HARRISBURG - Nearly two-thirds of Americans, or 64 percent, consider the economy and personal finances their most pressing problem while fewer than half approve of the way President Barack Obama is dealing with the nation's economic problems, a poll released Friday shows.

The Franklin & Marshall College poll, co-sponsored by Times-Shamrock Newspapers and other media outlets, finds that just 11 percent of Americans consider health-related issues their most important problem. It underlies a reason for mounting frustration with Obama and the challenge facing his administration as midterm elections loom in November, said G. Terry Madonna, Ph.D., poll director.

"Americans are focused like a laser on the economy," he said. "Reforming health care is important to them, but it doesn't trump the economy. People want the economy taken care of."

While Obama and the Democratic-controlled Congress have spent the past year trying to pass comprehensive health care reform legislation without success so far, four of five Americans (78 percent) say the current health care system meets their needs either very well or pretty well.

About one in five adults (21 percent) said they skipped a recommended medical test or treatment because of the costs, while approximately the same number (19 percent) said they were without health insurance coverage at some point during the previous year.

The F&M poll surveyed 920 U.S. adults, of whom 767 are registered to vote. The poll had a margin of error of plus or minus 3.2 percentage points for questions posed to all adults and plus or minus 3.5 percentage points for adults who are registered to vote. The poll was conducted between Feb. 2 and Feb. 8.

The poll data underscores how Obama's low approval rating on economic issues is affecting the political climate.

Overall, 45 percent of adults approve of Obama's handling of the economy, but the numbers range widely based on party affiliation. Seventy percent of registered Democrats give the president positive ratings on the economy question, but that drops to 43 percent when independents respond and to 23 percent when Republicans respond.

The disaffection among independents over the economy is shaping the political climate. Independents played a key role in helping GOP candidates win gubernatorial elections in November in New Jersey and Virginia and the election of U.S. Sen. Scott Brown, R-Mass., to succeed the late Edward M. Kennedy in a special election last month.

The future impact of this political shift by independent voters is seen in the poll data that more Americans - 35 percent to 39 percent - would vote for the generic Republican candidate than the generic Democratic candidate if the midterm elections for U.S. House seats were held today.

As recently as September, Democrats led the Republicans, 43 percent to 30 percent, on this generic congressional vote question.