Notes
Before You Read
As someone born and raised in the hills and hollers of Appalachia who later found her way into scholarship, I have learned that the studies about our people can often overlook our humanity. Debt, especially in rural areas, isn’t just a number in a report. It is a reflection of the systems we’ve inherited, the tough choices that have been made, and the resilience that keeps families going despite the burdens.
Appalachia’s culture grew from poverty and perseverance; communities have had to build traditions of foodways and mutual aid networks to help everyone get by. As you read this report, go beyond the statistics and remember that behind each percentage is a family making hard decisions with what they have and few safety nets to rely on. I encourage you to think more deeply about the region. How did we get here? What structures led to the financial burden of these people? What needs to change so all people can live more comfortable lives? These questions may not have easy answers, but hopefully they will encourage you to recognize that the people behind these numbers are worthy of respect, compassion, and real, lasting change.
Introduction by Rachel Hampton
Rural Appalachians Face Higher Debt Burdens Than Other Areas Across America
Map of Appalachian Counties. Appalachian counties are defined according to the Appalachian Regional Commission. Rural and urban status definitions are from the U.S. Department of Agriculture (USDA) Rural-Urban Commuting Area Codes. PPC stands for persistent poverty county. PPC definitions stem from the Economic Development Administration (EDA). (Source: Consumer Finances in Rural Appalachia)
Nearly 24% of rural Appalachians have a medical debt in collections, compared to just 17% nationally, according to a new report.
Moreover, rural Appalachians with medical debt collections have over double the rates of delinquency for other credit products compared to those without medical debt collections in each category, the Consumer Financial Protection Bureau (CFPB) found in a recently released study.
It’s the first report in a series of reports about rural America, said Shawn Sebastian, senior fellow at the CFPB leading the Rural Initiative.
“It's our opportunity to really focus on the challenges that are facing rural communities when it comes to consumer finances,” he said in an interview with the Daily Yonder. “So what we did was we looked across the country and persistent poverty counties…and we plan to do further reports on regions with high concentrations of persistent poverty counties, but we started with rural Appalachia.”
Persistent poverty counties (PPCs) are defined as counties that have had poverty rates of 20% or higher for the past 30 years. Consumers in PPCs often encounter higher interest rates and fewer financial offerings due to the increased credit risk in the county.
“The Appalachian region of our country faces distinct challenges from other parts of rural America,” said CFPB Director Rohit Chopra in a statement. “Rural America plays a pivotal role in our nation’s food security and national security, so we must work to ensure that the financial marketplace can help families survive and thrive.”
The report also found that 15% of rural Appalachians had a credit card delinquency, while 37% of rural Appalachians dealing with a medical debt collection also had a credit card delinquency. Eighteen percent of rural Appalachians had student loans that were delinquent, while rural Appalachians with a medical debt collection had a 37% rate of student loan delinquency.
“That medical debt that more rural Appalachians experience actually has all of these downstream effects on a lot of other areas of their finances,” Sebastian said.
He said the CFPB has talked to local government officials and a lot of civil society actors, including local banks, community development, financial institutions, and nonprofits.
“And what we're really looking to do is to start a conversation so we can understand some of the stories behind these numbers and see where the CFPB can act to help to make sure that rural Appalachians are being treated fairly and hopefully can keep more money in their pockets,” he added.
The Appalachian region spans across 13 states, and is disproportionately rural. Of the 26 million Appalachians, nearly 33% live in a rural county, compared to 14% of people nationwide. More than two million Appalachians live in Persistent Poverty Counties (PPCs).
“This report is just one expression of our Rural Initiative and people in rural Appalachia should know that the Consumer Financial Protection Bureau is here to protect consumers, particularly rural consumers and rural consumers in Appalachia and rural consumers across the country,” Sebastian said.
Rural Appalachians Face Higher Debt Burdens Than Other Areas Across America first appeared on The Daily Yonder and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.
Eaton, Kristi. “Rural Appalachians Face Higher Debt Burdens Than Other Areas Across America.” The Commons: Tools for Reading, Writing, and Rhetoric (2nd ed.), edited by Jill Parrott and Dominic Ashby, Eastern Kentucky University, 2026.