Many people still struggle to pay bills — even for something as basic as food.

That’s the difficult conclusion of a new report released this week by the Urban Institute, a nonpartisan, nonprofit policy group based in Washington, D.C., which surveyed almost 7,600 adults last December. Some 39.4% of adults said their families had trouble meeting at least one basic need for food, health care, housing, or utilities last year. Nearly 24% of respondents reported two or more hardships in 2017 and 14% said they experienced at least three of these.

The Urban Institute’s “Well-Being and Basic Needs Survey” tracks individual and family health and financial security at a time when the economy is improving and unemployment is falling, but the researchers said the social safety net for low-income Americans “may be undergoing significant changes.” In fact, almost two-thirds of families with incomes below the federal poverty level — currently $25,100 for a family of four — had problems meeting these basic needs.

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The most common hardship Americans said they faced was food insecurity, with 23.3% of respondents saying they did not have reliable access to a sufficient amount of affordable and nutritious food. Other basic needs Americans had trouble meeting included paying medical bills (18% of respondents), getting medical care (17.8%), missing utility bill payments (13%) and missing rent or mortgage payments (10.2%).

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Adults under the age of 35 were 8.6 percentage points more likely to report a financial hardship, which echoes recent research that has suggested young adults experience more difficulty staying afloat financially. Women, black Americans, Hispanic Americans and single adults were also more likely to struggle to make ends meet. Close to 20% of people whose household income was 400% above the federal property level also experienced some sort of difficulty meeting a basic need.

These results are supported by previous research. Earlier this year, 43% of households said they couldn’t afford a basic monthly budget for housing, food, transportation, child care, health care and a monthly smartphone bill, according to an analysis of U.S. government data released in June by the United Way Alice Project, a nonprofit based in Cedar Knolls, N.J. that aims to highlight the number of people who live in poverty. (Alice stands for “asset limited, income constrained, employed.”)

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Last December, the same month the Urban Institute conducted its survey, the Pew Research Center, a nonprofit think tank in Washington, D.C., released its own study of nearly 43,000 people in 38 countries around the globe that question this past spring. Residents in 20 countries said people like them were better off than they were 50 years ago, but the U.S. was not among them. The U.S was one of 18 countries in which people said they were actually worse off than half a century ago.

Some economists point to growing inequality in the U.S. and say the rich get richer, while the poor are stuck in low-paid jobs. One example: Out of 100 children whose parents are among the bottom 10% of income earners, only 20 to 30 of them go to college. But closer to 90 out of 100 children go to college if their parents are among the top 10% earners. And yet when elite colleges welcome students from poor backgrounds, academic performance at the institution doesn’t decline.

(Jacob Passy contributed to this story.)