Debt Takes Toll on Health, Study Finds
Elizabeth Sweet, PhD, is a biocultural anthropologist researching economic and racial disparities in health and an alumna of the Robert Wood Johnson Foundation (RWJF) Health & Society Scholars program (2008-2010). She was the lead author of a recent study exploring the impact of financial debt on health.
Human Capital Blog: You have published more than one study that looks at the impact of debt on health. What led to your interest in this topic?
Elizabeth Sweet: My interest is driven by both intellectual and personal reasons. As someone who studies the impact of social inequalities on health, I am interested in personal debt as a dimension of socioeconomic status, a site of racial and economic disparity, and a reflection of broader social, cultural, and political-economic forces. Also, as someone who completed education with a fair amount of debt, I am personally familiar with the profound stress that debt can cause.
HCB: College tuition is rising and more people are defaulting on student loan debt. How does student loan debt affect young people’s mental and physical health?
Sweet: This is such an important question. Our study suggests that financial debt indeed impacts the health and well-being of young people—leading to higher stress and depressive symptoms, worse general health, and higher blood pressure. The specific impact of student loan debt, vs. other kinds of debt, is an open question though; the Add Health data that we used did not have that level of detail regarding the types of debt that respondents had.
HCB: This study received a lot of media coverage. Why do you think that is?
Sweet: Personal financial debt has skyrocketed in this country in recent years. Nearly everyone now has debt and, as a result, there is a lot of interest in what that means and what the implications are for people’s lives, including their health and well-being. I also think that as a society we are currently grappling with important policy questions about how and to what extent we regulate the lending and credit industry; the potential health impact of debt has implications for that very public conversation.
HCB: You have said that student loan debt has long-term implications for physical health. How so?
Sweet: There is now fairly strong and consistent evidence that debt is associated with stress, and chronic stress is an important risk factor for cardiovascular and other diseases. Findings from our recent study also suggest that debt is associated with higher blood pressure in a young adult sample. Blood pressure is another important cardiovascular risk factor.
HCB: What are the implications of this study for higher education?
Sweet: I think realizing that debt can impact both mental and physical health for young people adds weight and urgency to the need to solve the student loan problem, likely through a combination of making higher education more affordable and relieving some of the debt burden that young people are struggling with.
HCB: You’re embarking on a new research project on this subject. What will the focus be?
Sweet: I am collaborating with another former RWJF Health & Society Scholars program alumnus, Arijit Nandi, PhD, (2008-2010) and other colleagues at Northwestern University on an R01 research grant from the National Institute on Minority Health and Health Disparities that will examine the impact of debt on health in greater detail. Specifically, we are using national, longitudinal data from the Panel Study of Income Dynamics (PSID) to explore the association of debt with health over time as well as the role of debt in racial and socioeconomic health disparities. We are also conducting a mixed-methods community-based study that will explore how different kinds of debt may differentially impact mental health and biomarkers of cardiovascular and metabolic risk. For instance, is the impact of high-interest payday loans on blood pressure different than that of a home mortgage?
HCB: How does this study relate to your previous research into health disparities?
Sweet: My previous work on symbolic capital suggested that consumption-based status markers are an important part of the relative deprivation pathway of health inequality, but particularly when they are inconsistent with other socioeconomic resources. In other words, I have found that individuals who consume high-status goods but have lower incomes suffer higher blood pressure and worse health.
This previous work did not directly tie those findings to debt, but the study did raise questions for me about the potential role that debt could play in the stress of competitive consumption (keeping up with the Joneses). Furthermore, my previous work has dealt with issues of racial disparities, and financial debt is an area where racial inequalities and discriminatory practices are overt: Racial and ethnic minorities are more likely to be denied loans and offered unfavorable loan terms (higher interest rates, etc.) compared to non-minorities, and predatory lenders are overrepresented in lower income and minority neighborhoods. So I think financial debt is an important issue to examine within the context of racial health disparities.
HCB: Did the RWJF Health & Society Scholars (HSS) program prepare you to work in this area and, if so, how?
Sweet: Without a doubt. The interdisciplinary environment of HSS, and the social epidemiological training and mentorship I received from HSS faculty at Harvard, were instrumental in helping me think more broadly and creatively about the health disparities topics that I study and providing me with the proper tools to ask and answer these research questions. The other scholars have also been extremely important to me and my work. Ari Nandi and I are collaborating on all of this research, and it is truly a joint, interdisciplinary effort.