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Medical Debt and Related Financial Consequences Among Older African American and White Adults

Bibliographic Data

ID11039649
AuthorsJacqueline C Wiltshire (Jacqueline C. Wiltshire is with the Department of Health Policy and Management, University of South Florida College of Public Health, Tampa. Keith Elder is with the Department of Health Management and Policy, Saint Louis University School of Public Health, St Louis, MO. Jeroan J. Allison and Catarina Kiefe are with the Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester.), John Wiltshire (0000-0002-9371-5675, Saint Louis University), Keith Elder (0000-0002-4932-0852, Jacqueline C. Wiltshire is with the Department of Health Policy and Management, University of South Florida College of Public Health, Tampa. Keith Elder is with the Department of Health Management and Policy, Saint Louis University School of Public Health, St Louis, MO. Jeroan J. Allison and Catarina Kiefe are with the Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester.), Catarina I Kiefe (0000-0001-8719-6963, Saint Louis University), Catarina Kiefe (Jacqueline C. Wiltshire is with the Department of Health Policy and Management, University of South Florida College of Public Health, Tampa. Keith Elder is with the Department of Health Management and Policy, Saint Louis University School of Public Health, St Louis, MO. Jeroan J. Allison and Catarina Kiefe are with the Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester.), Jeroan J Allison (0000-0003-4472-2112, Jacqueline C. Wiltshire is with the Department of Health Policy and Management, University of South Florida College of Public Health, Tampa. Keith Elder is with the Department of Health Management and Policy, Saint Louis University School of Public Health, St Louis, MO. Jeroan J. Allison and Catarina Kiefe are with the Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester.)
Year2016
Volume106
Issue6
Pages1086-1091
Publication date2016-06-01
Open AccessNo
TypeARTICLE
VenueAmerican Journal of Public Health (JOURNAL)
Journal identifiersISSN: 0090-0036 • E-ISSN: 1541-0048
PublisherAmerican Public Health Association (PUBLISHER • US)
DOI10.2105/ajph.2016.303137
PMID27077346
OpenAlexW2341821456
LanguageEN
Citations received11
References cited25

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, and more than 40% of this is mediated by health status, income, and insurance disparities. Public health implications. In Medicare, low-income beneficiaries, especially low-income African Americans with poor health status, should be protected from the unintended financial consequences of cost-reduction strategies

Confidence interval · Debt · Demographic economics · Economics · Environmental health · Health and Retirement Study · Logistic regression · Marital status · Odds · Odds ratio · Population · Public health · Sociology · Demography · Economic and Financial Impacts of Cancer · Finance · Healthcare Policy and Management · Healthcare Systems and Reforms · Medicine · Gerontology

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Citations per year1.38
Citation span2018 - 2026 (9)
Highly citedNo

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