How the Stress of Carrying Student Debt Can Impact Heart Health Later On

Having student debt may increase your risk of heart issues in middle-age, a new study shows.

Published in the American Journal of Preventive Medicine, the study analyzed the link between adults who failed to pay down student debt—or took on new educational debt between young adulthood and early mid-life—and an elevated risk of cardiovascular disease.

Study results showed that those with student loan debt had higher heart disease risk scores and C-reactive protein risks, which is a substance made in your liver and released into the bloodstream in response to inflammation in your body.

Even when researchers adjusted for socioeconomic factors and other sources of debt outside of student loans, the heart health disparity between households with student debt and those without such debt persisted.

"As the cost of college has increased, students and their families have taken on more debt to get to and stay in college. Consequently, student debt is a massive financial burden to so many in the United States, and yet we know little about the potential long-term health consequences of this debt," lead investigator Adam Lippert, PhD, an assistant sociology professor at the University of Colorado Denver, said in a published statement.

Here's a closer look at the study and its ramifications in a country where 43 million Americans carry student debt.

Study Background and Findings

Previous research surrounding student loan debt and its health ramifications had found that, in the short term, there was an association between the financial burden of higher education and self-reported health and mental health challenges. For this new study, researchers were interested in understanding whether such debt was also associated with cardiovascular illness among adults in early mid-life.

To help answer that question, researchers used data from the National Longitudinal Study of Adolescent to Adult Health, which included 20,745 participants. Study participants were first followed from grades 7 to 12, then again between the ages of 22 and 44. As part of the study, researchers assessed biological measures of cardiovascular health and C-reactive protein levels for qualified participants.

The study findings showed that participants who consistently had debt or took on debt had higher cardiovascular disease risk scores than those who had never been in debt or had paid off their debt. Researchers also found clinically significant C-reactive protein levels among study participants who took on new debt or were consistently in debt between young adulthood and early mid-life. It's also important to note that the study indicated that race and ethnicity had no impact on outcomes.

The researchers' findings underscore the potential population health implications associated with the United States' transition to debt-financed education, said Dr. Lippert.

"Our study respondents came of age and went to college at a time when student debt was rapidly rising with an average debt of around $25,000 for four-year college graduates. It's risen more since then, leaving young cohorts with more student debt than any before them," Lippert said in a published statement. "Unless something is done to reduce the costs of going to college and forgive outstanding debts, the health consequences of climbing student loan debt are likely to grow."

America's Student Debt Crisis

America's student debt crisis is hardly a secret. More than half of students leave school with debt, according to a report from Forbes. What's more, the cost of going to college has skyrocketed over the past three decades or more in this country. As Forbes reported, during that time, tuition costs at public four-year colleges increased from $4,160 to $10,740. Meanwhile, at private non-profit schools, the cost has soared from $19,360 to $38,070, adjusting the prices for inflation.

"Student loan debt is a vicious cycle," John Kassotis, MD, professor of medicine and fellowship director in the Division of Cardiovascular Diseases and Hypertension at Rutgers Robert Wood Johnson Medical School, told Health. "If you have a lot of loans, you're scraping by and that can affect other factors that can impact your heart health."

There are likely a few different reasons why student debt may cause heart health issues, Dr. Kassotis said. "When you're scraping by, one of the first things to go is healthy food choices," Dr. Kassotis said. "Usually, people will go on a less-expensive carbohydrate-rich diet."

That type of diet, of course, is not ideal, said Dr. Kassotis.

The study also noted that people seem to have the poorest health with student debt after they leave college and are required to start paying back their loans. "You superimpose the stress of trying to find a job and get established in a profession, along with the stress of needing to pay back loans," Dr. Kassotis said. "You're looking at the perfect storm [for heart health]."

The good news when it comes to student debt in America is that the Biden administration has been openly contemplating student loan forgiveness, a move that may very well help ease the health issues highlighted in the study.

Ragavendra Baliga, MD, a cardiologist and professor of internal medicine at The Ohio State University Wexner Medical Center, said the move to wipe out at least a portion of student debt could have significant implications for health.

"Debt forgiveness by the federal government should go a long way, particularly in low socio-economic families," Dr. Baliga said.

Health Ramifications of Debt: Who's Most Impacted?

The study findings indicate that people from lower socio-economic backgrounds are disproportionately impacted by the negative health consequences of having student debt. The study also raises fundamental questions about what had been the long understood benefits of a post-secondary education.

"These findings provide a benchmark for widening health inequalities among a cohort bearing more student debt than any other in U.S. history," the study points out in its conclusion. "As student debt accumulates, within-cohort disparities in cardiovascular disease and related morbidities may undermine the health benefits of postsecondary education."

In other words, the benefits of continuing education may be outweighed by the health ramifications associated with the growing debt burden of higher education. For low-income populations, the ramifications may be even more significant.

"Those of lower socio-economic backgrounds often find debt more difficult to repay," Rigved Tadwalkar, MD, a board-certified cardiologist at Providence Saint John's Health Center in Santa Monica, California, told Health. "It's more likely that they would be consistently unlikely to repay the loans or to take on more debt."

And while the current study only focused on student debt, experts said it's likely that the findings have broader implications. A separate study, from 2013, seems to suggest that all debt is bad for your health. That study focused on 8,400 young-adult participants from the National Longitudinal Study of Adolescent Health, and found that higher levels of debt are linked with greater levels of stress and depression. People with significant debt also reported being in worse health and having higher blood pressure than those with lower levels of debt or no debt at all.

"Because we live in a consumption-related society, the burdens of debt are far-reaching," Dr. Tadwalkar said.

How Can You Minimize the Impact of Debt on Heart Health

For those who have debt and are worried about the health implications, it's important to focus on the things you can control, said Dr. Tadwalkar.

"Having a sound financial plan in place for repayment of debt should technically ease the burden because there's less day-to-day stress involved," Dr. Tadwalkar said. "But good heart health habits can help as well—and most individuals can pursue those in some form without the need of excessive wealth or time."

Some of the heart health habits that you can control, per the American Heart Association (AHA), include:

• Avoiding smoking
• Eating a diet rich in fruits, vegetables, and whole grains
• Getting at least 150 minutes of moderate aerobic activity a week, plus strength training twice a week
• Maintaining a healthy weight
• Managing blood pressure
• Controlling cholesterol
• Reducing blood sugar levels

"The psychological and physical stresses of debt aren't well appreciated—but they should be," said Dr. Tadwalkar.