Medical debt and subsequent use of alternative financial services among U.S. adults
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ID: 322659
2026
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Abstract
Abstract Introduction Medical debt is persistent among adults in the United States, challenging an individual’s ability to meet other financial obligations. However, less is known about financial wellbeing impacts beyond the traditional banking system. Methods We conducted a prospective longitudinal study to investigate the association between medical debt and subsequent use of alternative financial services, including buy now, pay later loans, payday loans, and cash advance products, using a nationally-representative sample of 2,021 adults from the Cumulative Life Stressors Impact on Mental Health and Well Being Study 2023-2025. Results Of the analytic sample, 451 (22.3% weighted) had ever reported medical debt, and 477 individuals (23.9% weighted) reported subsequent alternative financial service use. Having any medical debt in the baseline year was associated with a 11.9 percentage point [95% CI: 7.3, 16.6] increase in the probability of subsequent alternative financial service use. This finding was significant for those with $500 to $999, $1,000 to $2,499, and more than $5000 in medical debt at baseline. Conclusion Individuals with medical debt are more likely to report using alternative financial services, reflecting a broader cycle in which health challenges and costly medical care are associated with financial precarity and poorer health.
| Reference Key |
openalex_W7171388392
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|---|---|
| Authors | Hridika Shah, Kyle J. Moon, Katherine Miller, Sandro Galea, Catherine K. Ettman |
| Journal | Health Affairs Scholar |
| Year | 2026 |
| DOI |
10.1093/haschl/qxag185
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| URL | |
| Keywords | Keywords not found |
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