Wider range of conditions associated with medical debt, U. researchers find

A recent Rutgers study found that a larger array of health issues than previously thought are associated with elevated rates of medical debt and bankruptcies. 

Irina Grafova, the study's principal investigator and assistant professor in the Department of Health Behavior, Society and Policy, said there is already public awareness about how diseases like cancer and diabetes are correlated with medical debt.

She said that these two particular diseases require expensive out-of-pocket costs which leads to their more popular link to financial issues, as opposed to health conditions with lesser-known costs as analyzed in this study.

The study found that individuals with medical conditions such as asthma, heart disease, lung disease, anxiety and other mood disorders can also observe a rise in medical debt. The study also analyzed how individuals’ health behaviors like smoking and drinking can affect medical debt.

Grafova said that individuals with medical conditions can accumulate debt due to costs associated with medical treatment as well as how their condition may negatively affect their employment.

She said the study, which used data from 9,174 American households, looked at the health behaviors that respondents had and then compared them to the respondents’ levels of medical debt through a logistic regression analysis technique.

The team made sure its analysis accounted for factors such as respondents’ income, savings and health insurance, Grafova said.

The study found that certain income levels and health conditions are associated with medical debt. For example, low-income households with heart disease and anxiety disorders, middle-income households with chronic lung disease and mood disorders and high-income households with a current smoker are associated with medical debt.

Grafova said that, to her knowledge, no prior studies have found a correlation between medical debt and conditions such as asthma, lung disease, anxiety disorders and smoking habits.

She said she was surprised that the study not only found associations between disease and medical debt in low-income households but also in middle-income and high-income households.

Grafova said that while the study did not analyze whether the association between disease and medical debt affects any demographics disproportionately, the research team found that some characteristics were linked to medical debt.

“For instance, in middle-income households, older age was associated with lower risk of debt while in higher-income households, Black race was associated with higher risk of medical debt,” she said.

Grafova said further research on this issue can explore the specific causes behind the link between medical debt and the conditions analyzed in this study. When looking at the issue of medical debt, health policies should use a lens that includes a wide range of diseases, she said. 

“Existing policies and programs soften the impact of medical debt, but they do not address the root causes of medical debt, including underinsurance, high cost-sharing, lack of competition in health care provision markets (and) high administrative costs,” Grafova said.