Geographic and Socio-Demographic Correlates of Medical Debt Among Rural Residents

Research center:
Lead researcher:
Project funded:
September 2023
Anticipated completion date:
August 2025

Medical debt – that is, debt incurred because of health care costs and related expenditures – impacts 40% of adults in the U.S., amounting to approximately 100 million people. Medical debt has multiple deleterious effects, including creating barriers to accessing additional health care, stress, and difficulty managing finances for other basic needs, such as housing and nutrition. Further, high rates of medical debt in a community can negatively impact health care providers' and facilities' financial stability. Despite the widespread impact of medical debt on the U.S. population, relatively little is known about rural/urban differences in medical debt. Of the research that does exist, there is an indication that rural residents experience greater rates of medical debt, as evidenced by higher rates of contact by debt collection agencies. Even less is known about differences in medical debt among rural residents by geography (e.g., region, state, county) and by socio-demographic characteristics (e.g., age, race, ethnicity, gender, health status). This information is critical to inform rural health policy, especially as rural residents experience poorer health and rural health care facilities navigate financially tenuous situations. Further, additional information on rural medical debt is needed to inform widespread policies such as Medicaid expansion, which has been shown to reduce medical debt. This project will address the aforementioned gaps in the research.


Publications