Type 2 Diabetes and Financial Outcomes
Authors' conclusion
This economic evaluation of patient health records linked to credit records and wage earnings shows a positive association of type 2 diabetes with adverse financial outcomes. These findings suggest that patients with type 2 diabetes may experience substantially more adverse financial outcomes compared with patients without diabetes, highlighting the need to consider patient financial health when treating type 2 diabetes, particularly for patient groups at higher risk.
Study context
- Population
- Adults aged ≥18 years with ≥1 medical encounter at a primary care medical center in Ohio, October 1, 2017 to December 31, 2021, with an HbA1c value, T2D diagnostic code or antidiabetic prescription41.7% with T2D
- Participants
- 166,285 adults
- Comparison
- T2D vs no diabetes
- Outcome
- Adjusted probability of any adverse financial outcomes, below-prime credit score, nonmedical and medical debt in collections, delinquent debt, debt charge-offs, bankruptcy filing and foreclosure
Methodological detailselectronic health records linked to credit records
- Electronic health records linked to credit records
Main finding
As reported in the abstract
Adjusted probability of any adverse financial outcomes
Further findings
Maximum nonmedical debt in collection
Maximum delinquent debt
| Outcome | Diabetes | No diabetes |
|---|---|---|
| Below-prime credit score | 59.7% (CI 59.3%–60.1%) | 45.9% (CI 45.6%–46.2%) |
| Medical collections | 36.9% (CI 36.5%–37.3%) | 23.9% (CI 23.7%–24.2%) |
| Nonmedical collections | 38.4% (CI 38.0%–38.8%) | 27.7% (CI 27.5%–28.0%) |
| Delinquent debt | 23.3% (CI 22.9%–23.7%) | 15.6% (CI 15.4%–15.8%) |
| Debt charge-offs | 15.4% (CI 15.1%–15.8%) | 10.1% (CI 9.9%–10.2%) |
| Bankruptcy filings | 2.1% (CI 2.0%–2.3%) | 1.4% (CI 1.3%–1.5%) |
| Foreclosures | 0.5% (CI 0.5%–0.6%) | 0.3% (CI 0.2%–0.4%) |
| Number of adverse financial outcomes | 1.9 | 1.2 |
| Credit scoreMean | 618.7 (SE 0.4) | 664.2 (SE 0.5) |
- Below-prime credit score: 95% CIs
- Medical collections: 95% CIs
- Nonmedical collections: 95% CIs
- Delinquent debt: 95% CIs
- Debt charge-offs: 95% CIs
- Bankruptcy filings: 95% CIs
- Foreclosures: 95% CIs
- Maximum nonmedical debt in collection: 95% CIs
- Maximum delinquent debt: 95% CIs
Patient groups at risk
- Adjusted prevalence of adverse financial outcomes higher among Black race, Medicaid enrollees, Hispanic ethnicity, age <65 years, no earned income and female sex
Original publication
Type 2 Diabetes and Financial Outcomes. JAMA Netw Open. Published 1 July 2025. doi:10.
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