Debt in Collections by US County

The highest rates of debt in collections concentrate in South Texas border counties, the Mississippi Delta, and parts of Appalachia. Many of these counties also have some of the lowest median incomes in the United States. Debt collection rates above 40% mean that nearly half of all adults in the county have at least one account that has progressed past delinquency to active collections.

The Urban Institute Debt in America dataset captures four distinct types of debt stress. Each reveals a different dimension of financial fragility — from the breadth of overall collections debt to the specific vulnerability of healthcare financing and vehicle loans.

At the state level, South Carolina ranks worst in the country: the average county carries 36.3% of adults with debt in collections. Texas (33.8%), Georgia (33.5%), Louisiana (33.4%), and Alabama (32.2%) round out the top five. All five are Southern states where low health insurance rates, weaker wage floors, and limited access to mainstream credit compound over time into elevated collections rates.

At the other end: Minnesota counties average 12.2% — less than one-third of South Carolina's figure. North Dakota (12.7%), Nebraska (13.6%), and Utah (13.7%) also rank among the lowest-stress states. The difference between Minnesota and South Carolina is not a matter of degree; it is a structural divide in how financial distress accumulates across communities.

Nationally, 762 counties — nearly 1 in 4 — have more than 30% of adults with debt in collections. 162 counties exceed 40%. These are not marginal cases: a county where 4 in 10 adults carry collections debt represents a level of systemic financial strain that affects local commerce, credit availability, and household stability.

The relationship between household income and debt stress is steep and consistent across all four debt types. At the county level, every $10,000 rise in average household income is associated with roughly a 3–4 percentage point drop in the share of adults with debt in collections — until income reaches around $100k, where the curve flattens.

The full gradient by income quintile, across all four debt measures:

Auto and retail loan delinquency shows the steepest relative drop — from 7.4% in the lowest quintile to 3.7% in the highest, a 50% reduction. Credit card delinquency follows a similar curve (7.6% → 4.1%). Medical debt is the most income-resistant: it falls from 8.6% to 4.2%, but still affects a substantial share of adults even in the highest-income counties — reflecting that medical emergencies do not respect income levels in the same way that discretionary spending does.

At the bracket level, the steepest drop is between $60–80k: counties averaging $60k have 29.4% in collections; those averaging $80k have 20.9%. Counties above $100k household income show much slower improvement — the relationship between income and debt stress compresses significantly above that threshold.

Source: Urban Institute Debt in America (July 2024). Income figures are county-level household income averages from the same dataset. Individual household experience varies. All 3,143 US counties included.

The Urban Institute dataset reports debt rates separately for communities of colour and white communities across 696 counties. The gap is consistent and large across every debt type — and it is not explained by income differences alone.

Across all counties where paired data exists, the communities-of-colour rate exceeds the overall county rate in 83% of cases, by an average of 5.7 percentage points. The largest individual county gaps appear in Hill County, MT (+37.9pp), Erie County, PA (+34.7pp), and Knox County, TN (+33.5pp) — none in the South, confirming the racial debt gap is national, not regional.

The income gap compounds the debt gap. Across the 3,133 counties where both figures are available, the median household income for communities of colour is $67,126 against $82,983 for white households — a $15,858 difference. That income gap places PoC households closer to the high-stress end of the income-debt curve by default.

But crucially, even controlling for income, the racial gap persists. In the wealthiest quarter of counties — where average household incomes are highest — communities of colour still carry a median debt-in-collections rate of 27.8%, against just 16.0% for white communities in those same counties. That 11.8 percentage point gap in high-income counties is actually larger than the 8.7pp gap in the lowest-income counties (40.7% vs 32.0%). The racial debt gap does not shrink when the county gets wealthier — it widens. This is consistent with research showing that access to mainstream credit, banking relationships, and debt resolution options differs by race independently of income level.

Coverage note: Racial breakdown data is available for 696 of 3,143 counties. Urban Institute suppresses figures where sample sizes are insufficient to produce reliable estimates. Data reflects communities of colour as a combined group vs non-Hispanic white; it does not disaggregate by specific racial or ethnic group. Source: Urban Institute Debt in America, July 2024.

The share of adults with a bachelor's degree or higher correlates with debt stress at r = −0.497 — almost as strongly as household income (r = −0.522). Counties in the lowest education quintile, where an average of just 13% of adults hold a degree, carry a median debt-in-collections rate of 31.5%. Counties in the highest education quintile — averaging 39.7% degree holders — carry just 17.4%. The gradient is consistent across all four debt types.

The gap is especially stark in predominantly white, low-education communities. Looking at counties where the population is at least 80% white and fewer than 20% of adults hold a bachelor's degree — a reasonable proxy for non-college-educated white communities — the median debt-in-collections rate is 23.8%, with card delinquency at 5.4% and auto delinquency at 4.5%. Compare that to predominantly white counties with high educational attainment (35%+ degree holders): median debt in collections drops to 12.9%, medical debt to 2.4%, and card delinquency to 3.0%. That is an 84% higher debt burden in low-education white communities than high-education white communities — a gap nearly as large as the racial gap, and one that operates independently of it.

Educational attainment is a distinct structural predictor of debt stress — one that operates independently of race and income. County-level correlations confirm it: the relationship between degree attainment and debt-in-collections holds within both predominantly white and predominantly minority counties, and persists after controlling for median household income.

Methodology note: "Non-college white" and "college-educated white" are county-level proxies based on the share of people of colour (Urban Institute) and share of adults with a bachelor's degree or higher (US Census Bureau ACS 5-Year 2022). This is ecological analysis — it describes county-level patterns, not individual-level outcomes. Individual experiences within any county will vary. Education data: ACS table B15003. Debt data: Urban Institute Debt in America, July 2024.

South Texas border counties: Brooks County, TX leads the nation at 56.3% of adults with debt in collections — on a median household income of just $46,187. Zapata (55.7%), Zavala (55.2%), Jim Hogg (54.7%), and Duval (53.1%) counties follow. Five of the ten worst counties in the country are concentrated in this single corridor. These are homeowner-dominant communities where formal eviction is rare, meaning standard stress indices understate their distress. The debt data is unambiguous.

Medical debt — North Carolina: The highest medical debt rate in the country is in Anson County, NC, where 32.5% of adults carry medical debt in collections against a total collections rate of 49%. Four of the ten worst counties for medical debt nationally are in North Carolina, reflecting that state's history of Medicaid non-expansion and high rates of uninsured rural residents. When a medical bill goes unpaid long enough, it becomes a collections account — and those accounts persist on credit files for years.

Card delinquency — Mississippi Delta: Credit card delinquency has its own geography. Calhoun County, GA leads the nation at 23.6% delinquent, but the Mississippi Delta dominates the list: Sharkey (18.8%), Humphreys (18.1%), Tunica (17.6%), Jefferson (17.5%), and Holmes (16.1%) counties all rank in the top ten nationally. These are some of the lowest-income counties in the United States, where credit cards often substitute for absent emergency savings — and delinquency follows.

High cost, low stress — Colorado resort counties: Boulder, Clear Creek, and Pitkin counties have high absolute housing costs and top-decile rent-to-income ratios. But their debt collections rates are well below the national average. Cost burden does not automatically translate into financial failure when incomes are high enough to sustain it. The Financial Stress Index captures this distinction; raw housing cost data does not.