Have you missed a loan payment in the last month? Seen your credit card rates go up? Had trouble paying a medical bill? These are the kinds of questions we ask a cross-section of Americans each month to come up with theConsumer Reports Index’s Trouble Tracker. It shows financial troubles up sharply for the second month in a row.

Consumer Reports’ latest survey finds it’s not just low-income families who are suffering. Now middle-income families are feeling the pinch. The most pervasive problem — difficulty paying for medicine or medical care.

A fundamental issue is jobs. When Consumer Reports asked if you’ve found a job or lost a job in the past 30 days, it finds the employment index has fallen below 50. That means more people are losing jobs than gaining jobs.

Jobs are key to getting the economy moving. Without secure employment, people don’t want to spend, and that’s crucial as we enter the last quarter of the year.

The Consumer Reports Index does find some people are optimistic, especially those between the ages of 18 to 34. In fact in the last month, that group has gotten more upbeat about their financial situation.