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CFPB Report Details Family Finances and Debt in Rural Appalachia

Appalachians Face Higher Debt Burdens and Worse Credit Conditions than Most Other Parts of Rural America

WASHINGTON, D.C. – The Consumer Financial Protection Bureau (CFPB) has issued the first in a series of reports focusing on the finances of consumers living in rural areas. Today’s report focuses on rural Appalachians, who tend to earn less than consumers in other rural areas and have higher rates of subprime credit. In particular, medical debt collections are a much more prevalent issue among rural Appalachians, and consumers with medical debt collections often experience difficulties making ends meet on other financial obligations.

“The Appalachian region of our country faces distinct challenges from other parts of rural America,” said CFPB Director Rohit Chopra. “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 CFPB’s report finds that nearly 24 percent of rural Appalachians have a medical debt in collections, compared to just 17 percent nationally. 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.

For example, while 12 percent of rural Appalachians had auto loans that were delinquent, those with medical debt collections had a 29 percent rate of auto loan delinquency. The CFPB’s report also found:

  • Fifteen percent of rural Appalachians had a credit card delinquency, while 37 percent 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 percent rate of student loan delinquency.

Today’s report examines the Appalachian region, which spans across 13 states, and is disproportionately rural. Thirty-three percent of the nearly 26 million Appalachians live in a rural county, compared to 14 percent of people nationwide. More than 2 million Appalachians live in Persistent Poverty Counties (PPCs), which are defined as counties that have had poverty rates of 20 percent 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.

Other findings in the CFPB’s report include:

  • Only 71 percent of rural Appalachians and 63 percent of rural Appalachians living in PPCs have an active credit card, compared to 80 percent of consumers nationally. Consumers that do not have access to credit cards often have to turn to more costly alternatives for credit, such as payday loans and pawn shops.
  • The median of student loan balances as a percentage of household annual income is 41 percent for rural Appalachians, compared to 32 percent for the nation. Auto loan balances account for 31 percent of household annual income for rural Appalachians, compared to 21 percent nationally.
  • Denial rates for mortgage applications in rural Appalachia (21 percent) were almost twice the rate of mortgage applications nationally (11 percent). For rural Appalachian PPCs, the denial rates were 35 percent.
  • Rural Appalachians endured higher home loan interest rates for home purchases in 2021 compared to the nation. The national average was 3.13 percent, while rural Appalachians had an average rate of 3.41 percent. Rural Appalachian PPCs had average rates of nearly 4 percent (3.86).

Read today’s report Consumer Finances in Rural Appalachia.

Today’s report is part of a series that will highlight consumer finances in rural communities across the country with higher concentrations of Persistent Poverty Counties.

The CFPB encourages consumers to use the Bureau’s Tell Your Story tool to share positive or negative experiences they have had with the financial products and services. Consumers can also submit complaints by visiting the CFPB’s website or by calling (855) 411-CFPB (2372).


The Consumer Financial Protection Bureau is a 21st century agency that implements and enforces Federal consumer financial law and ensures that markets for consumer financial products are fair, transparent, and competitive. For more information, visit consumerfinance.gov.