Sick To Debt: Hospital Medical Debt-Issues, Challenges, Solutions

Just Economy Conference – May 5, 2021


Nationally, healthcare access and cost are growing concerns for many Americans. In 2019, 28.9 million people were uninsured, an increase of more than one million from 2018. Moreover, an October 2020 report estimated that at least 7.7 million workers lost jobs with employer-based insurance, meaning that approximately 14.6 million individuals lost health insurance amidst the global pandemic. Nearly 1 in 6 Americans was contacted by a debt collector in the past year over a health care bill.

Medical debt disproportionately affects patients from low-income households and communities of color. However, 36.2% of African Americans had medical debts compared with 22.9% of Whites and a higher total number of debts overall (2.17 vs 1.92). They were also more likely than Whites to be adjudicated for the same debt.

This session will examine medical debt and the disparate impact of this debt on White and Black communities, as well as policies, programs and campaigns at the national and state level to improve the health and wealth of low-income and working families.

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Redlining and Neighborhood Health

Before the pandemic devastated minority communities, banks and government officials starved them of capital.

Lower-income and minority neighborhoods that were intentionally cut off from lending and investment decades ago today suffer not only from reduced wealth and greater poverty, but from lower life expectancy and higher prevalence of chronic diseases that are risk factors for poor outcomes from COVID-19, a new study shows.

The new study, from the National Community Reinvestment Coalition (NCRC) with researchers from the University of Wisconsin–Milwaukee Joseph J. Zilber School of Public Health and the University of Richmond’s Digital Scholarship Lab, compared 1930’s maps of government-sanctioned lending discrimination zones with current census and public health data.

Table of Content

  • Executive Summary
  • Introduction
  • Redlining, the HOLC Maps and Segregation
  • Segregation, Public Health and COVID-19
  • Methods
  • Results
  • Discussion
  • Conclusion and Policy Recommendations
  • Citations
  • Appendix

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