Americans in the prime of their lives are generally viewed as being financially secure and in good health, but a new report by The Commonwealth Fund dispels that idyllic notion. For many Americans, mid-life is a time when chronic health problems begin to surface and the loss of health coverage poses a real financial risk, the New York-based foundation reports.

As the Fund describes the problem, "The fragile nature of job-based health insurance leaves adults who have reached middle age vulnerable in the face of heightened risk for chronic disease, disability, or loss of employment." According to the survey, more than 1 in 5 adults ages 45 to 64 rated their health as fair or poor, twice the rate of those under 45. Among 55 to 64 year olds, nearly 1 in 3 termed their health fair or poor.

A third of mid-life adults did not get needed care because of financial barriers, the survey responses indicated. They also showed that mid-life Americans lacking insurance are at great risk for healthcare problems and financial difficulties. Fifty-nine percent of uninsured Americans aged 45 to 64 did not get needed care during the past year, and 72% had problems paying medical bills or gaining access to healthcare.

"The survey findings underscore the importance of having adequate, affordable health insurance upon entering the prime working years," the report noted.

The Commonwealth Fund's analysis of Americans aged 45 to 64 is based on data from a larger survey of 5,002 adults aged 18 to 64. The Fund also found that most working-age adults prefer the current employer-based system of health insurance coverage.