Americans with medical debt were two to three times more likely to struggle with housing and food insecurity — key social determinants of health — a new study published in JAMA Network Open found.
The study, which analyzed Census Bureau data from 2018 to 2020, found that 10.8 percent of Americans carried medical debt, including 10.5 percent of those with private insurance.
The authors of the study, from the City University of New York and Cambridge Health Alliance, wrote that low and middle-income Americans carry the majority of medical debt, with the highest-income and highest-educated Americans "relatively spared."
Those with medical debt were more likely to be food insecure, unable to afford utilities and rent or mortgage payments and to be evicted from their homes. These are key social determinants of health, the study's authors said, linked to worse health outcomes.
"Unaffordable medical bills may constitute an SDOH in their own right and contribute to a downward spiral of ill health and financial precarity," the authors wrote.
In the study's cohort, those who had been hospitalized in the past year, had a disability, or self-rated their health as poor were more likely to have medical debt. Among Americans with insurance, individuals with high-deductible plans or Medicare Advantage plans were more likely to have medical debt.
Read the full study here.