One in 5 US Adults Chooses Against Handwashing, Some Citing it as "Unnecessary," National Survey Finds
While 20% of US adults choose not to wash their hands at appropriate times, nearly half admitted to forgetting to do it, according to a new national survey.
Despite the evidence that handwashing can prevent up to 80% of infectious diseases, 1 in 5 US adults admit they choose not to wash their hands, according to the 2025 State of Handwashing Report from the National Foundation for Infectious Diseases (NFID). Released today on World Hand Hygiene Day, the report reveals significant gaps in hand hygiene behaviors even after the worst flu season in more than a decade and widespread norovirus outbreaks.
Based on a national survey of 3,587 US adults conducted by NORC at the University of Chicago,* the findings show that while 62% of respondents correctly identified that washing hands with soap and water for 20 seconds effectively reduces germ transmission, nearly half (48%) reported forgetting or choosing not to wash at key times—such as after visiting grocery stores, restaurants, coffee shops, or healthcare settings.
“Forgetting is the most common reason reported for not washing hands," survey authors wrote, but concerningly the analysis revealed that 20% of respondents "actively choose not to wash their hands, citing reasons like thinking it’s unnecessary, a lack of time, or a concern about drying out their hands," NFID stated in the report. The survey also found gender differences among the subgroup that admitted not using soap and water, with men more likely to forget and women more likely to substitute hand sanitizer for soap and water.
The survey identified the top 3 situations that prompt handwashing: after using the bathroom (69%), handling food (48%), and handling human or animal waste (39%). Another disturbing finding was that less than one-third (30%) of surveyed adults said they are most likely to wash hands after coughing or sneezing—a major concern given the ease of respiratory disease transmission, and especially influenza, according to the report.
"Given the importance of handwashing in infectious disease prevention, the stakes are high—improving hand hygiene can help improve health for all," NFID Medical Director Robert H Hopkins, Jr, MD said in a statement. He emphasized that handwashing should complement vaccination efforts and noted that routine handwashing could save approximately 1 million lives globally each year.
The survey highlighted motivations for handwashing: 55% of respondents cited personal health as their primary reason and 68% included protecting others among their top three motivations.
For some adults, the survey found, handwashing has a seasonal cycle, with one-quarter (26%) reporting increased handwashing in the fall and winter months. Interestingly, and a bright spot amidst the concerning results, 33% said they now wash their hands more often than they did during the COVID-19 pandemic.
“Proper handwashing puts the power of health in our own hands,” Patricia A. Stinchfield, RN, MS, CPNP, NFID immediate past-president, said in the statement. “Handwashing is an easy and effective way to prioritize your health and the health of those around you.”
To further support public awareness, NFID has launched the "Hands In For Handwashing" campaign and introduced the Clean Hands Caravan—a mobile handwashing station designed to make hand hygiene accessible in public spaces. “The caravan was created to make handwashing accessible and visible during key moments in everyday life when it is important to wash hands,” NFID Marla Dalton, PE, CAE, NFID CEO said. The caravan debuted at a Washington Spirit soccer game on May 2, 2025, and will visit events like the World Barbeque Cooking Contest in Memphis (May 14-17) and the Atlanta Jazz Festival (May 24-26).
"We encourage organizations to join the Hands In For Handwashing movement to support healthier lives for all,” Dalton said.
For more information about the 2025 NFID State of Handwashing Report and hand hygiene resources, visit www.nfid.org/handwashing.
