What’s keeping you up at night? According to a newly released survey by the American Psychological Association, it’s probably money.

The latest edition of “Stress in America: Paying With Our Health” [PDF] reports that more than 70 percent of U.S. adults said they worry about money at least some of the time.

“Regardless of the economic climate, money and finances have remained the top stressor since our survey began in 2007,” APA CEO and Executive Vice President Norman B. Anderson said in a statement. “Furthermore, this year’s survey shows that stress related to financial issues could have a significant impact on Americans’ health and well-being.”

The survey of more than 3,000 adults conducted by Harris Poll also found that parents, millennials, and those in lower-income households reported higher stress levels—especially worries about money—than Americans overall.

Money stress tends to seep into other areas of Americans’ lives, including health and relationships. For example, roughly 20 percent reported they have either skipped or thought about skipping going to the doctor because of financial concerns, and 31 percent of Americans with a partner reported money is a major source of conflict in their relationship.

There is some good news in the report, though: Overall, Americans are apparently less stressed than in the past. The survey found that the average stress level, measured on a 10-point scale, decreased from 6.2 in 2007 to 4.9 this year. But 4.9 is still higher than the 3.7 APA considers healthy.

“Despite the good news that overall stress levels are down, it appears that the idea of living with stress higher than what we believe to be healthy and dealing with it in ineffective ways continues to be embedded in our culture,” Anderson said. “All Americans, and particularly those groups that are most affected by stress—which include women, younger adults, and those with lower incomes—need to address this issue sooner than later in order to better their health and well-being.”

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