Nearly 2% of consumers surveyed for Consumer Reports July consumer sentiment index missed at least one mortgage payment, down from 2.7% a month earlier and 2.4% from a year ago. Despite fewer Americans missing recent mortgage payments, the Consumer Sentiment Index for July — which measures consumer attitudes by interviewing 1,000 random Americans — ended up with an index score of 48.5, rising only slightly from the previous month. The index, which is published by the Consumer Reports National Survey Research Center, considers any score above 50 on the optimistic side of the consumer sentiment scale, while anything under 50 falls in the negative range. "The economy is treading water and really hasn't shown any momentum toward recovery," said Ed Farrell, a director at Consumer Reports National Survey Research Center. "Consumers remain cautious, especially households with income less than $50,000, who have been hurt the worst and face the biggest stresses regarding jobs, unpaid bills and health care access and affordability." While consumers seem to be doing more favorably in making their mortgage payments, health care expenses remain a top concern for many. The most prevalent consumer concern is one's ability to afford medical bills or medications, with 13.3% of respondents picking that as their top issue. Lower-income homes that bring in less than $50,000 a year reported having difficulty covering health care expenses. In the past 30 days, 21.4% said they were unable to afford medical bills or medications, while 16% missed at least one major payment unrelated to their mortgage. Write to Kerri Panchuk.