Study Links Medical Debt To Higher Risk Of Housing Instability

Johns Hopkins Bloomberg School of Public Health findings show medical debt can increase the risk of missing rent or mortgage payments. The financial services industry and collections professionals are equipped to help consumers with medical debt.

New research from the Johns Hopkins Bloomberg School of Public Health suggests people with medical debt are also more likely to experience housing instability (e.g difficulty paying rent or mortgage, eviction, or foreclosure.)

Specifically, the nationally representative cohort study, published Jan. 12 in JAMA Network Open, found that adults carrying medical debt in 2024 were significantly more likely to experience housing instability a year later. After adjusting for income, savings, insurance status, age, and other factors, the analysis showed that medical debt was associated with a “7 percentage-point higher probability of housing instability in the following year.”

That translates to a roughly 44% increased risk of housing instability for those with medical debt.

Researchers followed 1,515 U.S. adults over three years, drawing on data from the Cumulative Life Stressors Impact on Mental Health and Well-Being (CLIMB) study, according to a Bloomberg School article on the research. Of those surveyed, about one in six reported having medical debt in 2024, and roughly one in 12 experienced housing instability in 2025. Renters were disproportionately affected, accounting for roughly two in five adults with medical debt who later reported housing problems.

“…For many people, receiving health care can lead to medical debt, and then to housing instability,” co-author Kyle Moon, PhD candidate at Johns Hopkins, said in the Bloomberg School article. “This can create a cascade of consequences, including delayed health care, that jeopardizes health.”

The findings highlight how medical debt can extend beyond health care expenses and contribute to broader financial strain, including housing instability. The study adds to growing research showing that financial pressures tied to medical bills can have consequences that reach far beyond the health care system.

For ACA International members, the research can provide a possible glimpse into the experiences of consumers with medical debt when working with them to understand their bills and resolve their accounts on behalf of health care provider clients.

Debt collectors are an extension of a health care provider’s business office, who routinely advise consumers about financial assistance options, workers’ compensation coverage, insurance appeals, and how to examine hospital bills in detail.

Collection agents are equipped to provide reliable options for consumers to apply for free or reduced charity care, navigate the insurance claims process, dispute charges, or set up reasonable payment plans.

ACA’s Know My Debt website features information on how collections professionals can help consumers navigate the communications and decisions involved with collections.

Read the full study: “Housing Instability Following Medical Debt Exposure Among US Adults, 2023 to 2025.”

ACA also recently reported on these consumer spending and debt trends:

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