Debt carries profound psychological and physical health consequences, according to a narrative exploration of financial hardship’s impact on both individuals and public health systems. A case study of a single mother in New York City reveals how medical debt transformed from a manageable issue into a source of chronic stress—she owed nearly $50,000 to debt collectors after a hospital visit and emergency care, leaving her working three jobs while managing two children as a single parent.
The psychological toll is well-documented: a study of more than 7,000 people in England found those in debt were three times as likely to have a common mental disorder. Another study of 27,651 U.S. adults showed people with depression and anxiety were two to three times more likely to have medical debt, which doubled their chances of delaying or forgoing mental health treatment. In 2020 alone, medical debt collection brought in $1.5 billion in revenue for America’s 7,000 debt collection agencies.
The concept of “good” versus “bad” debt reveals stark racial and economic divides. Wealthy Americans can access “secured” debt with low interest rates, while marginalized communities often face “unsecured” debt—student loans, medical debt, credit card bills, and predatory payday loans. A Boston study of 286 people showed payday loans were associated with inflammation, high blood pressure, and anxiety. A typical two-week payday loan with an APR of 400 percent means an initial $300 loan can ultimately cost the borrower $800.
The impact extends globally. Between 1995 and 2018, approximately 400,000 farmers in India died by suicide, many citing debt in suicide notes. Farm sector debt in the United States rose 4.4 percent to $542 billion in 2024. Between 2003 and 2017, 1,652 U.S. farmers died by suicide. The research suggests that debt—not mental illness alone—is the true diagnosis driving these crises, as it disrupts the social support systems that traditionally protected people’s well-being.
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://lithub.com/the-pain-of-not-paying-debt-as-a-monetary-and-a-health-burden/