Medical debt and related financial consequences among older African American and white adults

J.C. Wiltshire, K. Elder, C. Kiefe and J.J. Allison

American Journal of Public Health, 2016, vol. 106, issue 6, 1086-1091

Abstract: Objectives. To evaluate African American-White differences in medical debt among older adults and the extent to which economic and health factors explained these. Methods. We used nationally representative data from the 2007 and 2010 US Health Tracking Household Survey (n = 5838) and computed population-based estimates of medical debt attributable to economic and health factors with adjustment for age, gender, marital status, and education. Results. African Americans had 2.6 times higher odds of medical debt (odds ratio = 2.62; 95% confidence interval = 1.85, 3.72) than did Whites. Health status explained 22.8% of the observed disparity, and income and insurance explained 19.4%. These factors combined explained 42.4% of the observed disparity. In addition, African Americans were more likely to be contacted by a collection agency and to borrow money because of medical debt, whereas Whites were more likely to use savings. Conclusions. African Americans incur substantial medical debt compared with Whites, andmore than 40% of this ismediated by health status, income, and insurance disparities. Public health implications. In Medicare, low-income beneficiaries, especially lowincome African Americans with poor health status, should be protected from the unintended financial consequences of cost-reduction strategies.

Keywords: adult; African American; Caucasian; confidence interval; education; female; gender; health status; household; human; lowest income group; major clinical study; male; marriage; medicare; money; odds ratio; public health; accounting; African American; aged; cross-sectional study; economics; health insurance; health service; health survey; income; socioeconomics; statistics and numerical data; United States, African Americans; Aged; Cross-Sectional Studies; European Continental Ancestry Group; Female; Health Services; Health Status; Health Surveys; Humans; Income; Insurance, Health; Male; Patient Credit and Collection; Socioeconomic Factors; United States (search for similar items in EconPapers)
Date: 2016
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Citations: View citations in EconPapers (3)

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Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:10.2105/ajph.2016.303137_5

DOI: 10.2105/AJPH.2016.303137

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