Story Highlights
- 61% of Americans worry a great deal about healthcare access and affordability
- Average national concern across 16 issues has declined from a year ago
- Republicans’ average worry has plunged now that Trump is in his second year
WASHINGTON, D.C. — As the Iran war intensified in March, the latest Gallup poll found healthcare topping Americans’ list of domestic concerns, with more saying they worry “a great deal” about it (61%) than about 15 other domestic policy areas. This was followed by four economic matters of high concern to about half of adults: the economy, inflation, federal spending and the budget deficit, and the way income and wealth are distributed.
Americans were least likely to be concerned about race relations, illegal immigration, unemployment, and the availability and affordability of energy. Roughly a third said they worry a great deal about each of these.
Hunger and homelessness, environmental quality, and the size and power of the federal government round out the top half of the list of 16 items rated this year. Social Security, at 43% high concern, matches this year's average level across the list. Terrorism, crime and violence, and drug use are among the lower-ranked concerns.
With sizable proportions worrying "a fair amount" about each of the 16 issues, all are significant concerns to at least the slight majority of Americans.
National Concerns Have Eased From 2025
Americans’ concerns about national issues have generally declined from a year ago. The average share worried a great deal across the 16 issues fell to 43% this year, down from 46% in March 2025. This is the lowest average concern Gallup has found since 2020, just as the COVID-19 pandemic was starting, when the average reached a record low of 38% in the trend originating in 2001.
The biggest year-over-year declines in elevated worry about specific issues are for the Social Security system and the economy, each down nine percentage points from 2025. The percentages worried a great deal about each of these had surged at the start of President Donald Trump’s second term, but are now back to 2024 levels. Those earlier spikes largely reflected sharp increases in Democratic concern as the new administration took office, even as heightened Republican concern about the issues under the Biden administration had not fully abated.
Meaningful drops this year in Americans’ concern about crime (-8 points) and immigration (-7) largely reflect reduced worry among Republicans, and bring these figures to their lowest levels since at least 2020.
The six-point decline in those worried a great deal about inflation, also owing to Republicans, results in 50% worried. That is the lowest recorded since Gallup began tracking worry about inflation in 2022. It was added to the list that year as high inflation pushed the issue back onto the national agenda after several decades of dormancy.
There has been no significant increase in worry about any issue over the past year. Rather, the percentages highly worried about the remaining 11 items on this year's list, including healthcare, are generally unchanged.
Healthcare's current position represents a return to its prominence in prior decades. It ranked as the top concern from 2015 to 2020, before being displaced during the Biden presidency by other issues, especially the economy and inflation. Before that, from 2002 to 2014, the economy and healthcare had either tied or traded places as the leading concern. While healthcare roughly tied the economy as Americans' top concern in 2025, it now leads by a full 10 points.
As Gallup has reported separately, the steadiness in Americans’ concern about the availability and affordability of energy compared with a year ago is notable, given the disruption to the global energy-supply network that was unfolding at the time of the poll.
Republicans Focus on Immigration; Democrats, on Healthcare
Republicans and Democrats worry about sharply different things, with illegal immigration the chief concern of Republicans, at 55%, followed by federal spending and the budget deficit (47%), drug use (42%), and crime and violence (41%). By contrast, Democrats’ top concerns are healthcare (80%), income/wealth distribution (77%) and the economy (69%).
Meanwhile, independents’ top concerns (healthcare, inflation, federal spending and the economy) overlap with both partisan groups, although more with Democrats.
The sharpest partisan divides are seen on income and wealth distribution, where Democrats’ concern (77%) leads Republicans’ (19%) by 58 points. There is a 52-point difference on the environment (67% Democratic vs. 15% Republican). Illegal immigration is the one issue where Republicans’ concern (55%) far outweighs Democrats’ (17%), a 38-point difference.
Flip in Partisan Ratings Under Trump Is Complete
Republicans’ average concern across all issues measured has fallen considerably over the past three years — from 53% during President Joe Biden's final year in office to 42% in 2025, after Trump had been in office a month and a half, to 30% now. Meanwhile, Democrats' average concern, at 51%, remains elevated and similar to the 52% measured last year, but up substantially from 37% in Biden’s last year in office.
These patterns mirror those seen in Gallup’s historical data, whereby supporters of the party out of power worry more about the issues, and supporters of the president’s party worry less.
Democrats’ current average concern is slightly higher than the 47% to 49% levels recorded during Trump’s first term, and is equivalent to the highest readings of George W. Bush’s presidency. Republicans’ average concern is lower than that seen in the initial years of Trump’s first term but not as low as in 2020. Meanwhile, at 46%, independents’ current average concern is consistent with the relatively high level seen for that group over the past five years, since 2022.
Bottom Line
Healthcare has reclaimed its position as Americans' foremost domestic concern, returning to the top tier after several years when economic matters commanded more attention. While the percentage highly worried about the availability and affordability of healthcare hasn’t increased over the past year, ongoing public concerns about healthcare costs, including personal challenges in affording care, make this a perennial concern.
Overall, Americans’ anxiety about national issues has eased to its lowest level since the eve of the COVID-19 pandemic, driven largely by declining Republican concern, as the issues that drove that party’s worry during the Biden years (particularly the economy and inflation) have receded.
Behind the national figures, Republicans’ outlook on national problems has now fully transitioned from a Democratic-control mindset influencing their ratings during Biden’s presidency to a Republican-control mindset, now that Trump has been in office a full year. Democrats had already adopted a Republican-control mindset last year, and they retain those low ratings today.
Since the survey was conducted, the Iran war has escalated and led to further increases in energy costs and potentially to greater public anxiety about its broader effects on prices, employment and national security. Thus, while the figures reported here document how Americans viewed national problems at the start of the war, they may not reflect their feelings today.
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