Research Alert: November 4, 2024

Medical Debt in Collections Among Counties by Rural-Urban Location and Racial-Ethnic Composition

Medical debt, or medical costs owed for health care services, is a pressing issue across the U.S., with implications for health and well-being for those facing debt burden. While recognition of medical debt as a social problem is growing, details about who is most at risk of holding this debt remain less clear. This policy brief addresses this gap by examining the differences in the proportion of people with medical debt in collections and median amount of medical debt by rural-urban location. Researchers also focus on additional differences within rural and urban communities of color.

Key Findings:

• Rural counties have a higher proportion of people with medical debt in collections than urban counties (15.7% vs 14.8%), and this difference is associated with lower average household incomes in rural counties in general.
• The county-level median amount of medical debt in collections held by rural residents is $62 higher compared to their urban counterparts, even after accounting for income differences.
• The proportion of people with and amount of medical debt in collections are both higher in rural and urban communities of color than in rural and urban communities overall.

Additional Resources of Interest:

• More FORHP-funded research on Poverty
• More information about the University of Minnesota Rural Health Research Center