Consumer credit, chronic disease and risk behaviours

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

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.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Chronic Disease / epidemiology*
  • Cross-Sectional Studies
  • Female
  • Financial Management*
  • Humans
  • Male
  • Philadelphia / epidemiology
  • Risk-Taking*