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Study: More older African Americans incur medical debt than older whites

Substantially more older African American adults incur medical debt compared to older white adults, according to a new study by researchers at UMass Medical School, the University of South Florida and St. Louis University.

  Jeroan Allison, MD

Jeroan Allison, MD


  Catarina Keife, MD, PhD

Catarina Kiefe, MD, PhD

Jeroan J. Allison, MD, vice chair and professor of quantitative health sciences, and Catarina I. Kiefe, MD, PhD, the Melvin S. and Sandra L. Cutler Chair in Biomedical Research and chair and professor of quantitative health sciences, co-authored the study that found African American adults were 2.6 times more likely to have medical debt than whites. The study appears in the online edition of the American Journal of Public Health.

“As out-of-pocket expenses continue to rise and older adults face the prospect of shrinking income, medical debt represents a major threat to the economic security of older African Americans,” the authors said in the paper. “Understanding the racial and ethnic disparities in medical debt and financial consequences may inform policy on health care affordability for a large and growing proportion of our aging population.”

Jacqueline Wiltshire, PhD, assistant professor of health policy and management at the University of South Florida College of Public Health, is the study’s first author. Keith Elder, PhD, professor and chair of health management and policy at Saint Louis University, is a co-author.

The researchers examined nationally representative data from the 2007 and 2010 U.S. Health Tracking Household Survey—which collected information on access to care; health care experiences; health expenses and bills; insurance coverage; health status; and socioeconomic characteristics—and created population-based estimates of medical debt attributable to economic and health factors. The sample included non-Hispanic whites and African Americans ages 65 and older.

Health status, income and insurance accounted for more than 40 percent of the racial and ethnic disparity in debt. African Americans were also more likely to be contacted by a collection agency and to borrow money because of medical debt, while whites were more likely to use savings to pay off medical bills.