Student loan debt is a public health concern

Student loan debt isn’t just an economic issue, it’s a public health issue. Even as a new Gallup poll shows nearly half of Americans consider COVID-19 to be over, the stress of student debt, though eased temporarily by a moratorium on loan payments, is not.

Unfortunately, student loans are often only seen as an economic problem, not a public health problem. Student loan debt in the United States has reached a crisis moment: 48 million borrowers collectively owe $1.6 trillion in federal student loan debt. Including private student loans, the debt increases to $1.7 trillion.

Student loan debt is second only to mortgage debt. The average debt owed is almost $38,000, which is double the average auto loan debt and four times the average credit card debt.

Student loan debt, however, is not treated like other forms of debt. Interest is calculated and can compound differently, resulting in an increase, rather than decrease, in the principal balance and interest. This “negative amortization,” or balance growth over time, happens even as borrowers make regular payments and can disproportionately affect borrowers of color.

The reality is that those hardest hit with debt are those who never finished their degree and struggle to pay or default on their student loans. In worst-case scenarios of financial hardship, people can discharge other consumer debt through bankruptcy. But discharging student loan debt is still significantly more difficult, something President Joe Biden sought to change with his debt relief plan. Meanwhile, borrowers are left with debt that is virtually inescapable.

All of this adds up to a burden that isn’t just financial. It’s a health burden too, one that should be acknowledged this month, which is National Stress Awareness Month.

Higher health risk factors

Financial debt is one of the most stressful things families have had to deal with this year, due to economic uncertainty and inflation. Having higher debt is known to affect mental and physical health, with higher perceived stress and depression, worse self-reported general health, and higher diastolic blood pressure. High blood pressure can affect most organs, and is known to lead to heart attack and stroke.

A 2022 report shows that those carrying student debt into their 30s and 40s showed more biological risk factors like higher risk of inflammation, high blood pressure, diabetes, smoking and excess weight.

The burden of student loan debt can impact mental health, and it’s been reported that 1 in 14 high-debt student loan borrowers reported thoughts of suicide. One survey of student borrowers noted, among other findings, that 84% had delayed a major life event, 54% experienced mental health issues, 32% reported depression and 32% delayed starting a family due to student debt.

One analysis of data from a national, long-term study of young people found that student loans were associated with poorer psychological functioning while in school and in early adulthood.

Since student loan debt is more burdensome on borrowers of color, any debt forgiveness plans should be seen not only as economic equity, but public health equity for Black and Hispanic borrowers.

Alleviate the crisis

I would never have been able to pursue college and medical school without incurring student loan debt. But even with years of on-time payments, there’s a massive balance that does not seem to budge, and it has influenced basic life decisions such as “Can I afford to buy a home?” or “When can we start a family?” with my partner.

Taking on student loan debt is the only path to college and career for many young people. Our nation makes it easy for teenagers to take out massive debt, with the promise of a brighter future.

Policy makers and administrators need to show full support for any form of debt forgiveness including Biden’s plan, which the U.S. Supreme Court will rule on this year. Support for debt forgiveness is especially critical after the massive economic, social, and health issues caused by the pandemic.

If elected officials truly believe debt collection falls within their power of the purse, then these same lawmakers should act — with legislation on student debt forgiveness.

Doing so will alleviate another public health crisis.

Alejandro Vargas, MD, is an assistant professor of neurology and a vascular neurologist at Rush University Medical Center. He is the medical director of the Mobile Telestroke Program at Rush University Medical Center and of the Primary Stroke Center at Rush Oak Park Hospital. He is a Public Voices Fellow of The OpEd Project. Follow him at @alexvargasmd

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