Consumer debt is quietly shaping who stays healthy and who does not in the United States, according to a new policy brief published in Health Affairs, a peer-reviewed health policy journal read widely by researchers and policymakers. The analysis frames debt as a public health issue that reinforces racial inequality, particularly for Black Americans who carry heavier debt burdens and face fewer financial protections.
The brief explains that Black Americans have been systematically excluded from wealth accumulation through policies and practices that increase debt and limit asset building. That exclusion has produced chronic financial vulnerability, which is closely tied to worse physical and mental health. Debt constrains household resources, forcing people to delay care, skip medications, and avoid preventive services, while also fueling financial stress and stigma that contribute to anxiety and depression.
Unsecured debt plays a central role. Medical bills, student loans, credit cards, and payday loans are more likely to end up in collections in communities of color. The analysis reports that 29% of African American, Hispanic, Asian or Pacific Islander, American Indian or Alaska Native, and multiracial communities carry debt in collections, compared with 19% of White communities. These patterns reinforce the racial wealth gap and magnify health risks tied to economic insecurity.
Evidence that debt relief can improve health is emerging but uneven. Studies cited in the brief suggest bankruptcy protection may lower mortality, yet Black and Latinx borrowers often experience less benefit because they are more likely to hold nondischargeable debts and encounter bias within the bankruptcy system. Structural inequities in debt collection and legal processes further limit potential health gains.
The Health Affairs brief concludes that treating debt as a social determinant of health is essential. Expanding health insurance, supporting student debt relief, reforming bankruptcy practices, and investing in asset-building policies could help reduce racial health disparities rooted in long-standing economic inequality.
See: “Consumer Debt, Race, And Health: Can Debt Relief Be A Solution For Reducing Racial Health Disparities?” (December 11, 2025)
