Poor health is the No. 1 concern middle class Americans have about living longer, according to a new study by the Bankers Life and Casualty Company Center For A Secure Retirement.

Concern about health is four times the concern over having inadequate retirement savings, 10 percent, or outliving their money, 9 percent.

The study, "Longevity Risk and Reward for Middle-Income Americans," surveyed 500 Americans between the ages of 55 and 75 with annual household incomes between $25,000 and $75,000.

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The study found that Americans plan to deal with retirement income shortfalls by reducing spending (63 percent), working part-time in retirement (41 percent), selling their home (25 percent), giving less money to their family (24 percent), or not doing anything at all (15 percent).

Most middle-income Americans are living within their budget, according to the study. Seventy percent of respondents say they live within their means. Only 9 percent admit to living beyond their means.

Forty-four percent of respondents don't believe their retirement savings will last until the end of their life but when it comes to developing a retirement savings goal, only 21 percent of middle-income retirees and pre-retirees calculated a monthly retirement income goal number and only 13 percent determined a total savings goal to reach.

"Realistically assessing longevity can be a powerful tool in planning for retirement," said Chris Campbell, vice president of marketing and business development at Bankers Life and Casualty Co., a national life and health insurer.  "Set a clear retirement goal and be realistic about the amount of savings it will take to be able to live the retirement lifestyle you desire."

The study also found that 55 percent of middle-income Boomers have saved less than $100,000 for retirement. In light of this reality, it's not surprising that nearly two-thirds (62 percent) of middle-income pre-retirees report some level of anxiety about retirement; one in four (28 percent) report being "anxious" or "very anxious."

The survey took place in November 2012 and was conducted by independent research firm The Boomer Project.

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