Updated 13 December 2013

High debt may have negative health consequences

A new study found that high financial debt is associated with higher blood pressure and poorer general and mental health in young adults.


If young people are drowning in debt, their blood pressure may be on the rise and their health could suffer. A new Northwestern Medicine® study has found that high financial debt is associated with higher diastolic blood pressure and poorer self-reported general and mental health in young adults.

The study, published in the August issue of Social Science and Medicine, offers a glimpse into the impact debt may have on the health of young Americans.

“We now live in a debt-fuelled economy,” said Elizabeth Sweet, lead author of the study. “Since the 1980s American household debt has tripled. It’s important to understand the health consequences associated with debt.”

Sweet is an assistant professor of medical social sciences at Northwestern University Feinberg School of Medicine and a faculty associate of Cells to Society (C2S): The Center on Social Disparities and Health, at the Institute for Policy Research at Northwestern.

Researchers used data from the National Longitudinal Study of Adolescent Health to explore the association between debt and both psychological and general health outcomes in 8 400 young adults, ages 24 to 32.

Previous studies have found evidence that debt is associated with adverse psychological health, but this is the first to look at physical health as well.

Here are some key findings of the study:

•             20% of participants reported that they would still be in debt if they liquidated all of their assets (high debt-to-asset-ratio).

•             Higher debt-to-asset ratio was associated with higher perceived stress and depression, worse self-reported general health and higher diastolic blood pressure.

Those with higher debt were found to have a 1.3% increase (relative to the mean) in diastolic blood pressure, which is clinically significant. A two-point increase in diastolic blood pressure, for example, is associated with a 17% higher risk of hypertension and a 15% higher risk of stroke.

The researchers found that individuals with high compared to low debt reported higher levels of perceived stress (representing an 11.7% increase relative to the mean) and higher depressive symptoms (a 13.2% increase relative to the mean).

“You wouldn’t necessarily expect to see associations between debt and physical health in people who are so young,” Sweet said. “We need to be aware of this association and understand it better. Our study is just a first peek at how debt may impact physical health.”

Debt-to-asset ratio

In the study, personal financial debt was measured in two ways. Participants were asked about their debt-to-asset ratio by answering this question: “Suppose you and others in your household were to sell all of your major possessions (including your home), turn all of your investments and other assets into cash, and pay off all of your debts. Would you have something left over, break even or be in debt?”

Second, participants were asked how much debt, besides a home mortgage, they have. Response categories ranged from “less than R9 970.00” to “R249 255.00 or more".

Perceived stress, depressive symptoms and general health were measured through a series of questions. Both systolic and diastolic blood pressures were measured on each participant by a field interviewer.

Other study authors include Thomas W. McDade, professor of anthropology at Northwestern and director of C2S: The Center on Social Disparities and Health, at the Institute for Policy Research, Emma K.

Adam, professor of human development and social policy at C2S and in the school of education and social policy at Northwestern, and Arijit Nandi, assistant professor at the Institute for Health and Social Policy and the department of epidemiology, biostatistics and occupational health at McGill University.

Support for the analyses presented in this paper was provided by grant #1R01 HD053731-01 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development.




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