Recorded presentation

Matthew Levi, University of Iowa, Department of Community and Behavioral Health, 200 Hawkins Drive, E225 GH, Iowa City, IA 52242-1008, 3193358203, matthew-levi@uiowa.edu and Anne Wallis, PhD, Dept. of Community & Behavioral Health, Center for Public Health Program Evaluation, University of Iowa, College of Public Health, 4258 Westlawn, Iowa City, IA 52242.

This research investigates individual, social, and environmental factors associated with medical debt for residents in low-income neighborhoods of Des Moines, IA. The consequences of medical debt include a range of negative outcomes including social, economic, and health outcomes. It can result in failure to seek care, pay for basic goods or services, receive bank loans or other lines of credit, personal bankruptcy, stress, anxiety, and hopelessness. Medical debt becomes a community issue as residents turn to friends and family for help . This study analyzed interviews with over 700 Des Moines residents living in low-income neighborhoods. 34% of Des Moines respondents reported debt from medical or health expenses - the highest prevalence of ten cities surveyed. Our analysis found that families with children, employed respondents, and African-American respondents were more likely to have medical debt. Families earning $15,000-25,000 were most likely to have medical debt (40%), although families earning both under (31%) and over this range (36 %) were also likely to have medical debt. Further data collection and analysis will seek to learn more about disparities in medical debt across Polk County by geography, race/ethnicity, and socioeconomic status; and levels, sources, and consequences of medical debt. Amidst current national debate about high costs of healthcare for the low-income uninsured, these results help define those populations most vulnerable to the medical debt and its consequences.

Learning Objectives:

At the conclusion of the session, the participant will be able to (
• Describe five consequences of medical debt, (
• Articulate four risk factors significantly associated with medical debt, and (
• Discuss unique challenges as evaluators offer technical assistance to community-based initiatives aimed at medical debt

Keywords: Vulnerable Populations, Low-Income

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: We analyzed data based on interviews conducted by the Urban Institute and NORC and funded by the Annie E. Casey Foundation's Making Connections project.
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation