Financial barriers due to medical debt may be linked to delayed care, with dental services being the most frequently postponed, according to a study recently published in the Journal of General Internal Medicine.
Therefore, policies that improve the affordability of care and address challenges related to medical debt may support better oral health outcomes, the study’s authors wrote.
“Dental care was most often deferred among those with medical debt,” wrote the authors, led by Kyle J. Moon of the Johns Hopkins Bloomberg School of Public Health (J Gen Intern Med, March 10, 2026).
The cross-sectional study analyzed data from the U.S. National Health Interview Survey (NHIS), a nationally representative sample of the U.S. civilian, noninstitutionalized adult population. In 2023, 28,699 adults participated in the survey. The main exposure examined was medical debt, which was measured through a self-reported indicator of medical financial hardship, the team wrote.
The outcomes of interest were deferred medical, mental health, and dental care, defined using composite variables based on whether participants reported delaying or forgoing needed care in the past year because of cost. Using sampling weights to produce nationally representative estimates, the study calculated the prevalence of medical debt and deferred care and compared rates of delayed and forgone care by medical debt status.
In unadjusted analyses, about one-third of U.S. adults with medical debt reported delaying medical care because of the cost (33.3% [95% confidence interval [CI], 31.2 to 35.3]) compared with 5.3% (CI, 5 to 5.7) of those without medical debt. Deferred mental health care was also more common among adults with medical debt (20.3% [CI, 18.4 to 22.2]) than those without debt (5.1% [CI, 4.8 to 5.5]). More than half of adults with medical debt reported delaying dental care (53.2% [CI, 51.1 to 55.2]) compared with 17.3% (CI: 16.7 to 18) of those without medical debt, they wrote.
After adjusting for sociodemographic factors, medical debt was associated with a 24.6 percentage point increase in the probability of deferred dental care (95% CI, 22.4 to 26.8), a 17.6 percentage point increase in deferred medical care (CI, 15.9 to 19.4), and a 9.3 percentage point increase in deferred mental health care (CI, 7.9 to 10.7). Overall, about 1 in 7 U.S. adults reported medical financial hardship, and across all insurance types, medical debt was consistently linked to higher rates of delayed care, with dental care most frequently deferred.
The study had limitations. The researchers could not determine whether medical debt occurred before delayed care, limiting the ability to establish causality, the authors added.
“Policy interventions that aim to address financial barriers to care and the accompanying burden of medical debt may mitigate the health and economic consequences of delayed and forgone care,” Moon and colleagues concluded.
