Medical Debt In The US: Associations With Cancer Screening, Mortality, And Health Status.
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| Title: | Medical Debt In The US: Associations With Cancer Screening, Mortality, And Health Status. |
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| Authors: | Chatzipanagiotou OP; Odysseas P. Chatzipanagiotou, Ohio State University, Columbus, Ohio., Baldo A; Andrea Baldo, Ohio State University., Akabane M; Miho Akabane, Ohio State University., Sarfraz A; Azza Sarfraz, Ohio State University., Mevawalla A; Areesh Mevawalla, Ohio State University., King J; Jasmine King, Ohio State University., Thammachack R; Razeen Thammachack, Ohio State University., Pawlik TM; Timothy M. Pawlik (tim.pawlik@osumc.edu), Ohio State University. |
| Source: | Health affairs (Project Hope) [Health Aff (Millwood)] 2025 Dec; Vol. 44 (12), pp. 1457-1465. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Project Hope Country of Publication: United States NLM ID: 8303128 Publication Model: Print Cited Medium: Internet ISSN: 2694-233X (Electronic) Linking ISSN: 02782715 NLM ISO Abbreviation: Health Aff (Millwood) Subsets: MEDLINE |
| Imprint Name(s): | Publication: Original Publication: Millwood, Va. : Project Hope, c1981- |
| MeSH Terms: | Early Detection of Cancer*/statistics & numerical data , Early Detection of Cancer*/economics , Health Status* , Neoplasms*/mortality , Neoplasms*/diagnosis , Health Services Accessibility*/economics , Health Services Accessibility*/statistics & numerical data , Health Expenditures*/statistics & numerical data, Humans ; United States/epidemiology ; Female ; Male ; Middle Aged ; Aged ; Adult ; Medical Debt |
| Abstract: | The people most vulnerable to medical debt often face systemic barriers to health care that are further exacerbated by debt accumulation, creating a compounding effect leading to adverse health outcomes. This ecological panel study assessed associations among county-level medical debt and cancer screening, cancer mortality, and community-level health status. Medical debt data (from 2017, 2019, and 2021) from the Urban Institute Credit Bureau Panel were analyzed using generalized estimating equations with an exchangeable correlation structure and lagged exposure-outcome modeling. A total of 8,954 county-years were included. In multivariable analysis, each 5-percentage-point increase in medical debt was associated with a 0.43-percentage-point and a 1.35-percentage-point decrease in colorectal and breast cancer screening rates, respectively, and 10.9 per 100,000 population more deaths from cancers with guideline-recommended screening. Medical debt was consistently associated with worse health and cancer outcomes. Addressing this burden is important for improving population health and mitigating cancer-related disparities. |
| Entry Date(s): | Date Created: 20251202 Date Completed: 20251202 Latest Revision: 20251202 |
| Update Code: | 20251203 |
| DOI: | 10.1377/hlthaff.2025.00869 |
| PMID: | 41329895 |
| Database: | MEDLINE |
Nájsť tento článok vo Web of Science | Abstract: | The people most vulnerable to medical debt often face systemic barriers to health care that are further exacerbated by debt accumulation, creating a compounding effect leading to adverse health outcomes. This ecological panel study assessed associations among county-level medical debt and cancer screening, cancer mortality, and community-level health status. Medical debt data (from 2017, 2019, and 2021) from the Urban Institute Credit Bureau Panel were analyzed using generalized estimating equations with an exchangeable correlation structure and lagged exposure-outcome modeling. A total of 8,954 county-years were included. In multivariable analysis, each 5-percentage-point increase in medical debt was associated with a 0.43-percentage-point and a 1.35-percentage-point decrease in colorectal and breast cancer screening rates, respectively, and 10.9 per 100,000 population more deaths from cancers with guideline-recommended screening. Medical debt was consistently associated with worse health and cancer outcomes. Addressing this burden is important for improving population health and mitigating cancer-related disparities. |
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| ISSN: | 2694-233X |
| DOI: | 10.1377/hlthaff.2025.00869 |