Still vexed — an overview of anxiety and depression
In 2018, the Deseret News published a series called Generation Vexed, exploring and detailing the then-growing scope of teenage anxiety in the United States. It was already well on the rise even before the pandemic, the land wars that broke out in the Middle East and Europe, and the political schism of the 2020 election.
Approximately 1 million teenagers struggled with anxiety, and experts at the time estimated that nearly 1 in 4 had some form of an anxiety disorder, with that ratio going up to nearly 1 in 3 when just girls were considered.
Census data from 2015 'estimated more than 17 million (children) had already experienced a diagnosable mental disorder,' the Deseret News reported. That number was 'the equivalent of the entire populations of Utah, Idaho, Arizona and Colorado' combined.
That was just teenagers, and just the disorder of anxiety — and that was seven years ago.
Anxiety is still rising.
From 2018 through the first two years of the pandemic in 2022, anxiety rates for all Americans went up by over 16%, and depression rates by over 15%.
In 2023, the American Psychiatric Association said that more than a third of all adults felt more anxious than they did the year before.
Then, when it did the same study last year, the number of adults reporting that they felt more anxiety jumped to 43%. For perhaps a brief moment, 2023's number seemed small by comparison.
Today, the National Institute of Mental Health reports that some 40 million Americans have anxiety disorders — nearly one-fifth of the total U.S. population — and more than 14 million suffer from depression. That is another mental health disorder that has steadily been rising, with 29% of all Americans experiencing depression, according to Gallup, up from 19% eight years earlier.
Now, the NIH research suggests that 21 million people in the U.S. will experience a depressive episode in their lifetimes. Mental Health America, a nonprofit dedicated to mental health and prevention, published a report that says 46% of Americans will at some point confront a mental-health-related disorder.
Those numbers, while shocking, are not as surprising to encounter in 2025 as they may have been even a few years ago. That's because, while there are more people experiencing disorders such as anxiety and depression, general awareness of broader mental health issues has risen, too.
According to Michele Nealon, a psychologist and president of the Chicago School of Professional Psychology, writing for the United Nations in 2021, the pandemic 'accelerated positive momentum in our communities to raise awareness about these issues and increased accessibility to crucial support and services for those affected.'
Talking about mental health — interpersonally, on the news, social media or via the numerous celebrities who often show support (including Michelle Obama, Demi Lovato, Simone Biles, Prince Harry and Dwayne Johnson) — has become so common that the cause and effect of anxiety and depression are beginning to look like the chicken and the egg question to some, too.
The BBC reported earlier this year that experts in England are now openly debating if the proliferation of awareness has actually caused more young people to self-diagnose, which results in 'over-pathologising distress.' The argument is that, rather than learning resilience, some are diagnosing what might be the normal discomfort of growing up as anxiety or depression.
Regardless of the possible pitfalls, the pandemic had one recognizable silver lining, Nealon wrote: it 'resulted in more open dialogue on, and greater knowledge of, mental health than ever before.'
This is not to say that stigma no longer exists; it does. The Centers for Disease Control and Prevention has a webpage that was updated in January of 2025, explaining and contextualizing the ways people with mental health disorders are made to feel stigma — the negative sentiment, shame or disgrace leveled onto an action or behavior. It included structural stigma, where institutions are not prepared to support those with them; public stigma that comes from individuals and groups judgmental toward mental health issues; and even self-stigma, where someone with a mental health issue 'may believe they are flawed or blame themselves for having the condition.'
All of which is why experts say it's so important to keep talking about the resources that exist for people who are experiencing anxiety and depression. Not just in order to combat the stigma that individuals, communities, cultures and organizations may have, but also the sheer volume of those who are already experiencing anxiety and depression and need to know how and where to find help for a legitimate and pressing health concern. There are resources that exist, and — as always — much more to learn. It's a topic that's been investigated, it turns out, since the days of ancient Greece and Rome.
The first known medical reference to mental health disorders like anxiety or depression is within the texts attributed to Hippocrates from ancient Greece. They describe a subject named Nicanor who's stricken with an irrational fear — a phobia — of the woman who plays the flute at the symposium. Hearing the music played at night, Nicanor would have panic attacks, yet he was unaffected when he encountered the same flutist during the day. Its inclusion by one of modern medicine's founders made clear that mental disorders had long been considered health issues.
Ancient Roman thinkers investigated the variations of mental disorders more specifically. It was Cicero, the Roman statesman and stoic philosopher, who carved out the notion of anxiety and depression — separately — and sought to solve them. 'In some there is a continual anxiety, owing to which they are anxious … for all are not anxious who are sometimes vexed, nor are they who are anxious always uneasy in that manner,' he wrote in 45 B.C.
According to Marc-Antoine Crocq, a psychiatrist, who wrote 'A history of anxiety: from Hippocrates to DSM' in the scientific journal Dialogues in Clinical Neuroscience, Cicero's arguments come from a book written after his daughter's untimely death and was 'a plea for Stoicism, a branch of philosophy that is one of the pillars of today's cognitive therapy.' Kathleen Evans, of Griffin University in Australia, suggested that Cicero's whole book was indicative of a 'major depressive episode' for the great ancient philosopher. His work may have been a means for him to navigate the struggles of his own life.
Another stoic called Seneca, wrote Crocq, 'taught his contemporaries how to achieve freedom from anxiety in his book 'Of Peace of Mind.'' Later, Seneca suggested in another of his treatises that people should stay present in their day-to-day lives, previewing thousands of years ago what is now commonly referred to as 'living in the moment.'
Depression was long called by the other name of 'melancholia,' especially so during the period between the late 1700s and the late 1800s. It was defined as 'a disorder of intellect or judgment, a 'partial insanity' often, but not always, associated with sadness,' wrote Kenneth S. Kendler, of Virginia Commonwealth University. He wrote that it was a 'mood disorder.' That name, itself, helps to understand why there is some lasting stigma felt today by folks whose lives and work are disrupted by their depression as if it is a matter of mood, rather than a debilitating health disorder. Not until the German psychiatrist Emil Kraepelin began using the word 'depressive' to describe elements of 'melancholia' in the late 1900s did its name change to what we know today.
That definition and symptoms have changed, too. While it is common for people to feel sad or low in the course of their days, depression manifests itself with more pronounced symptoms, some of which include feeling down, empty, pessimistic or hopeless. Those experiencing depression report feeling tired, lacking in pleasure or interest in the things they care about, difficulty concentrating and trouble sleeping, among many others. Though not always, some also report suicidal thoughts. Understandably, these feelings often implicate behaviors and moods — the poor descriptor from the Victorian period raising its ugly head — like anger, restlessness, a tendency to isolate or a struggle to manage responsibilities.
The list of symptoms is long, and not everyone who has depression exhibits all of those that are published by the National Institutes of Health, the Mayo Clinic, or any of other national and local agencies. Additionally, age plays a role in which symptoms are more or less pronounced, as does gender. There are a kaleidoscope of different possible symptoms — many of which everyone feels at some point or other in the course of their lives — and it makes it difficult to determine when one is momentary and another a disorder.
If someone is feeling any of these symptoms for prolonged periods, they should speak to their regular medical care provider about it or call one of the local or national hotlines published with this article to discuss their specific circumstances. Taking advantage of available resources and learning more is the first step to care. To help someone who may not have recognized these symptoms for themselves, Harvard Health suggests encouraging that person to use the resources or seek help, or a softer touch might be to offer emotional support.
The symptoms of anxiety — just like Cicero suggested a couple millennia ago — are not necessarily unique to those who suffer from an anxiety disorder. Most people will feel some version of what we understand anxiety to be at some point in their lives. It could be before starting a new school, prior to a test, a date or a job interview, or even when rent and other bills are due. To a certain extent, anxiety is a regular part of most lives, which makes its disorder also hard to firmly categorize and understand.
The Mayo Clinic explains the disorder as an escalation of the common occurrences of anxiety. 'People with anxiety disorders frequently have intense, excessive and persistent worry and fear about everyday situations,' its website reads. Those symptoms show up as constant worry, elevated heart rates, fear, trouble sleeping, feeling a sense of looming issue or problems. There are also many different permutations of anxiety that also exhibit these symptoms. These issues can lead to other health issues or even depression itself.
If someone is uncertain, they should also discuss the matter with their regular health care provider or one of the national hotlines. The treatment for both begins with asking questions and seeking help, no matter how certain or uncertain someone might be.
Part of that seeking of help, too, can be speaking with your friends, family, clergy or teachers. The ancient Greek and Roman philosophers asked each other these bigger questions about their minds and health at the lyceum in order to reach reasonable conclusions, and it turns out that many of them are still in place. Today, we have doctors, phone and text hotlines, and our respective loved ones to seek out more and better information about anxiety and depression.
The more we know, too, the less likely we are to judge or to suffer needlessly from anxiety or depression. Seneca wrote that 'there are more things … likely to frighten us than there are to crush us; we suffer more often in imagination than in reality.'
If you need help, please refer to this document for contacts that can speak over the phone or text in either moments of crisis or those who need support.
You can always call or text the national Disaster Distress Hotline at 1-800-985-5990 (para Español: Llama o envía un mensaje de texto 1-800-985-5990 presiona '2.').
If you're in Utah, Huntsman Mental Health Institute lists several ways to get help for a mental health crisis:
University of Utah community crisis intervention and support services: 801-587-3000.
Text or call Suicide & Crisis Lifeline: 988. Utah Crisis Line: 1-800-273-TALK (8255).
Walk-in crisis center for adults: 955 W. 3300 South, South Salt Lake.
Utah Warm Line: 8 a.m. to 11 p.m. 1-833-773-2588 (SPEAKUT) or 801-587-1055.
For parents, teachers and educators: SAFEUT Crisis Chat & Tip Line, download the app or call 833-372-3388.
For active National Guard members, their family and civilian personnel: download SafeUTNG app or call 833-372-3364 (SAFENG).
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San Francisco Chronicle
41 minutes ago
- San Francisco Chronicle
Many forget the damage done by diseases like whooping cough, measles and rubella. Not these families
SIOUX FALLS, S.D. (AP) — In the time before widespread vaccination, death often came early. Devastating infectious diseases ran rampant in America, killing millions of children and leaving others with lifelong health problems. These illnesses were the main reason why nearly one in five children in 1900 never made it to their fifth birthday. Over the next century, vaccines virtually wiped out long-feared scourges like polio and measles and drastically reduced the toll of many others. Today, however, some preventable, contagious diseases are making a comeback as vaccine hesitancy pushes immunization rates down. And well-established vaccines are facing suspicion even from public officials, with Robert F. Kennedy Jr., a longtime anti-vaccine activist, running the federal health department. 'This concern, this hesitancy, these questions about vaccines are a consequence of the great success of the vaccines – because they eliminated the diseases,' said Dr. William Schaffner, an infectious disease expert at Vanderbilt University Medical Center. 'If you're not familiar with the disease, you don't respect or even fear it. And therefore you don't value the vaccine.' Anti-vaccine activists even portray the shots as a threat, focusing on the rare risk of side effects while ignoring the far larger risks posed by the diseases themselves — and years of real-world data that experts say proves the vaccines are safe. Some Americans know the reality of these preventable diseases all too well. For them, news of measles outbreaks and rising whooping cough cases brings back terrible memories of lives forever changed – and a longing to spare others from similar pain. Getting rubella while pregnant shaped two lives With a mother's practiced, guiding hand, 80-year-old Janith Farnham helped steer her 60-year-old daughter's walker through a Sioux Falls art center. They stopped at a painting of a cow wearing a hat. Janith pointed to the hat, then to her daughter Jacque's Minnesota Twins cap. Jacque did the same. 'That's so funny!' Janith said, leaning in close to say the words in sign language too. Jacque was born with congenital rubella syndrome, which can cause a host of issues including hearing impairment, eye problems, heart defects and intellectual disabilities. There was no vaccine against rubella back then, and Janith contracted the viral illness very early in the pregnancy, when she had up to a 90% chance of giving birth to a baby with the syndrome. Janith recalled knowing 'things weren't right' almost immediately. The baby wouldn't respond to sounds or look at anything but lights. She didn't like to be held close. Her tiny heart sounded like it purred – evidence of a problem that required surgery at four months old. Janith did all she could to help Jacque thrive, sending her to the Colorado School for the Deaf and the Blind and using skills she honed as a special education teacher. She and other parents of children with the syndrome shared insights in a support group. Meanwhile, the condition kept taking its toll. As a young adult, Jacque developed diabetes, glaucoma and autistic behaviors. Eventually, arthritis set in. Today, Jacque lives in an adult residential home a short drive from Janith's place. Above her bed is a net overflowing with stuffed animals. On a headboard shelf are photo books Janith created, filled with memories like birthday parties and trips to Mount Rushmore. Jacque's days typically begin with an insulin shot and breakfast before she heads off to a day program. She gets together with her mom four or five days a week. They often hang out at Janith's townhome, where Jacque has another bedroom decorated with her own artwork and quilts Janith sewed for her. Jacque loves playing with Janith's dog, watching sports on television and looking up things on her iPad. Janith marvels at Jacque's sense of humor, gratefulness, curiosity and affectionate nature despite all she's endured. Jacque is generous with kisses and often signs 'double I love yous' to family, friends and new people she meets. 'When you live through so much pain and so much difficulty and so much challenge, sometimes I think: Well, she doesn't know any different,' Janith said. Given what her family has been through, Janith believes younger people are being selfish if they choose not to get their children the MMR shot against measles, mumps and rubella. 'It's more than frustrating. I mean, I get angry inside,' she said. 'I know what can happen, and I just don't want anybody else to go through this.' Delaying the measles vaccine can be deadly More than half a century has passed, but Patricia Tobin still vividly recalls getting home from work, opening the car door and hearing her mother scream. Inside the house, her little sister Karen lay unconscious on the bathroom floor. It was 1970, and Karen was 6. She'd contracted measles shortly after Easter. While an early vaccine was available, it wasn't required for school in Miami where they lived. Karen's doctor discussed immunizing the first grader, but their mother didn't share his sense of urgency. 'It's not that she was against it," Tobin said. "She just thought there was time.' Then came a measles outbreak. Karen – who Tobin described as a 'very endearing, sweet child' who would walk around the house singing – quickly became very sick. The afternoon she collapsed in the bathroom, Tobin, then 19, called the ambulance. Karen never regained consciousness. 'She immediately went into a coma and she died of encephalitis,' said Tobin, who stayed at her bedside in the hospital. 'We never did get to speak to her again.' Today, all states require that children get certain vaccines to attend school. But a growing number of people are making use of exemptions allowed for medical, religious or philosophical reasons. Vanderbilt's Schaffner said fading memories of measles outbreaks were exacerbated by a fraudulent, retracted study claiming a link between the MMR shot and autism. The result? Most states are below the 95% vaccination threshold for kindergartners — the level needed to protect communities against measles outbreaks. 'I'm very upset by how cavalier people are being about the measles,' Tobin said. 'I don't think that they realize how destructive this is.' Polio changed a life twice One of Lora Duguay's earliest memories is lying in a hospital isolation ward with her feverish, paralyzed body packed in ice. She was three years old. 'I could only see my parents through a glass window. They were crying and I was screaming my head off,' said Duguay, 68. 'They told my parents I would never walk or move again.' It was 1959 and Duguay, of Clearwater, Florida, had polio. It mostly preyed on children and was one of the most feared diseases in the U.S., experts say, causing some terrified parents to keep children inside and avoid crowds during epidemics. Given polio's visibility, the vaccine against it was widely and enthusiastically welcomed. But the early vaccine that Duguay got was only about 80% to 90% effective. Not enough people were vaccinated or protected yet to stop the virus from spreading. Duguay initially defied her doctors. After intensive treatment and physical therapy, she walked and even ran – albeit with a limp. She got married, raised a son and worked as a medical transcriptionist. But in her early 40s, she noticed she couldn't walk as far as she used to. A doctor confirmed she was in the early stages of post-polio syndrome, a neuromuscular disorder that worsens over time. One morning, she tried to stand up and couldn't move her left leg. After two weeks in a rehab facility, she started painting to stay busy. Eventually, she joined arts organizations and began showing and selling her work. Art "gives me a sense of purpose,' she said. These days, she can't hold up her arms long enough to create big oil paintings at an easel. So she pulls her wheelchair up to an electric desk to paint on smaller surfaces like stones and petrified wood. The disease that changed her life twice is no longer a problem in the U.S. So many children get the vaccine — which is far more effective than earlier versions — that it doesn't just protect individuals but it prevents occasional cases that arrive in the U.S. from spreading further. ' Herd immunity " keeps everyone safe by preventing outbreaks that can sicken the vulnerable. After whooping cough struck, 'she was gone' Every night, Katie Van Tornhout rubs a plaster cast of a tiny foot, a vestige of the daughter she lost to whooping cough at just 37 days old. Callie Grace was born on Christmas Eve 2009 after Van Tornhout and her husband tried five years for a baby. She was six weeks early but healthy. 'She loved to have her feet rubbed," said the 40-year-old Lakeville, Indiana mom. "She was this perfect baby.' When Callie turned a month old, she began to cough, prompting a visit to the doctor, who didn't suspect anything serious. By the following night, Callie was doing worse. They went back. In the waiting room, she became blue and limp in Van Tornhout's arms. The medical team whisked her away and beat lightly on her back. She took a deep breath and giggled. Though the giggle was reassuring, the Van Tornhouts went to the ER, where Callie's skin turned blue again. For a while, medical treatment helped. But at one point she started squirming, and medical staff frantically tried to save her. 'Within minutes,' Van Tornhout said, 'she was gone.' Van Tornhout recalled sitting with her husband and their lifeless baby for four hours, "just talking to her, thinking about what could have been.' Callie's viewing was held on her original due date – the same day the Centers for Disease Control and Prevention called to confirm she had pertussis, or whooping cough. She was too young for the Tdap vaccine against it and was exposed to someone who hadn't gotten their booster shot. Today, next to the cast of Callie's foot is an urn with her ashes and a glass curio cabinet filled with mementos like baby shoes. 'My kids to this day will still look up and say, 'Hey Callie, how are you?'' said Van Tornhout, who has four children and a stepson. 'She's part of all of us every day.' Van Tornhout now advocates for childhood immunization through the nonprofit Vaccinate Your Family. She also shares her story with people she meets, like a pregnant customer who came into the restaurant her family ran saying she didn't want to immunize her baby. She later returned with her vaccinated four-month-old. 'It's up to us as adults to protect our children – like, that's what a parent's job is,' Van Tornhout said. 'I watched my daughter die from something that was preventable … You don't want to walk in my shoes.'


San Francisco Chronicle
41 minutes ago
- San Francisco Chronicle
Takeaways from interviews with families forever changed by diseases that vaccines can prevent
SIOUX FALLS, S.D. (AP) — In the time before widespread vaccination, devastating infectious diseases ran rampant in America, killing millions of children and leaving others with lifelong health problems. Over the next century, vaccines virtually wiped out long-feared scourges like polio and measles and drastically reduced the toll of many others. Today, however, some preventable, contagious diseases are making a comeback as vaccine hesitancy pushes immunization rates down. And well-established vaccines are facing suspicion even from public officials, with Robert F. Kennedy Jr., a longtime anti-vaccine activist, running the federal health department. 'This concern, this hesitancy, these questions about vaccines are a consequence of the great success of the vaccines – because they eliminated the diseases,' said Dr. William Schaffner, an infectious disease expert at Vanderbilt University Medical Center. 'If you're not familiar with the disease, you don't respect or even fear it. And therefore you don't value the vaccine.' Anti-vaccine activists even portray the shots as a threat, focusing on the rare risk of side effects while ignoring the far larger risks posed by the diseases themselves — and years of real-world data that experts say proves the vaccines are safe. Some Americans know the reality of vaccine-preventable diseases all too well. Here are takeaways from interviews with a few of them by The Associated Press. Getting a disease while pregnant can change two lives. Janith Farnham has helped shepherd her daughter Jacque through life for decades. Jacque, 60, was born with congenital rubella syndrome, which resulted in hearing, eye and heart problems at birth. There was no vaccine against rubella back then, and Janith contracted it in early pregnancy. Though Janith, 80, did all she could to help Jacque thrive, the condition took its toll. Jacque eventually developed diabetes, glaucoma, autistic behaviors and arthritis. Today, Jacque lives in an adult residential home and gets together with Janith four or five days a week. Janith marvels at Jacque's sense of humor and affectionate nature despite all she's endured. Jacque is generous with kisses and often signs 'double I love yous,' even to new people she meets. Given what her family has been through, Janith finds it 'more than frustrating' when people choose not to get children the MMR shot against measles, mumps and rubella. 'I know what can happen,' she said. 'I just don't want anybody else to go through this.' Delaying a vaccine can be deadly. More than half a century has passed, but Patricia Tobin still vividly recalls seeing her little sister Karen unconscious on the bathroom floor. It was 1970, Karen was 6, and she had measles. The vaccine against it wasn't required for school in Miami where they lived. Though Karen's doctor discussed immunizing the first grader, their mother didn't share his sense of urgency. 'It's not that she was against it,' Tobin said. 'She just thought there was time.' Then came a measles outbreak. After she collapsed in the bathroom, Karen never regained consciousness. She died of encephalitis. 'We never did get to speak to her again,' Tobin said. Today, all states require that children get certain vaccines to attend school. But a growing number of people are making use of exemptions. Vanderbilt's Schaffner said fading memories of measles outbreaks were exacerbated by a fraudulent, retracted study claiming a link between the MMR shot and autism. The result? Most states are below the 95% vaccination threshold for kindergartners — the level needed to protect communities against measles outbreaks. Preventable diseases can have long-term effects. One of Lora Duguay's earliest memories is lying in a hospital isolation ward with her feverish, paralyzed body packed in ice. She was three years old. It was 1959 and Duguay, of Clearwater, Florida, had polio. It was one of the most feared diseases in the U.S., experts say, causing some terrified parents to keep children inside and avoid crowds during epidemics. Given polio's visibility, the vaccine against it was widely and enthusiastically welcomed. Given polio's visibility, the vaccine against it was widely and enthusiastically welcomed. But the early vaccine that Duguay got was only about 80% to 90% effective. Not enough people were vaccinated or protected yet to stop the virus from spreading. Though treatment helped her walk again, she eventually developed post-polio syndrome, a neuromuscular disorder that worsens over time. She now gets around in a wheelchair. The disease that changed her life twice is no longer a problem in the U.S. So many children get the vaccine — which is far more effective than earlier versions — that it doesn't just protect individuals but it prevents occasional cases that arrive in the U.S. from spreading further and protects the vulnerable. When people aren't vaccinated, the vulnerable remain at risk. Every night, Katie Van Tornhout rubs a plaster cast of a tiny foot, a vestige of the daughter she lost to whooping cough at just 37 days old. Callie Grace was born on Christmas Eve 2009. When she turned a month old, she began having symptoms of pertussis, or whooping cough. She was too young for the Tdap vaccine against it and was exposed to someone who hadn't gotten their booster shot. At the hospital, Van Tornhout recalled, the medical staff frantically tried to save her, but 'within minutes, she was gone.' Today, Callie remains part of her family's life, and Van Tornhout shares the story with others as she advocates for vaccination. 'It's up to us as adults to protect our children – like, that's what a parent's job is,' Van Tornhout said. 'I watched my daughter die from something that was preventable … You don't want to walk in my shoes.' ____


Boston Globe
2 hours ago
- Boston Globe
New Englanders clash over Trump's sweeping health reforms
And he is not alone. In a recent Globe survey of 11 New Englanders across the political spectrum, all seven respondents who voted against Trump said they worry that basic health insurance and many vaccines will be harder to obtain for those who need them if the Big Beautiful Bill becomes law. The four respondents who voted for Trump, despite being unfamiliar with many of the legislation's specifics, said they support changes to health care programs to repair what some of them called a broken, bloated system. Advertisement The voters were surveyed as part of an ongoing Globe series on their views on the first year of the Trump administration, with previous installments centered on The cost of health care has been a major focus for Trump, who has said he wants to eliminate waste and fraud from programs such as Medicaid. The president has said he wants the legislation passed before July 4. But along with savings, Trantham noted, many experts predict that more Americans will end up uninsured if Trump's vision becomes the new landscape of national health care. Advertisement 'There will be more people who can't afford their medications. There'll be more people who avoid going to the doctor because they don't have the money,' said Trantham, who is an unenrolled voter and voted for former vice president Kamala Harris in 2024. 'And then they'll end up needing a higher level of medical care, which then puts a broad burden on the rest of us,' he added. Related : Trump's passed by the House, many The agency also predicted that 4 million people could see their access to food stamps reduced or eliminated. In addition to benefit cuts, the Congressional Budget Office estimated that the House bill would increase the US deficit by $2.4 trillion over the next decade. And on Thursday, Joann Flaminio, 69, a retired Democrat from Providence, said she is concerned that few people are aware of the myriad dangers tucked into the sprawling bill. 'The devil really is in the details. And one of the proposals in the Big Beautiful Bill — that requires Medicaid recipients to re-enroll every six months — is a draconian measure designed to deny services to those most in need,' said Flaminio, who served as retirement administrator for the state of Rhode Island. Advertisement 'My sister was on Medicaid in the final years of her life, and I know what the application process is like in order to get somebody approved. Many people hire a lawyer in order to do that, but it can be arduous, and it certainly is,' she added. The president's bill also would impose work requirements on Medicaid recipients, from ages 19 to 64, who would need to work at least 80 hours per month if they did not qualify for exemptions. From her experience, Flaminio said, linking benefits to work requirements is impractical. 'We tried to mandate work requirements ... for those people who are on disability benefits,' Flaminio said. 'And I would say, for the most part, it's a waste of time and effort. The vast majority of recipients, an estimated 96 percent, cannot work, which is the reason why they apply for Medicaid in the first place.' But for the survey's Trump supporters, trimming the Medicaid rolls is worthwhile if it rids the system of fraud and abuse. Seth Sole-Robertson, a 45-year-old Republican from Medway, was asked if Medicaid cuts concern him. 'I'd be concerned if I was an illegal alien,' Sole-Robertson answered, 'and I'd be concerned if I were committing fraud.' The goal is to strip benefits from 'people who are ineligible or taking it in two different states,' said Sole-Robertson, who owns a marine repair business. 'There's lots of hoopla or fake news about what's going on with Medicaid.' Karen Sysyn, 54, an unenrolled Trump supporter from Londonderry, N.H., said she wasn't sure where the bill was headed or what was in it. 'I hear a lot of rumors that they're looking at cutting Social Security and disability and stuff like that,' she said. Advertisement If people are able to work, taxpayers should not bear their burden, said Sysyn, who is searching for work after losing her job as a housing inspector. But if people are genuinely in need of support from Social Security or Medicare, they should receive support, she added. Another unenrolled Trump supporter, 56-year-old Brian Jankins of Sutton, was asked what he knew about the bill. 'Full disclosure, very little,' said Jankins, who works in banking. However, he added, 'our current health care system is broken and dysfunctional ... I'm not versed in what this bill does to address that, but it is broken.' Related : Respondents' opinions about Robert F. Kennedy Jr., the health and human services secretary, also were sharply divided, with Trump supporters endorsing his stance against vaccines, among other initiatives, and the president's opponents saying Kennedy was endangering lives. 'I think more Americans are going to die under some of the changes that he's making around vaccinations,' said Vanessa Coppola, a 42-year-old Democrat from North Yarmouth, Maine. Over the administration's first five months, Kennedy became a lightning rod for controversy because of his antivaccine stance, his references to autism as a preventable disease, and his ouster and replacement of the entire immunization advisory panel for the Centers for Disease Control and Prevention. Coppola, a job coach and consultant, is particularly worried about Kennedy's proposal to eliminate the COVID vaccine recommendation for healthy pregnant women. Those vaccinations provide coverage for newborns, who are particularly vulnerable to respiratory disease, she said. Anand Sharma, 53, a Democrat from Shrewsbury and electrical engineer, called the rolling drama at the Department of Health and Human Services part of 'the chaos [that] is everywhere right now.' Advertisement And Justina Perry, a 37-year-old Democrat from New Bedford, denounced Kennedy's antivaccine agenda. 'Viruses are going to love this,' said Perry, who runs a physical therapy clinic. 'They're going to be able to spread and spread, and they win in this situation because we're pulling back vaccine access. So the only one who should be excited about this is a virus.' But Darryll White, an unenrolled Trump voter from Skowhegan, Maine, supports Kennedy's efforts to change government guidance on vaccines. Kennedy's work is 'a long-haul scenario — to make America healthy again,' said White, 66, who added that efforts by the news media to 'demonize' the secretary have made his job harder. 'People have to understand that Robert Kennedy is under intense pressure,' added White, the director of a nonprofit community park. White said he supports Kennedy's proposal to upend the government's vaccine guidance. 'That's exactly what needs to happen,' said White, who believed the government was not transparent during the pandemic about possible adverse effects of the COVID vaccine. The respondents were sharply divided yet again about the administration's drastic cuts in medical research grants, and those views aligned with whether they had voted for the president. The cuts have had an outsize effect on universities and other research institutions in the Boston area, particularly at Harvard University, where the government has canceled about $2.6 billion in awarded grants. 'He's cutting off his nose to spite his face,' Rosemary Shea, 62, an unenrolled voter from Hampton, N.H., said of Trump, who she voted against. 'I mean, Harvard is not just doing this research for themselves. They're doing it for the world.' Advertisement 'These universities are doing great research for diseases that are still out there that we have not cracked yet — Parkinson's, cancer, all different types of cancers," Shea added. 'He's just decided 'nope.' And I haven't even heard a logical explanation for it.' Sole-Robertson, the Medway Republican, offered a sharply different take on the government's role in funding medical research. 'A lot of this needs to be shifted back to private industry and raising funds in the private sector,' he said. 'I think a lot of it is just pure nonsense.' Brian MacQuarrie can be reached at