Consumer credit, chronic disease and risk behaviours

Lorraine T. Dean, Emily A. Knapp, Sevly Snguon, Yusuf Ransome, Dima M. Qato, Kala Visvanathan

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish (US)
Pages (from-to)73-78
Number of pages6
JournalJournal of epidemiology and community health
Issue number1
StatePublished - Jan 1 2019


  • United States
  • chronic disease
  • consumer credit
  • diabetes
  • hypertension
  • obesity

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health


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