Seventy-four percent of U.S. adults believe they are worse off or about the same financially as they were a year ago, according to a new survey for the American Institute of CPAs by Harris Poll, but stress levels about finances have not increased in the past year.

In both 2013 and 2014, 44 percent of U.S. adults said their stress about personal finance matters is somewhat or very high. The leveling off of anxiety about personal finances could indicate that Americans have changed their view of the financial norm and grown accustomed to some financial pain in their lives. The survey polled 1005 U.S. adults of age 18 and older in March and was done in recognition of National Financial Capability Month.

Within the past year, shrinking household budgets, increasing debt loads and difficulty coping with living expenses have become the reality for many Americans. Twelve percent of U.S. adults said that managing day-to-day expenses was their primary financial concern, followed by medical expenses (10 percent), retirement (9 percent) and student loans (9 percent).

Only 2 percent are concerned about their emergency savings, which may indicate that emergency savings is not a priority—given that only 31 percent of U.S. adults said they contributed to it in the last year. Only 10 percent of U.S. adults said they had no financial worries.

“With slightly more than half of U.S. adults expressing little to no stress about their increasingly difficult financial circumstances, it seems that many Americans are reconciled to an uphill financial battle and that financial juggling and sacrifice will be a part of the foreseeable future,” said Ernie Almonte, chair of the AICPA’s National CPA Financial Literacy Commission, in a statement. “The good news, however, is that you can improve your situation through simple steps—many of which Americans are already being forced to do. Creating a monthly budget, sticking to it and putting $50 a month into savings are small actions that can make a big difference over time.”

The AICPA’s National CPA Financial Literacy Commission recommends the following additional steps to help alleviate the four major financial concerns identified by survey respondents:

• Managing day-to-day expenses. Look at all of your daily expenses and ask yourself: do I need this or do I want this? If I spend the money on this, what will I have to do without?  Tracking where your money goes and making sure that your spending doesn’t exceed your income is the best way to stay financially healthy.

• Paying for medical care. Pay attention to your insurance plan. Your out-of-pocket costs can vary significantly depending on which providers you choose, especially if your insurance has a narrow network. If you find yourself with steep medical bills, it’s important that you address issues with your healthcare provider as soon as possible, even when you have a billing dispute, as medical billing companies are quick to send bills to collections which will affect your credit.

• Funding retirement. An easy rule of thumb in estimating how much you’ll need to save for retirement is to multiply your salary (that you are earning immediately prior to retirement) by 16. That’s roughly how much you should have saved before you can retire. If you haven’t already started putting money away for retirement, start with something simple like contributing to your 401(k) or other retirement accounts—especially if your company will match contributions. Every bit helps and it’s never too early to be building your savings.

• Paying off student loans. Pay down your higher-interest-rate student loans first (those that impose more than 4.5 percent interest). After you pay them, decide if it makes sense to pay down those with rates around 2 percent. Paying down higher-rate loans first is often a good starting point to get debt under control.

Many additional recommendations are available at www.360financialliteracy.org, the CPA profession’s dedicated resource to help Americans achieve financial soundness.