When was the last time you truly took a vacation? Away from both home and work and all of the stresses and daily duties required at each? If it's been more than a year, take heart to know that you are in good company. The majority of Americans are unable or unwilling to take a break from it all. And it could be affecting the overall health of the nation.

A recent telephone survey conducted by the insurance company Allianz Global Assistance found that 56 percent of Americans have not taken a vacation — defined as travel at least 100 miles from home that lasted for at least one week — in more than a year. That's an increase from the 52 percent of Americans who made the same claim in 2014.

Why do Americans skimp on vacation time? The Allianz survey didn't ask participants why they hadn't gone on vacation, but similar surveys have. Those results show that most Americans either don't have paid time off from work or they're unwilling to use it.

A 2013 report from the Center for Economic and Policy Research found that the United States “is the only advanced economy in the world that does not guarantee its workers paid vacation.” In countries such as Belgium and New Zealand, workers are guaranteed 20 paid vacation days every year in addition to 10 paid holidays. Employees in the U.K. get at least 28 paid vacation days a year while in France they enjoy 30 days. In the U.S., that number is zero.

Still, that just means that businesses in the U.S. aren't required to offer paid vacation days, but surely most do, right? Wrong. The CEPR report found that almost one-quarter of American workers have no paid vacation or paid holidays. Disproportionately, the lowest-paid Americans make up the majority of this group.

But even Americans who are lucky enough to have paid vacation days offered as a term of their employment tend not to use them. A report in the Atlantic last year found that 41 percent of American workers do not use all of their vacation days. An online survey conducted last year by the U.S. Travel Association attempted to find out why Americans skimp on vacations.

Their results showed that 40 percent of Americans said they avoided vacations because they didn't want to return to a mountain of work. Thirty-five percent of those surveyed felt that the work would not get done without them, and 22 percent worried that they would be seen as replaceable if they took a vacation.

With companies such as Netflix announcing unlimited family leave vacation policies, it begs the question: Will American workers take advantage of such perks? Or are we doomed to remain the no-vacation nation?