For the first time, “illness, addiction or accident” is the most common cause of private over-indebtedness in Germany in 2024, according to the latest data from the Federal Statistical Office (DESTATIS). With a share of 18.1 percent, this factor overtakes unemployment, which is at 17.4 percent. Witten/Herdecke University sees this as an alarming signal and is urgently calling for more research and preventative measures to protect those affected from the financial consequences of serious illness. The figures highlight a challenge for society as a whole that affects the healthcare system, politics and science in equal measure.

The statistics confirm the experiences of many of those affected: a serious illness not only leads to health problems, but often also to considerable financial burdens. “A serious illness affects many people twice over: healthwise and financially,” says Prof. Dr. Eva Münster, holder of the professorship for general medical care research in vulnerable population groups at the Institute of General Practice and Outpatient Healthcare at Witten/Herdecke University. “The financial burden associated with this has so far been recognized far too little – in research, in care and in politics.”

There are many reasons for financial hardship. Long periods of illness lead to loss of income, while ongoing loan payments and high co-payments for medication or rehabilitation measures drive up expenses. The spectrum of illnesses is broad and ranges from orthopaedic problems such as severe slipped discs to mental illnesses such as depression and life-threatening diagnoses such as cancer or heart attacks. For many of those affected, the combination of a health crisis and financial obligations becomes an insurmountable hurdle that plunges them into over-indebtedness.

The scientific debate on this topic is still in its infancy. “We know that illness can lead to over-indebtedness – but we know far too little about how exactly this happens,” emphasizes Münster. Although the category “illness, addiction or accident” is included in the over-indebtedness statistics, there is a lack of detailed knowledge about the underlying mechanisms. What role do certain diagnoses play? How do mental illness, shame or digital consumption patterns influence the development? Such questions remain largely unanswered, as research on this is only rudimentary.

One particularly problematic aspect is the lack of differentiation in the case of addictions. As these are not shown separately in the statistics, they remain invisible, which can reinforce existing social prejudices. In order to counteract this shortcoming, Witten/Herdecke University has commissioned young researcher Neele Kufeld to systematically investigate the connection between addiction and over-indebtedness. With her expertise in psychology and medicine, Kufeld will provide sound data that can serve as a basis for future measures.

The experts are urging a change in strategy. “We don’t need more reaction, we need more targeted research and evidence-based prevention measures based on this,” explains Münster. “Anyone who receives a serious diagnosis must also be informed about financial risks and supported at an early stage.” However, it is still unclear what such support could look like in concrete terms. Münster emphasizes that detailed analyses are needed to determine the right time and the appropriate measures. Without such an approach, the number of people who are over-indebted due to illness threatens to rise further.

Witten/Herdecke University sees the current developments as an urgent social task. The link between health and financial stability requires a rethink in politics and the healthcare system. Without targeted prevention and sound research, the problem of illness-related over-indebtedness will continue to burden not only individual sufferers, but society as a whole.

Original Paper:

Main causes of over-indebtedness in % – Federal Statistical Office

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Gender note. The personal designations used in this text always refer equally to female, male and diverse persons. Double/triple references and gendered designations are avoided in favor of better readability.