Millions of Americans faced financial hardships in 2017 and are likely still struggling to afford basic needs, so which one are your employees struggling with?

Nearly 40 percent of Americans had trouble meeting at least one basic need (food, healthcare, housing, or utilities) last year, according to a recent study from the Urban Institute. This echoes an earlier report from the Federal Reserve that showed more than 25 percent of Americans skipped needed medical care in 2017 because they couldn’t afford it.

Urban Institute’s study found more than 20 percent of respondents experienced two or more financial hardships in 2017 and close to 15 percent experienced at least three. It’s not just families below the federal poverty level experiencing financial hardships either. Roughly 20 percent of people whose household income was four times the federal poverty level still struggled to meet the basics.

Almost 20 percent of Americans had trouble getting medical care or paying medical bills in 2017. More than 10 percent missed a utility bill, rent or mortgage payments. Over 20 percent did not have reliable access to a sufficient amount of affordable and nutritious food, making food insecurity the top financial hardship Americans faced.

Food insecurity is an issue that reaches outside of Urban Institute’s scope. Their “Well-Being and Basic Needs Survey” extends to adults aged 18-64 but older Americans struggle with food insecurity as well. It’s estimated that there are 8 to 10 million people over age 65 lacking consistent access to enough food for an active healthy life.

“Older adults who are chronically food insecure suffer other health problems such as low muscle mass, increased fatigue, impaired cognition and increased hypertension. In turn, this can lead to increased risk for falls, limit mobility, reduce ability for self-care, and ultimately force a move into institutional care,” says Liz Seegert, Association of Health Care Journalists’ topic editor on aging.

Employers should be concerned that some of their employees deal with food insecurity on a day-to-day basis. Hunger affects their ability to focus and can cause drastic shifts in mood. There’s also a host of health issues linked to food insecurity that can cause employees to miss more days at work or develop a chronic health issue. Something as simple as providing healthy snacks or occasional staff lunches for employees can make a huge difference in their performance.