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Increasingly, data shows that financial health and mental health are deeply intertwined. While much research has focused on the impact of income on mental health and wellbeing, a led by Catherine Ettman, PhD, Assistant Professor in the Department of Health Policy and Management at the Bloomberg School, shows credit scores are also an important factor. People living in ZIP codes with lower average credit scores are significantly more likely to report frequent symptoms of depression and anxiety, even after adjusting for income and demographic factors. The findings, published in the online American Journal of Epidemiology, suggest that area credit scores—long used by lenders to evaluate financial risk—may also be a proxy for mental health risks.

“Credit scores capture something deeper about neighborhood context—including access to capital, historical investment, and community resources,” says Ettman. “When we talk about the relationship between economic inequity and health, we often stop at income, but this work suggests that area-level credit scores are also an important indicator.”

Researchers analyzed survey responses from more than 500,000 responses across 1,438 ZIP codes in Pennsylvania, collected between September 2020 and June 2022 during the COVID-19 pandemic. Adults living in ZIP codes with average credit scores between 700 and 725 were 31% more likely to report frequent feelings of depression and 22% more likely to report anxiety symptoms than those living in areas with the highest credit scores (850+).

Beyond Income: What Credit Scores Reveal About Health 

Credit scores are shaped by financial behavior, such as paying bills on time, access to lines of credit, and loan history, but they also reflect structural and historical factors, including patterns of disinvestment, segregation, and discriminatory lending practices. Higher credit scores often indicate more well-resourced communities, while lower scores may signify neighborhoods with historic economic disadvantages.

The study found that the relationship between area credit scores and mental health persisted even after adjusting for median household income at the ZIP code level. This suggests that credit scores capture unique dimensions of neighborhood economic conditions—such as the ability to borrow money for home repairs, business ventures, or education—that income alone may miss.

“Addressing neighborhood credit scores may be more amenable to policy intervention than other wealth-based assets,” said Ettman. “Programs that provide financial literacy education and cap predatory fees could have both financial and mental health benefits.”

Mental Health Disparities Across the Map 

Using data from the COVID-19 Trends and Impact Survey (CTIS), conducted in partnership with Facebook, researchers measured mental health based on respondents’ self-reported experiences of frequent depression and anxiety over the previous five days. ZIP code credit scores were derived from pre-pandemic (2017) Equifax VantageScore data.

The analysis showed a clear pattern: as average neighborhood credit scores declined, rates of depression and anxiety symptoms were higher. For example, adults in neighborhoods with scores between 700–725 had a predicted depression rate of 13.7%, compared to 10.9% in ZIP codes with scores of 850 or higher. The corresponding anxiety rates were 17.4% and 14.9%, respectively.

Although differences in the strength of association were observed across age, race, gender, and educational groups, those differences were not statistically significant. This indicates that area-level credit scores may affect the mental health of residents across demographic lines, although future research is needed to explore possible subgroup-specific effects.

The strongest associations were seen among adults aged 45–54, non-Hispanic white respondents, and those with college degrees, though again, the differences were not statistically distinct. Notably, Black and Hispanic respondents in low credit score ZIP codes reported lower prevalence of depression symptoms overall, consistent with the well-documented “Black-White depression paradox," though underreporting or unmeasured protective factors such as social support could play a role.

Broader Implications for Public Health 

The study is one of the first to examine area-level credit scores in relation to mental health. Previous research has linked individual or community credit ratings with physical health outcomes such as chronic disease and self-rated health. Still, few have investigated credit scores as a predictor of mental health. 

The authors suggest that policymakers and public health practitioners could incorporate area-level credit score data into community health assessments or as part of broader strategies to improve mental well-being. Credit score improvement initiatives could complement traditional approaches like increasing access to care or expanding insurance coverage.

Looking Ahead 

The research team plans to expand the study nationally to determine whether the findings in Pennsylvania hold true across other states and regions. They also hope to explore how neighborhood credit scores interact with other social and environmental factors. 

“Area-level credit scores represent more than financial data—they’re a window into how structural inequality shapes our health,” said Ettman. “By paying attention to this indicator, we may find new ways to build healthier, more equitable communities.”

Funding for this research was provided by Meta and the National Institute of Mental Health (R01MH115487).