Medical Debt and Hunger-Coping Economic Tradeoffs Among Charitable Food Assistance Clients
4 affiliations
- 1Department of Epidemiology, Center for Healthy Communities, The University of Texas Health Science Center at Houston, 1200 Pressler St., Houston, TX 77030, USA
- 2Cizik School of Nursing, The University of Texas Health Science Center at Houston, 6901 Bertner Ave., Suite 591, Houston, TX 77030, USA
- 3School of Social Work, Andrew Young School of Policy Studies, Georgia State University, 55 Park Place NE, Atlanta, GA 30303, USA
- 4Hankamer School of Business, Baylor University, 1621 S. 3rd St., Waco, TX 76706, USA
Abstract
Objective: Medical debt is a long-term hardship, typically unplanned, and difficult to resolve. Hunger-coping economic tradeoffs (e.g., choosing between food or another basic need) are smaller financial constraints related to implementing short-term strategies to resolve cash shortages. This study examined associations between long-term financial constraint (medical debt) and engagement in short-term financial strategies (hunger-coping economic tradeoffs) among charitable food assistance (CFA) recipients. Methods: Survey data were collected in 10 Houston-area and 10 Atlanta-area food pantries in 2022. Hunger-coping economic tradeoff experiences were based on affirmative responses to whether anyone in the household ever had to choose between food and five basic needs. Covariate-adjusted logistic regression models were used to assess the relationship between medical debt (defined as unpaid medical bills) and each hunger-coping tradeoff. Results: Among 999 participants (mean age, 55 years), 41% reported medical debt. Participants with medical debt had greater odds of having to choose between paying for food or (1) childcare (AOR = 1.92, 95% CI 1.37–2.69, p < 0.001), (2) utilities (AOR = 2.05, 95% CI 1.59–2.64, p < 0.001), (3) rent/mortgage (AOR = 2.34, 95% CI 1.75–3.14, p < 0.001), (4) transportation/gas (AOR = 2.81, 95% CI 2.05–3.85, p < 0.001), and (5) education (AOR = 2.18, 95% CI 1.42–3.34, p < 0.001). Conclusions: Long-term hardship (i.e., medical debt) was associated with CFA recipients reporting engaging in short-term financial strategies (i.e., hunger-coping economic tradeoffs) to make ends meet. These findings highlight the need to screen CFA recipients for medical debt, economic hardship, and financial management skills, with food pantries serving as key referral points.
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BibTeX
@article{almohamad2026medical,
title = {{Medical Debt and Hunger-Coping Economic Tradeoffs Among Charitable Food Assistance Clients}},
author = {Maha Almohamad and Crystal Cartwright and Fred P. Brooks and Craig Gundersen and Daphne C. Hernandez},
journal = {Nutrients},
year = {2026},
month = oct,
doi = {10.3390/nu18213475},
url = {https://www.mdpi.com/2072-6643/18/21/3475},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Medical Debt and Hunger-Coping Economic Tradeoffs Among Charitable Food Assistance Clients
AU - Maha Almohamad
AU - Crystal Cartwright
AU - Fred P. Brooks
AU - Craig Gundersen
AU - Daphne C. Hernandez
PY - 2026
DA - 2026/10/22
JO - Nutrients
DO - 10.3390/nu18213475
UR - https://www.mdpi.com/2072-6643/18/21/3475
AB - Objective: Medical debt is a long-term hardship, typically unplanned, and difficult to resolve. Hunger-coping economic tradeoffs (e.g., choosing between food or another basic need) are smaller financial constraints related to implementing short-term strategies to resolve cash shortages. This study examined associations between long-term financial constraint (medical debt) and engagement in short-term financial strategies (hunger-coping economic tradeoffs) among charitable food assistance (CFA) recipients. Methods: Survey data were collected in 10 Houston-area and 10 Atlanta-area food pantries in 2022. Hunger-coping economic tradeoff experiences were based on affirmative responses to whether anyone in the household ever had to choose between food and five basic needs. Covariate-adjusted logistic regression models were used to assess the relationship between medical debt (defined as unpaid medical bills) and each hunger-coping tradeoff. Results: Among 999 participants (mean age, 55 years), 41% reported medical debt. Participants with medical debt had greater odds of having to choose between paying for food or (1) childcare (AOR = 1.92, 95% CI 1.37–2.69, p < 0.001), (2) utilities (AOR = 2.05, 95% CI 1.59–2.64, p < 0.001), (3) rent/mortgage (AOR = 2.34, 95% CI 1.75–3.14, p < 0.001), (4) transportation/gas (AOR = 2.81, 95% CI 2.05–3.85, p < 0.001), and (5) education (AOR = 2.18, 95% CI 1.42–3.34, p < 0.001). Conclusions: Long-term hardship (i.e., medical debt) was associated with CFA recipients reporting engaging in short-term financial strategies (i.e., hunger-coping economic tradeoffs) to make ends meet. These findings highlight the need to screen CFA recipients for medical debt, economic hardship, and financial management skills, with food pantries serving as key referral points.
SN - 2072-6643
ER -