Friday’s Daily Dose: Healthcare costs, tobacco control and sleep health

CLEVELAND — Americans are voicing clear concerns about their ability to afford healthcare, according to new polling data from KFF. The survey reveals that healthcare costs have emerged as the top economic anxiety across political affiliations, surpassing worries about food, housing and transportation expenses.

The national poll found that one-third of Americans report being “very worried” about affording healthcare for their families – more than those concerned about groceries, rent, or utility bills. This anxiety comes after Congress allowed enhanced Affordable Care Act tax credits to expire, significantly increasing premium costs for marketplace enrollees. A majority of Americans, 56 percent, expect their family’s healthcare costs to become less affordable in the coming year.

Two-thirds of the public say Congress made the wrong decision by not extending the enhanced tax credits, though opinions divide sharply along party lines. While large majorities of Democrats and independents opposed the expiration, most Republicans and supporters of the “Make America Great Again” movement supported the decision. More than four in 10 voters indicate that healthcare costs will significantly influence both their decision to vote and which candidates they support.

Meanwhile, the American Lung Association’s annual “State of Tobacco Control” report card shows both progress and concern. Adult smoking rates have dropped from just over 23 percent in 2000 to below 11 percent in 2023, and youth tobacco use has reached its lowest level in 25 years. However, more than two million middle and high school students still use tobacco products, including e-cigarettes, and experts warn that hard-won progress could unravel.

Tobacco use remains the leading cause of preventable death and disease in the United States, claiming more than 490,000 lives annually. The report assigns mixed grades to federal efforts: a “D” for tobacco product regulation and smoking cessation coverage, an “F” for federal tobacco taxes, and a “B” for prevention and control funding. Chief author Thomas Carr noted that no state received all A’s.

The report recommends strengthening public policies including higher tobacco taxes, comprehensive smoke-free workplace laws, and greater federal regulation such as reducing nicotine levels in cigarettes and ending flavored tobacco product sales, particularly important since nearly 90 percent of youth who use e-cigarettes prefer flavored products.

New research published in the Journal of the American Heart Association also highlights health risks for people who naturally stay up late. The study tracked more than 322,000 middle-aged and older adults in the United Kingdom over nearly 14 years, finding that night owls were 79 percent more likely to have poor overall cardiovascular health and faced a 16 percent higher risk of developing cardiovascular disease. The connection was particularly strong for women.

Researchers attribute this increased risk partly to unhealthy habits more common among night owls, including poor diet, less exercise and smoking. Experts recommend that late-night individuals establish consistent sleep and wake times, get morning light exposure, stop smoking and maintain healthy lifestyle habits.

Cleveland Clinic sleep psychologist Alicia Roth emphasizes the importance of a gradual wind-down period before bed. She explains that people cannot expect to transition instantly from high activity to sleep like flipping a light switch. Instead, she recommends creating a relaxing bedtime routine starting about an hour before sleep, which might include reading or taking a warm bath.

Doctor Roth advises avoiding caffeine, heavy meals and alcohol before bedtime, and limiting daytime naps so most sleep occurs at night. She stresses that people should only get into bed when they already feel sleepy, and if sleep doesn’t come within 30 minutes, they should get up and do something relaxing. Anyone struggling regularly with falling asleep should consult a doctor to rule out underlying sleep disorders.