For the first time in more than four decades of polling on the issue, a majority of Americans favor legalizing the use of marijuana. A national survey finds that 52% say that the use of marijuana should be made legal while 45% say it should not.

Support for legalizing marijuana has risen 11 points since 2010. The change is even more dramatic since the late 1960s. A 1969 Gallup survey found that just 12% favored legalizing marijuana use, while 84% were opposed.

The survey by the Pew Research Center, conducted March 13-17 among 1,501 adults, finds that young people are the most supportive of marijuana legalization. Fully 65% of Millennials –born since 1980 and now between 18 and 32 – favor legalizing the use of marijuana, up from just 36% in 2008. Yet there also has been a striking change in long-term attitudes among older generations, particularly Baby Boomers.

Half (50%) of Boomers now favor legalizing marijuana, among the highest percentages ever. In 1978, 47% of Boomers favored legalizing marijuana, but support plummeted during the 1980s, reaching a low of 17% in 1990. Since 1994, however, the percentage of Boomers favoring marijuana legalization has doubled, from 24% to 50%.

Generation X, born between 1965 and 1980, came of age in the 1990s when there was widespread opposition to legalizing marijuana. Support for marijuana legalization among Gen X also has risen dramatically – from just 28% in 1994 to 42% a decade later and 54% currently.

The Silent Generation continues to be less supportive of marijuana legalization than younger age cohorts. But the percentage of Silents who favor legalization has nearly doubled –from 17% to 32% – since 2002.

The survey finds that an increasing percentage of Americans say they have tried marijuana. Overall, 48% say they have ever tried marijuana, up from 38% a decade ago. Roughly half in all age groups, except for those 65 and older, say they have tried marijuana.

About one-in-ten (12%) say they have used marijuana in the past year. Age differences are much more pronounced when it comes to the recent use of marijuana: 27% of those younger than 30 say they have used marijuana in the past year, at least three times the percentage in any other age group.

Among those who say they have used marijuana in the past year, 47% say they used it “just for fun,” while 30% say it was for a medical issue; 23% volunteer they used it for medical purposes and also just for fun.

As support for marijuana legalization has grown, there has been a decline in the percentage viewing it as a “gateway drug.” Currently, just 38% agree that “for most people the use of marijuana leads to the use of hard drugs.” In 1977, 60% said its use led to the use of hard drugs.

More recently, there has been a major shift in attitudes on whether it is immoral to smoke marijuana. Currently, 32% say that smoking marijuana is morally wrong, an 18-point decline since 2006 (50%). Over this period, the percentage saying that smoking marijuana is not a moral issue has risen 15 points (from 35% then to 50% today).

Amid changing attitudes about marijuana, a sizable percentage of Americans (72%) say that government efforts to enforce marijuana laws cost more than they are worth. And 60% say that the federal government should not enforce federal laws prohibiting the use of marijuana in states where it is legal. Last fall, voters in two states – Colorado and Washington state – approved the personal use of small amounts of marijuana for recreational use.

There are partisan differences over legalizing marijuana use and whether smoking marijuana is morally wrong. But Republicans and Democrats have similar views on enforcing marijuana laws: 57% of Republicans and 59% of Democrats say that the federal government should not enforce federal marijuana laws in states that permit its use. Substantial majorities of both Republicans (67%) and Democrats (71%) also say federal enforcement of marijuana laws is not worth the cost.

While Americans increasingly support legalizing marijuana and fewer see its potential dangers, many still do not like the idea of people using marijuana around them. About half (51%) say they would feel uncomfortable if people around them were using marijuana, while 48% would not feel uncomfortable. As with nearly all attitudes about marijuana, there are substantial age differences in discomfort with others using marijuana – 74% of those 65 and older say they would be uncomfortable if people around them used marijuana, compared with 35% of those under 30.

Recent Rise in Support for Legalization

The long-term shift in favor of legalizing marijuana has accelerated in the past three years. About half (52%) of adults today support legalizing the use of marijuana, up from 41% in 2010. Since then, support for legalization has increased among all demographic and political groups.

Nearly two-thirds of those under 30 (64%) favor legalizing marijuana use, as do about half or more of those 30 to 49 (55%) and 50 to 64 (53%). There is far less support for legalization among those 65 and older (33%); still, there has been an 11-point rise in support among older Americans since 2010.

Men (57%) are somewhat more likely than women (48%) to support marijuana legalization. Support is comparable among racial and ethnic groups — roughly half of whites (52%), blacks (56%) and Hispanics (51%) favor legalizing the use of marijuana.

Only about three-in-ten conservative Republicans (29%) say marijuana use should be legal. Moderate and liberal Republicans are far more likely than conservatives to favor legalization (53%).

Like Republicans, Democrats are ideologically divided over legalizing marijuana. While 73% of liberal Democrats favor legalizing use of marijuana, only about half of conservative and moderate Democrats agree (52%).

Fully 70% of those who have ever tried marijuana, including 89% of those who have tried it in the past year, say the use of marijuana should be legal. That compares with just 35% of those who have never tried marijuana. Support for legalization has increased since 2010 among those who have ever tried marijuana (by six points) as well as those who have not (by 10 points).

Opinions about legalizing marijuana vary little among states that have more permissive marijuana laws and those that do not. A majority (55%) of those in states that have legalized medical marijuana or have decriminalized (or legalized) marijuana for personal use favor legalizing marijuana. Yet 50% of those in states in which marijuana is not decriminalized (or legal for any purpose) also favor its legalization.

Shifting Attitudes about Marijuana

Over the past three decades, there has been a substantial decline in the percentage saying that for most people marijuana leads to the use of hard drugs. Just 38% express that view currently; in a 1977 Gallup survey, 60% said marijuana led to the use of hard drugs.

Much of this shift is the result of generational change. In the 1977 survey, most of those in Greatest Generation (76%), born before 1928, accepted the link between marijuana and hard drug use. The generations that have come of age since 1977 – Gen X and Millennials – are far less likely to say that marijuana use leads to the use of hard drugs (36% of Gen X, 31% of Millennials).

Notably, Boomers view this issue in about the same way as they did in 1977, when there was relatively broad support among this age cohort for legalization. Currently, 37% of Boomers say that marijuana use leads to the use of hard drugs; in 1977, 39% expressed this view. Similarly, 60% of Silents currently say that marijuana use leads to the use of hard drugs, which is virtually the same as opinion among this age cohort in 1977 (62%).

Those who have never tried marijuana are much less likely to view marijuana as a gateway to hard drugs than in the 1970s. In 1977, 72% of those who had never tried marijuana said it led to use of hard drugs; today, just half (50%) of those who have never tried it express this view. In 1977, few who had tried marijuana said there was a link to hard drugs (19%); that remains the case today (26%).

Most Say Marijuana Has Medical Uses

Opinions also have changed about whether marijuana has legitimate medical uses. By 77% to 16%, most say that marijuana does have legitimate medical uses. In an ABC News survey in 1997, a smaller majority (58%) said it had legitimate medical uses, while 34% said it did not.

There are only modest partisan differences in views of the medical uses of marijuana: 82% of independents, 76% of Democrats and 72% of Republicans say it has legitimate medical uses. Age is also a factor in these views, but even among those 65 and older – who oppose legalizing marijuana use by nearly two-to-one – a majority (60%) says that marijuana has legitimate medical uses.

Morality of Smoking Marijuana

The percentage of Americans who say that smoking marijuana is morally wrong also has declined dramatically since 2006. A survey earlier this year found that 32% of Americans say that smoking marijuana is morally wrong, down 18 points since 2006. Over the same period, the percentage saying it is not a moral issue has increased by 15 points (from 35% to 50%).

As with many of the changes in opinions about marijuana and its use, the decline in the percentages who think that smoking marijuana is morally wrong has occurred across most demographic and political groups.

Those in the Silent Generation are more likely than younger people to say that smoking marijuana is morally wrong. But since 2006, the percentage of Silents expressing this view has decreased from 71% to 48%.

Federal Enforcement of Marijuana Laws

Nearly three-quarters of Americans (72%) say that in general, government efforts to enforce marijuana laws cost more than they are worth. And when it comes to the question of whether the federal government should enforce marijuana laws in states that have approved marijuana use, a majority (60%) says it should not.

There is agreement across partisan and demographic groups that federal government enforcement of marijuana laws is not worth the cost. Fully 78% of independents, 71% of Democrats and 67% of Republicans say government enforcement efforts cost more than they are worth.

Similarly, there is substantial opposition to the federal government enforcing marijuana laws in states that permit the legal use of marijuana: 64% of independents say the federal government should not enforce federal marijuana laws in such states, as do 59% of Democrats and 57% of Republicans.

Reported Marijuana Use Increases over Past Decade

Roughly half of adults (48%) say they have ever tried marijuana, the highest percentage ever. Just two years ago, 40% said they had tried marijuana. In both 2003 and 2001, 38% said they had used marijuana.

Of the 48% who have ever used it, about a quarter of them – 12% of the general public – say they did so in the past year. The other 36% say they have tried marijuana, but not in the past year.

People who say they have used marijuana in the past year did so both for medical reasons and “just for fun.” About half (53%) of those recent users say that a medical issue was part of the reason for their use, including 23% who volunteer that they used marijuana for both medical and recreational purposes. The remaining 47% say they used marijuana just for fun.

More than half of young people (56%) say they have ever tried marijuana, and 27% say they have tried it in the past year – by far the highest percentage in any age category.

About half of those 30- to 49 (51%) and 50-64 (54%) have ever tried marijuana, although only about one-in-ten did so last year. Just 22% of adults 65 and older have ever used marijuana, including 2% who say they have used it in the past year.

Men are more likely to say they have tried marijuana than women, 54% vs. 42%. Half of whites and blacks (50%) say they have ever tried marijuana, compared with 34% of Hispanics.

Democrats and Republicans are about equally likely to say they have tried the drug over their lifetimes, 47% vs. 43%; independents are somewhat more likely to have used it (53%). However, over the past year, more independents (14%) and Democrats (13%) than Republicans (7%) say they have used marijuana.

There is no significant difference in lifetime or recent use between people in states with some form of legalized marijuana and those in other states.

Half Would Be Uncomfortable around Marijuana Users

About half of Americans (51%) say they would feel uncomfortable if people around them used marijuana while 48% would not. Just 35% of those under 30 say they would be uncomfortable if people around them used marijuana, the lowest percentage of any age group. Twice as many of those 65 and older (74%) say they would feel uncomfortable around marijuana use.

More women than men say they would be bothered by people around them using marijuana. Nearly six-in-ten women (57%) say they would feel uncomfortable if people around them used marijuana, compared with 44% of men.

Parents are about as likely as non-parents to have ever tried marijuana and they have similar feelings about people using marijuana around them. About half of parents (50%) and non-parents (51%) say they would feel uncomfortable if people around them used marijuana.

Appendix: State Marijuana Laws

Only medical marijuana is legal:
AZ, DE, DC, HI, MI, MT, NJ, NM, VT

Marijuana is decriminalized:
MN, MS, NE, NY, NC, OH

Medical marijuana is legal and marijuana decriminalized:
AK, CA, CO, CT, ME, MA, MS, NV, OR, RI, WA

Not decriminalized or medical:
AL, AR, FL, GA, ID, IL, IN, IA, KS, KY, LA, MD, MO, NH, ND, OK, PA, SC, SD, TN, TX, UT, VA, WV, WI, WY

Source: National Conference of State Legislatures and National Organization for the Reform of Marijuana Laws, 2013.

Most Americans say the government should play a significant role in reducing obesity among children. But there is strong opposition to government involvement in this effort among conservative Republicans and Tea Party supporters.

The latest national survey by the Pew Research Center for the People & the Press, conducted Feb. 22-March 1 among 1,504 adults, finds that 57% say the government should play a significant role in reducing obesity among children, while 39% say it should not.

However, the public does not view the fight against obesity as a major policy priority for the president and Congress. In Pew Research’s annual policy priorities poll in January, just 19% rated dealing with obesity in this country as a top priority, the lowest among 22 items tested; nearly as many (14%) said it should not be done at all. (For more, see “Economy Dominates Public’s Agenda, Dim Hopes for the Future”.)

The new survey finds wide partisan and ideological differences regarding the government’s role in combating obesity. Overall, about seven-in-ten Democrats (71%) say government should have a significant role, compared with 57% of independents and 41% of Republicans.

Four-in-five liberal Democrats (80%) say the government should have a major role tackling this issue, a view shared by just 37% of conservative Republicans. Just a third (33%) of those who agree with the Tea Party think government should have a significant role in fighting childhood obesity, while about twice as many (65%) say it should not.

Hispanics and African Americans are far more likely than whites to say the government should play a role in combating childhood obesity. Large majorities in both groups (83% of Hispanics, 74% of African Americans) express this view, while just 49% of whites agree.

Younger Americans are far more likely to see a significant role for government in cutting childhood obesity than are older Americans: Almost seven-in-ten (69%) of those younger than thirty say government should play a major role, while just 45% of those 65 and older agree.

With a growing number of states moving to legalize medical marijuana, nearly three-quarters of Americans (73%) say they favor their state allowing the sale and use of marijuana for medical purposes if it is prescribed by a doctor, while 23% are opposed. Support for legalizing medical marijuana spans all major political and demographic groups, and is equally high in states that have and have not already passed laws on this issue.

There are public concerns about legalizing medical marijuana. For example, 45% say they would be very or somewhat concerned if a store that sold medical marijuana opened near other stores in their area. And roughly the same percentage (46%) says allowing medical marijuana makes it easier for people to get marijuana even if they don’t have a real medical need – though just 26% of Americans say this is something that concerns them. These concerns are highest among opponents of legalizing medical marijuana, but are no higher or lower in states that already allow marijuana for medical purposes.

Far more Americans favor allowing marijuana for prescribed medical purposes than support a general legalization of marijuana. But the proportion who thinks the use of marijuana should be legal has continued to rise over the past two decades.

The most recent national survey by the Pew Research Center for the People & the Press, conducted March 10-14 among 1,500 adults on landlines and cell phones, finds that 41% of the public thinks the use of marijuana should be made legal while 52% do not. In 2008, 35% said it should be legal and 57% said the use of marijuana should not be legal, according to data from the General Social Survey. Twenty years ago, only 16% of the public said the use of marijuana should be legal and 81% said it should not be legal.

Seniors, Conservatives Less Supportive

Younger Americans are more likely than their older counterparts to favor legalizing marijuana for medical use, but a majority across all age groups supports this; 80% of those younger than 30 favor allowing medical marijuana compared with 63% who are ages 65 and older.

About six-in-ten (61%) Republicans favor permitting medical marijuana in their state compared with 76% of independents and 80% of Democrats. Conservative Republicans are the least likely to support legalization of medical marijuana; still, 54% favor this while 44% are opposed. At least three-fourths in all other partisan and ideological groups favor this.

People living in states where medical marijuana laws have not been passed are just as likely to favor the idea as those living in the 14 states where such laws have already been passed (72% vs. 74%).

An overwhelming percentage (95%) of those who support general legalization of marijuana favor the sale and use of medical marijuana in their state. Yet even a majority (55%) of those who do not favor general legalization of marijuana say that the sale and use of medical marijuana should be allowed.

Does Medical Marijuana Lead to Broader Access?

The public is divided about whether legalizing marijuana for medical purposes inherently increases access to marijuana more generally: 46% say allowing medical marijuana makes it easier for people to get marijuana even if they don’t have a real medical need, while 48% think it doesn’t make a difference. When those who believe it does make it easier are asked whether this concerns them or not, just over half – representing 26% of the total public – say they are very or somewhat concerned about this, while 20% of Americans think this might happen but are not concerned about it.

About seven-in-ten Americans (71%) who oppose allowing medical marijuana in their state say this makes it easier for others to get access, and 53% say they are very or somewhat concerned about this. By contrast, just 39% of those who favor legalizing medical marijuana believe it leads to easier access for non-medical purposes, and only 18% are concerned. People living in states that currently allow medical marijuana are no more or less likely to see the policy as making it easier for people to get marijuana even if they don’t have a real medical need. There also are no differences in levels of concern between those living in states that have legalized medical marijuana and those that have not.

About a quarter (27%) of Americans say they would be very concerned if a store that sold medical marijuana opened up near other stores in their area, and 17% would be somewhat concerned. But a majority (54%) say they would be not too (20%) or not at all concerned (34%). Opponents of legalizing medical marijuana are far more likely to be at least somewhat concerned about this (81%) than supporters (32%). But again, there is no greater or less concern about medical marijuana stores in states that have legalized medical marijuana compared with states that have not.

Support for Legalization of Marijuana Continues to Grow

In terms of the public’s views about the general legalization of marijuana, 41% think the use of marijuana should be made legal while 52% don’t think it should be legal. These findings are similar to a Gallup Survey conducted in October 2009 that found 44% saying the use of marijuana should be made legal and 54% saying it should not be legal. Support for legalizing marijuana is the highest it has been in 40 years of polling on this issue.

In 1969, only 12% said the use of marijuana should be made legal. Support grew to a peak of 30% in 1978, and then declined over the course of the 1980s to a low of 16% by 1987. Since that time, the proportion of Americans who think marijuana should be made legal has been steadily increasing, to 31% in 2000 and 41% today.

Young People, Liberals Most Likely to Support Legalization

There are substantial demographic differences in opinions about the legalization of marijuana. A majority (58%) of those younger than 30 think that the use of marijuana should be made legal. That compares with 42% of those ages 30 to 49, 40% of those 50 to 64, and just 22% of those 65 and older.

While men are evenly divided over whether the use of marijuana should be legal (45% yes, 47% no), most women (57%) oppose legalization.

Fully 71% of Republicans – including 77% of conservative Republicans – oppose the legalization or marijuana. By contrast, Democrats are evenly divided, with a majority of liberal Democrats (57%) in favor of legalizing the use of marijuana. about half of independents (49%) favor legalizing the use of marijuana while 44% are opposed.

People living in states where medical marijuana laws already have been passed are more likely than those living in other states to support a more general legalization of marijuana (48% vs. 39%). Those who have tried marijuana are more than twice as likely as those who have not to favor legalization (64% vs. 25%).

Increased Support for Legalization Among Democrats and Independents

Although independents and Democrats have generally been more likely than Republicans to support legalization of marijuana over the past 40 years, the partisan gap on this issue has increased substantially since 2000. Democrats and independents are far more likely to say that marijuana should be made legal than they were 10 years ago while the views of Republicans are virtually unchanged.

Nearly half of Democra
ts (48%) and independents (49%) now support the legalization of marijuana. In 2000, 29% of Democrats and 35% of independents said the use of marijuana should be made legal. By comparison, 24% of Republicans support legalization now, similar to the 26% who favored this a decade ago.

Who Has Tried Marijuana?

Four-in-ten Americans say they have ever tried marijuana while 58% have not. Men are more likely than women to have tried marijuana – nearly half (48%) of men have tried marijuana compared with only 31% of women.

There also are substantial age differences. About half (49%) of young people admit to having tried marijuana, as do 47% of those ages 30 to 49 and 42% ages 50 to 64. By comparison, only 11% of people age 65 and older say they have ever tried marijuana.

Fewer Republicans than Democrats and independents say they have ever tried marijuana. About a third (32%) of Republicans admit to having tried marijuana compared with 41% of Democrats and 44% of independents. Conservative Republicans are the least likely to report trying marijuana (26%), compared with at least four-in-ten in all other partisan and ideological groups.

A year after the problems at Walter Reed Army Medical Center and other military hospitals made major news, the public remains highly critical of the government’s performance in supporting and caring for soldiers who have returned from Iraq and Afghanistan.

Fully 72% say the government does not give enough support to soldiers who have served in Iraq and Afghanistan, which is unchanged from March 2007. In addition, just 29% rate the government’s job of providing medical care for the returning troops as excellent or good, while 63% rate it as only fair or poor. These opinions about the medical care for returning troops also have changed little since last March.

The latest national survey by the Pew Research Center for the People & the Press, conducted Feb. 20-24 among 1,508 Americans, finds that opinions about the government’s handling of care for returning troops are divided along partisan lines, with Republicans less critical than Democrats of the government’s care of the troops. Nonetheless, 62% of Republicans say the government does not provide enough support for the returning troops, while just 32% say it does. Roughly three-quarters of Democrats (76%) and independents (74%) say the government does not do enough for soldiers who have served in Iraq and Afghanistan.

As the war in Iraq enters its sixth year, half of the public says the American people give enough support to soldiers, while 46% disagree. This is virtually the same as a year ago; in March 2007, 51% said Americans gave enough support, while 44% said they did not. Notably, there are no significant differences in opinion on this question by party or ideology.

Soldiers’ Families Views No Different

Just 5% of Americans say the government has done an excellent job in providing medical care for returning troops, while 24% say the care has been good. More than twice as many people rate the government’s medical care for the returning soldiers as either only fair (37%) or poor (26%).

Four-in-ten Republicans rate the government’s care for returning troops as excellent or good. That compares with 25% of independents and 24% of Democrats.

Notably, there are no differences in opinions about the government’s performance in caring for returning troops between those who say they have a close family member who has served in either Iraq or Afghanistan – 29% of the public – and those who do not. About three-in-ten (28%) of those with close family involved in the current wars say the government has done an excellent or good job of providing medical care to the soldiers, a view shared by 29% of those who are not so directly tied to the conflicts.

In rating the government’s overall support for returning military personnel, 22% of those with a close family member who has served in either conflict – and an identical percentage of those without a family tie to the troops – say the government has given enough support to the troops. In addition, half of those with close family who have served in Iraq or Afghanistan say the American people have given enough support to returning soldiers, the same as those who are not so directly linked to the wars.

Criticisms of Government’s Performance

People who say the government has not provided enough support for the returning troops offer detailed criticisms of where the government has fallen short. Nearly half (48%) specifically cite a medical concern as the kind of problem the government is doing too little about.

In addition, about a third (34%) cites a mental health issue, with 7% specifically mentioning depression and an additional 5% citing Post-Traumatic Stress Disorder. More than a quarter (27%) mention financial issues, including the difficulties that returning military personnel face in getting jobs and keeping their homes. Other issues, such as the need to support military families (5%) and the problems faced by disabled war veterans (3%) also are cited as issues on which the government has failed returning service members.

Hunger Widespread

As most Americans gather for Thanksgiving November 27–traditionally a time for festive overeating and self-indulgence–about one-in-seven of their fellow citizens say they occasionally can’t afford to put food on their tables. And the problem is not getting any better.

As many as 15% of Americans said there have been times in the last year when they did not have enough money to buy food for their families. In contrast, only one-in-eleven Western Europeans (9%) and one-in-25 (4%) Japanese said they periodically go hungry. These proportions have not changed significantly between 1974-5 and 2002, when compared with data collected by Gallup International. Only in Japan, notwithstanding a decade-long economic stagnation, has the proportion of people reporting they occasionally can’t pay for food declined significantly, by 10 percentage points since 1974-5.

In other, poorer parts of the world, putting food on the table is much tougher. Majorities in seven of ten African countries surveyed–including 59% of South Africans and 56% of Nigerians–said they went without food at some point because of the lack of money. And hunger is not simply a function of absolute poverty. Half of Russians (50%) and Ukrainians (55%) also complained they occasionally could not pay to feed their families. Moreover, it has become more difficult to regularly put food on the family table in parts of Latin America. In 2002, nearly half (45%) of Brazilians reported that they skipped meals because of a lack of cash. In 1974-5, only 26% of Brazilians occasionally went hungry.

The good news: for people fortunate enough to live in poor regions that have prospered in the last generation, hunger, while still disturbingly widespread, has declined. Two-in-three (66%) Indians said they periodically went without food in 1974-5. By last year, 44% claimed such deprivation.

While an overwhelming number of people in the United States, Canada and Europe said they have enough to eat, two-in-five low-income Americans at times go hungry, the highest such proportion in the industrial world. Only one-in-four low-income Canadians and Britons are so deprived. The young in the United States are also twice as likely as the old to be unable to pay for a meal – 21% of those aged 18-29 complained that they occasionally can’t buy food, compared with only 9% of those age 65 or older. U.S. women (19%) also were more likely than men (11%) to not be able to afford the occasional meal.

In most of the rest of the world, overwhelming portions of the poor occasionally went hungry: 71% of low income people in Brazil, 66% of low-income people in Russia, 65% of low income people in India. Notably, however, a third (36%) of people who have a middle-class income by Brazilian standards also reported not having enough money for food at times, and half (52%) of middle- class Russians and a quarter (25%) of middle-class Indians faced similar deprivation. Brazilian and Mexican women, like their sisters in the United States, are much more likely than men in their societies to have faced challenges feeding their families. But elsewhere in the developing world, women were not much more likely than men to complain about not being able to put food on the table regularly.

Access to Medical Care Worsening

Access to affordable medical care is often an even tougher challenge than putting food on the table in much of the world, rich and poor. One-in-four (26%) Americans said that there had been times in the last year that they did not have enough money to pay for medical and health care that their family needed. This was twice the percentage of Canadians (13%) and Italians (12%) and five times the percentage of French (5%) who had such complaints.

Moreover, the affordability of medical care is a growing problem in much of the industrial world. In 1974-5, 15% of Americans said they periodically couldn’t afford to see a doctor. In 2002, the percentage had grown to 26%. There was a similar increase in such complaints in Canada-(from 4% in 1974-5 to 13% in 2002) in Britain (from 1% to 11%) and in Italy from 9% to 12%. Access to affordable health care also became a more widespread problem in Brazil (36% to 51%) and Mexico (39% to 45%).

In a sign that government health insurance for older Americans has improved their access to care, only one-in-five (20%) Americans age 65 and older reported they had to go without medical care at some time over the past year because of a lack of funds. Without a comparably large government program for the young, one-in-three (33%) people age 18-29 had to forego health care because they could not afford it.

Overall, there was a stark difference in people’s experience with the American market-oriented health care system and the state-funded medical care provided in Canada and Western Europe. As many as 55% of low-income Americans occasionally could not afford to pay for care, only 25% of low-income Canadians, 17% of low-income Germans and 8% of low-income Japanese faced that problem. The United States lacks a universal health care system; Canada, Germany and Japan each have such a safety net.

Women are relatively disadvantaged by the U.S. medical care system. Nearly one-in-three (31%) American women said they had occasional trouble paying for health care, but only one-in-five (22%) American men had the same complaint. There was no such gender gap in Canada or Western Europe.

As might be expected, the poor almost everywhere have trouble paying for medical care: nearly two-in-three (64%) Nigerians said they had at times lacked the funds to pay for the care their families needed, as did more than half of Indonesians (56%) and three-in-five (61%) Mexicans. Half of Russians (54%) and Ukrainians (56%) had similar complaints.

These findings are drawn from the Pew Global Attitudes Project’s surveys of 38,000 people in 44 nations, conducted during the summer/fall 2002 under the direction of Princeton Survey Research Associates International.

The Pew Global Attitudes Project is a series of worldwide public opinion surveys. The project has issued two major reports, “What the World Thinks in 2002″ — based upon 38,000 interviews in 44 nations — and “Views of a Changing World, June 2003″ — based on 16,000 interviews in 20 nations and the Palestinian Authority. Surveys were conducted by local organizations under the direction of Princeton Survey Research Associates. The Gallup trends from 1974-5 are drawn from the “Human Needs and Satisfactions” survey published by Kettering and Gallup International in 1977. Full details about the surveys, and the project more generally, are available at www.people-press.org

No fewer than eight-in-ten in every African country surveyed view the spread of AIDS and other diseases as a top national problem. Yet worry is nearly as great in some Central American countries. Fully 93% in Hondurans say AIDS and other diseases are a major problem in their country. And among Asian nations, broad majorities in India (72%), the Philippines (71%) and Vietnam (69%) rank disease as a very big problem.

Concern about AIDS and infectious diseases is not limited to developing nations. Fully 68% of French and Italians say their countries are facing major problems in these areas, and 54% in Japan agreed. By comparison, concern is significantly lower in Germany (33%), Great Britain (30%) and Canada (31%). Just over four-in-ten Americans (42%) say AIDS and infectious diseases are a major problem for the United States.

Among Eastern Europeans, majorities in Ukraine and Russia see disease as a major problem in their nations (66% and 63%, respectively), but most people in Poland, Bulgaria and the Czech and Slovak Republics rank it as a moderate problem, at most.

Significantly, AIDS and infectious diseases rate higher than ethnic hatred or nuclear weapons among the biggest problems facing the world. The spread of these diseases were a top global concern in 17 of the 44 nations surveyed. Disease outranked other global problems in nine of the ten African nations surveyed, five of eight Latin American countries, as well as in Egypt and Vietnam.

This poll is part of the Pew Global Attitudes Project, a worldwide public opinion survey of more than 38,000 people in 44 countries. The project’s first major report, What the World Thinks in 2002, focusing on how people view their lives, their countries and the world, was released Dec. 4, 2002.

At week’s end 66% of the American public said they were following news about the Iraqi invasion and the deployment of American forces to Saudi Arabia very closely. Events in the Middle East now dominate public consciousness to an extraordinary degree. An unparalleled 85% of Times Mirror’s nationwide telephone sample volunteered this, in an open-ended question, as the most important news event of the month.