University of South Florida

Older African Americans incur more medical debt than older whites

Tampa, FL (April 15, 2016) — Older African American adults incur substantially more medical debt compared to older whites, reports a new study by researchers from the University of South Florida College of Public Health, the University of Massachusetts Medical School and St. Louis University.

The findings appeared online yesterday in the American Journal of Public Health.  Study lead author was Jacqueline Wiltshire, PhD, MPH, assistant professor of health policy and management at the USF College 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 preferred_600x400

Jacqueline Wiltshire, PhD, MPH, of the USF College of Public Health was the study’s lead 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.

Results showed that African American adults were greater than two times more likely to have medical debt than whites. 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.

In light of recent proposed changes to Medicare to reduce the national debt and maintain the program’s solvency, the authors concluded: “Although changes are necessary to sustain Medicare for the future, policymakers need to explicitly consider the impact that cost-cutting strategies will have on African American beneficiaries.”

The research was supported by grants from the Robert Wood Johnson Foundation New Connecticut Program and the National Institute of Minority Health and Health Disparities.

Article citation:
Jacqueline C. Wiltshire, Keith Elder, Catarina Kiefe, and Jeroan J. Allison.  Medical Debt and Related Financial Consequences Among Older African American and White Adults. American Journal of Public Health. April 14, 2016. doi: 10.2105/AJPH.2016.303137. [E-pub ahead of print].


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