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J Epidemiol Community Health. 2019 Jan;73(1):73-78. doi: 10.1136/jech-2018-211160. Epub 2018 Oct 15.

Consumer credit, chronic disease and risk behaviours.

Author information

1
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA.
2
Department of Oncology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
3
Department of Social and Behavioral Sciences, Yale University School of Public Health, New Haven, Connecticut, USA.
4
Department of Pharmacy Systems, Outcomes and Policy, University of Illinois College of Pharmacy, Chicago, Illinois, USA.

Abstract

BACKGROUND:

Credit scores have been identified as a marker of disease burden. This study investigated credit scores' association with chronic diseases and health behaviours that are associated with chronic diseases.

METHODS:

This cross-sectional analysis included data on 2083 residents of Philadelphia, Pennsylvania, USA in 2015. Nine-digit ZIP code level FICO credit scores were appended to individual self-reported chronic diseases (obesity, diabetes, hypertension) and related health behaviours (smoking, exercise, and salt intake and medication adherence among those with hypertension). Models adjusted for individual-level and area-level demographics and retail pharmacy accessibility.

RESULTS:

Median ZIP code credit score was 665 (SD=58). In adjusted models, each 50-point increase in ZIP code credit score was significantly associated with: 8% lower chronic disease risk; 6% lower overweight/obesity risk, 19% lower diabetes risk; 9% lower hypertension risk and 14% lower smoking risk. Other health behaviours were not significantly associated. Compared with high prime credit, subprime credit score was significantly associated with a 15%-70% increased risk of chronic disease, following a dose-response pattern with a prime rating.

CONCLUSION:

Lower area level credit scores may be associated with greater chronic disease prevalence but not necessarily with related health behaviours. Area-level consumer credit may make a novel contribution to identifying chronic disease patterns.

KEYWORDS:

United States; chronic disease; consumer credit; diabetes; hypertension; obesity

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