Cancer and diabetes aren’t the only conditions driving medical debt

Newswise – Costly ongoing treatments for cancer and diabetes are the most well-known drivers of medical debt that contribute to two-thirds of personal bankruptcies, but research from Rutgers indicates that other chronic conditions are also significant contributors.

Asthma, heart disease, lung disease, anxiety and other mood disorders are all associated with high rates of medical debt, according to an analysis of data from 9,174 households that participated in the wave 2019 Panel Study on Income Dynamics (PSID). The study was published in Preventive medecine.

“Medical debt has often been linked to cancer and, more recently, diabetes. The important finding here is that medical debt is linked to a wide range of chronic diseases,” said Irina Grafova, lead author of the study and assistant professor at the Rutgers School of Public Health. “The other important finding is that this link between chronic disease and medical debt exists at all income levels. It is not limited to low-income households. This also applies to middle- and upper-income households, so it’s really a society-wide problem.

The PSID, which began in 1968, conducted its 2019 wave of questionnaires in English and Spanish between February 28, 2019 and January 8, 2020. It covers a representative sample of U.S. households and contains data on household income, medical debt, demographics, illness and health-related behaviors.

The study team separated households by income levels: low (less than twice the census poverty line), middle (two to four times the line) and high (more than four times the line). Team members then calculated the correlation between 11 chronic conditions and two financial conditions: any reported medical debt or more than $2,000 of reported medical debt.

The chronic conditions most strongly associated with medical debt were:

  • Heart disease, asthma and anxiety disorders (in low-income households)
  • Diabetes, lung diseases and mood disorders (in middle-income households)
  • Cancer, lung disease, arthritis and mood disorders (in high-income households)

The rates for all medical debt were 8.74% in low-income households, 9.77% in middle-income households and 4.6% in high-income households. Rates of medical debt over $2,000 — a number that previous research points to as the threshold where serious financial problems often begin — were 5.82% in low-income households, 6.46% in households middle income and 3.05% in high income households.

Future research from the same team will dig deeper into the link between chronic disease and medical debt, explore how the COVID-19 pandemic has affected medical debt, and explore strategies to reduce medical debt.

“We look forward to seeing data from the 2021 wave of PSID, so we can see how COVID has affected debt levels,” Grafova said. “The pandemic itself and our response to it was so large and multifaceted that it is impossible to predict. Have COVID-related health care costs and rising unemployment increased medical debt, or have stimulus payments and lower spending on things like restaurants and vacations allowed Americans to reduce their medical debt? We still don’t know the answers, but we should know them soon.

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