one” or “myself.” Younger adults, in particular, lean on friends and family over experts. This signals a shift from institutional trust to interpersonal trust: people believe people.
Final Thoughts
At the heart of all this is a simple truth. Americans want to be well. They want to care for their families, protect their communities, and trust that the system will catch them when something goes wrong. But they are navigating rising costs, shifting messages, and an information landscape that keeps pulling their attention in different directions.
And when we asked what keeps them from being healthier, the answers revealed something both intimate and structural: people are tired. A quarter cited low motivation or energy. Nearly as many pointed to lack of time. These are more signals of a population stretched too thin.
This leaves us with a few questions:
What would it take for people to feel financially safe within the healthcare system?
How does trust get rebuilt when the information environment is fractured?
And how do communities maintain their health when so much of the burden has shifted onto individuals who already feel stretched thin?
What Americans reveal here is not a lack of resilience, but a longing for a system that matches the effort they put into caring for themselves and the people they love.
Until next time, stay well.
Murmuration is a non-profit that organizes a network of partners and equips them with the insights, tools, and services needed to help communities build and activate the power to transform America into a nation where everyone thrives. murmuration.org