BAM’s Key Details: 

  • A comprehensive study by Upgraded Points reveals how U.S. debt has changed over the past ten years and how different types of debt are influenced by region. 
  • Mortgage debt per capita has increased 14% nationwide, with state-wide increases up to 63% in West and Midwest markets
  • Student debt per capita increased 56% and now sits at over $5,600

A comprehensive study by Upgraded Points shows how U.S. debt has changed over the past ten years—and how different types of debt are influenced by different regions. 

From mortgages and medical bills to student loans and credit card debt, the study highlights 10 years of trends for states seeing the most debt paid off—versus those still struggling in the red. 

Here, we’ll focus on how the findings in this study could impact homebuying decisions in the coming year. 

Methodology behind the debt study

To get a comprehensive picture of Americans’ debt positions—nationwide and state-by-state— Upgraded Points collected data for an entire decade (2011 to 2021) on major sources of debt: 

  • Housing mortgages
  • Student loans
  • Medical bills
  • Car loans
  • Credit cards

Data was compiled from various sources, including the U.S. Census, The U.S. Department of Justice, OECD, the Federal Reserve Bank of New York, Urban Institute, Trading Economics, Education Data, and others. Their results yielded a series of downloadable data summaries, all organized by state. You can read the full debt summary here

Housing debt—national and by state

Total household debt has increased by 16% over the past ten years. And with housing prices on the rise, thanks to high mortgage rates and persistently high home prices, many Americans are putting home ownership on hold

Median mortgage debt per capita has risen 14% from 2011 to 2021. Among states, North Dakota has seen the biggest increase in mortgage debt (63%), while D.C. has the highest mortgage debt at $75,280 per homeowner. 

Over the past decade, the West and Midwest have seen the biggest increases in mortgage debt. Seven states have seen increases of more than 30%. North Dakota sits at the top of that list, with mortgage debt rising 63% from $18,030 to $31,050. 

Five states are in the top ten for both median home value and per capita mortgage debt: 


National student loan debt

Since 2011, while college enrollment has remained consistent, total student debt has grown by over 80%. And the average cost of annual tuition and fees for a four-year college in the U.S. has risen 11% nationally, reaching $9,375. 

Nationwide, student debt per capita increased 56% in the same period and now sits at over $5,600. Sixteen percent of Americans owe the government money for their college educations, whether or not their degrees made a substantial difference in their incomes. 

Meanwhile, President Biden’s student debt relief has hit a roadblock in the courts and may ultimately be shut down as “illegal.” 

Student loan debt at the state level

Since 2011, student loan debt has increased by more than 50% for 27 states. Nevada, where student debt nearly doubled (+94%) takes the number one spot, followed by North Carolina and Georgia. 

When it comes to the student debt-to-income ratio, Mississippi takes first place (43%). Southern states in general have higher ratios of student debt to income, which makes it all the more difficult to pay off. 

Pennsylvania has the highest share of residents burdened with student loan debt (19%).  Maryland residents have the largest debts to pay off, with a median amount of $23,966. 

Medical debt

Medical bills are another cause of financial stress for many Americans, with the average median medical debt in collections at $678.72. 

Wyoming has the highest amount ($1,515), likely due to a combination of its economic health, market conditions, and an aging population. Hawaii has the lowest at $339. 

Southern states tend to have a higher percentage of residents with medical debt, as well as a higher medical debt-to-income ratio. 

Four states have more than 20% of residents with medical debt in collections. West Virginia has the highest share at 24%. The other three are Oklahoma and North and South Carolina.  

In 10 states, at least 1 in 10 residents are without insurance. The top five on the list—

  1. Texas
  2. Oklahoma
  3. Georgia
  4. Florida
  5. Mississippi

The average state-wide share of residents without health insurance is at 8.5%. The average share of medical debt in collections is 12.3% 

Generally speaking, states with higher percentages of uninsured residents also tend to rank higher for outstanding medical debt. Massachusetts, with only 3% of its residents uninsured, is a prime example, ranking third for the least medical debt in collections. 

In Texas, which ranks fifth for the most medical debt in collections, 18% are without insurance. 

Some states, on the other hand, show an inverse relationship between the percentage of uninsured residents and the percentage with medical debt—

  • Alaska—with a high uninsured population and a low percentage of medical debt
  • West Virginia—with a low uninsured population and a high percentage of medical debt

Top takeaways for real estate agents

Clients looking for more affordable places to live will probably want to avoid states where mortgage debt has increased the most, as well as states with a higher than average debt-to-income ratio. 

And states where the cost of a four-year college has increased the most may be less attractive to prospective buyers with children, as well as those planning to have them. 

Know what the market is doing on both national and local levels. And get familiar with the questions your clients will need answers to, so you can become their number one guide and resource—someone they’ll be quick to recommend to their friends and family. 

Debt isn’t just about people spending too much on things they don’t need. Knowing your area’s debt profile can motivate you to steer your clients toward resources that improve their financial well-being now and in the years to come.