TOPLINE:
Medical debt significantly affects US adults with depression and anxiety, with over 27% delaying or forgoing mental health care. Those burdened with medical debt are twice as likely to delay or skip care compared with those without debt.
METHODOLOGY:
- Researchers analyzed 2022 data from the National Health Interview Survey (NHIS), a cross-sectional, nationally representative survey of the civilian, noninstitutionalized US adult population.
- A total of 27,515 adults were included in the analysis, with data on lifetime and current depression and anxiety, as well as medical debt.
- Lifetime depression was measured by asking participants if they had ever been diagnosed with any type of depression, including major depressive disorder, bipolar depression, dysthymia, postpartum depression, and seasonal affective disorder.
- Lifetime anxiety was measured by asking participants if they had ever been diagnosed with any type of anxiety disorder, including generalized anxiety disorder, social anxiety disorder, panic disorder, posttraumatic stress disorder, obsessive-compulsive disorder, and phobias.
- Current depression and anxiety were assessed using the Patient Health Questionnaire 8 and Generalized Anxiety Disorder 7 scales, with a cutoff score of ≥ 10 indicating moderate to severe symptoms.
TAKEAWAY:
- Among 27,651 adults, 18.2% reported lifetime depression, 7.3% reported current depression, 17.7% reported lifetime anxiety, and 6.6% reported current anxiety.
- Medical debt was reported by 19.9% of adults with lifetime depression and 19.4% of those with lifetime anxiety, compared with 8.6% and 8.8% of adults without these diagnoses, respectively.
- Among adults with current depression, 27.3% had medical debt, compared with 9.4% of those without current depression. For current anxiety, 26.2% had medical debt, compared with 9.6% without.
- Adults with medical debt were more likely to delay or forgo mental health care, with 29.0% of those with lifetime depression delaying care and 29.4% forgoing care, compared with 11.6% and 10.6% without medical debt.
IN PRACTICE:
"The prevalence of medical debt in the US is already quite high, and the prevalence was significantly higher among adults with depression and anxiety," lead author Kyle Moon, Johns Hopkins University Bloomberg School of Public Health, Baltimore, said in a press release. "On the flip side, a relatively high number of adults with no medical debt also report delaying or forgoing mental health care, and medical debt appears to compound the problem."
SOURCE:
Kyle Moon, of Johns Hopkins University Bloomberg School of Public Health, led the study, which was published online on July 18 in JAMA Psychiatry.
LIMITATIONS:
First, the NHIS is a cross-sectional survey, and investigators could not assess the temporal link between mental disorders and medical debt. In addition, they could not differentiate between those who had depression or anxiety before incurring medical debt and those whose medical debt may have precipitated or exacerbated anxiety and mood disorders.
DISCLOSURES:
The study was supported by an internal training grant from the Johns Hopkins Bloomberg School of Public Health's Health Equity Scholars program. Disclosures are noted in the original article.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
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