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Objective: Determine relationships between college students’ student loan presence and self-rated physical and mental health, major medical problems, mental health conditions, physical, dental, and mental health care visits and delays, and medication use and reductions. Participants: A total of 3,248 undergraduates at two regional public U.S. universities, surveyed Spring 2017. Methods: OLS and Logistic regression. Results: Loan presence was related to significantly worse self-rated physical and mental health and more major medical problems, but not to mental health conditions, or physical or mental health medication use. Respondents with loans were less likely to visit the dentist and more likely to report delaying medical, dental, and mental health care, and reducing medication use to save money. Conclusions: Results provide evidence of health and health care use divides among college students by loan presence. 

Social norms and expectations regarding marriage or childbearing while in debt—or with an indebted partner—may explain links between student loans and lower family formation rates. This study analyzes an original survey of college students (N = 2,990) at two universities examining how student loanswill,would,orshouldaffect romantic relationship and family formation decisions. A significant minority believed marriage should be delayed and nearly half believed childbearing should be delayed when people have student loan debt. Many reported they would hesitate to marry someone with high student debt, their loans would delay family formation, and they would form families earlier if their debt were forgiven. Those with loan debt and higher debt were more willing to partner with those who had high student debt. Women were less likely to believe peopleshoulddelay childbearing and marriage because of loans, but more hesitant to marry a partner with high student debt. Findings suggest social norms underlie childbearing and marriage delays among those with loans, and student loan debt creates a class divide among the highly educated.