The Covid pandemic is causing Americans stress over their declining economic situations, according to recently released research by the Certified Financial Planner Board of Standards and the consulting firm Heart + Mind Strategies.

More than half of Americans reported in early November they are experiencing high or very high levels of stress, with the cost of healthcare topping the list of concerns, the survey of 1,000 respondents showed. Other top financial concerns include unemployment or reduced income, protecting assets and managing debt.

“The uncertainty and volatility of this past year have strained Americans physically, mentally, emotionally and financially,” CFP Board CEO Kevin R. Keller said in a statement. “Given the impact of the Covid-19 pandemic across the country and the recent surge in cases, it is understandable that Americans are most concerned with the cost of their healthcare.”

Respondents said their personal economic situations are worsening. In an earlier survey in March, 25% of respondents said their personal economic situations were worse than four years ago. In the most recent survey, 34% of respondents said their personal economic situations were worse than four years ago.

The survey revealed distinct differences between generations regarding their stress levels and top financial concerns.

Younger respondents tend to experience higher levels of stress, with 60% of Gen Z and 64% of millennials reporting high or very high levels of stress. Their older counterparts are also stressed, but only 46% of baby boomers and 28% of the silent generation said they had high levels of worry.

Forty-six percent of baby boomers and half of the silent generation said their top concern is healthcare costs, while 40% of millennials said they are most concerned about unemployment or reduced income.

The CFP Board pointed out that most of those surveyed are not working with a financial advisor, which could help their situations.

“A financial planner can help lessen Americans’ financial concerns by addressing important topics such as reduced income, managing debt, or paying bills within the context of their financial plans,” Keller said.