Nationwide the data shows that 33 percent of Americans hold debt that is currently in collection. The median amount of debt in collections is $1,450.
But those figures show striking regional variation. In Louisiana, 46 percent of adults have debt in collection, the highest share in the nation. Rates of past-due debt are generally highest in southern and western states, and lowest in the upper Midwest. In Minnesota, for instance, only 17 percent of adults have debt in collections, the lowest rate in the nation.
At the county level, 68 percent of the residents of tiny Allendale County, S.C., (pop. 9,433) have debt currently in collections, the highest county rate in the nation. Cook County Minnesota can boast the nation's lowest prevalence of past-due debt, at just 6 percent.
Previous research by the Urban Institute has identified health insurance coverage as a chief driver of indebtedness: People who have health insurance tend to be less likely to fall behind on their bills.
At the neighborhood level, this relationship shows up vividly in these side-by-side maps of debt in collections (L) and insurance coverage (R) in Minnesota.
Urban's researchers looked at this relationship nationwide and found that “a 1 percentage-point increase in the share of population without health insurance is associated with a 0.16 percentage-point increase in the likelihood of having debt in collections and a 1.3 percent increase (equal to $20) in the average amount of debt in collections.”
Nationwide, nearly 1 in 5 households has medical debt in collections with a median amount of $681. But again, that particular number varies broadly: The prevalence of past-due medical debt is 10 times higher in Louisiana (30 percent) than it is Minnesota (3 percent).
In many counties in Texas and Louisiana, over 60 percent of the population carries past-due medical debt.
Share with medical debt in collections
Urban's numbers show that those sky-high health-care costs are saddling many Americans — nearly 20 percent of them — with debt they cannot pay.