Now it appears that a similar shift, toward the acknowledgment of debt as not just a financial burden but an emotional one, is occurring among employers who offer student loan benefits.

Yes, a small number of companies, including PWC, Aetna,  Hulu, and others, began offering benefits that pay down loans directly, with monthly payments of a $100 or more, a few years ago. At that time, though, they largely saw it as an opportunity to stand out at recruitment fairs and help keep employees from leaving in a competitive labor market.

These days, more businesses are apparently motivated to address student loan debt not strictly as a flashy perk, but out of concern for what it’s doing to employees’ psyches and ambitions—and therefore a company’s bottom line.

The “web effect” of student loan stress

Shann Grewal, vice president of IonTuition, a student loan benefits company that provides loan management and telephone counseling services, says he has noticed the change among his clients. The evolution was perhaps inevitable, he suggests, as more companies saw employees dealing with loan defaults and wage garnishment, or took notice of how staffers were not taking advantage of other benefits, like flexible spending accounts, which in turn left them more exposed to the financial burden of high medical bills.

As employers began asking questions, he says, they came to understand the “web effect” of student debt obligations, and the threat the hardship poses to productivity and morale.

“I think employers are really starting to realize that because student loans are so pervasive, there’s a need to have an element of, yeah, sure, financial wellness programs, but really overall wellness,” he says.

Indeed, in PwC’s latest Employee Financial Wellness Survey, employees cited money matters, including debt, as the lead cause of stress in their lives, more often than they named other life stressors—like their health or problems at work—combined. And the Society for Human Resource Management recently found that student loan benefits, specifically, ranked just behind paid time off and slightly ahead of the ability to work remotely as a most-desired perk among young employees out of college.

Carl Gagnon, assistant vice president of global financial well-being at Unum Group, recently told The Wall Street Journal that student loan perks that creatively address the debt crisis—by say, allowing employees to cash in unused holidays or by matching loan payments with 401k retirement fund contributions— have become “a critical need.” Citing studies, he suggests that student loan debt “is hurting employees’ well-being, focus at work, and retirement planning.”

Poor sleep and high anxiety rates

In fact, empirical evidence about the health effects of student loan debt remains limited to research that establish associations, not causality, and non-academic surveys. Nevertheless, the findings have been convincing and are gaining more attention, says Katrina Walsemann, an associate professor at the University of South Carolina and director of the Carolina Consortium on Health, Inequalities, and Populations.

In 2015, Walsemann led a landmark study with peers at UCLA that analyzed 13-years of data from a nationally representative sample of nearly 9,000 American adults, pulling out information about those who reported holding student loans. They found that student loan debt was correlated with lower levels of psychological wellbeing for 25- to 31-year-olds, even after accounting for income, family wealth, occupation, and the level of education attained.

Since that time, other researchers have examined other significant debt-connected behavioral patterns. “There’s a growing body of work that would suggest there are social, economic, and health implications of student debt,” says Walsemann. For example, people seem to be putting off marriage or home ownership, choosing jobs in high-paying instead of meaningful careers, and neglecting their 401ks because of their student loan bills. “We haven’t done any randomized controlled trials to figure out if it’s really debt that’s causing all of these things—it’s kind of hard to randomly assign people to debt—but the more that you see it across different studies, the more you feel like this might be something that’s actually true, that’s a real relationship,” she says.

What’s more, several studies have shown that debt of other types—including credit-card or auto loans—are strongly associated with serious issues like poorer mental health, mental disorders, depression, and drug dependency. Walsemann doesn’t believe that student debt should be thought of any differently, even if it supposedly symbolizes a ticket to social mobility.

“I’ve heard the argument before: ‘Well, you get something out of it’” when you take out debt for education, she says. “But usually when you have debt, you get something. You get a product, either a home or a car, or a degree, so I’m not super convinced that [getting something] makes this debt different.” (Besides, she underlines, many millions of people in the job market have student loan debt without a degree, because they left school before graduating.)

On the other hand, one feature that differentiates student debt from other obligations is that it’s almost impossible to escape, even in death. Depending on what type of loan you have, your invoices will land on your partner’s lap, or be taken from your estate, should you die before paying off what you owe.

So it’s no wonder that people talk of drowning, sinking, or being “crushed alive” by their student loans, or that surveys find—again and again—that people who have student loan debt report higher levels of anxiety, worry more about student debt than other credit obligations, and are even likelier to suffer physical complaints like headaches. It’s also likely that people of color, and particularly black women, are feeling the stress of loans more acutely, given that they carry a heavier burden of debt than other groups, even years after graduating—a disparity researchers of a new study chalk up to structural inequalities.

All of this is to say that, as Walsemann notes, it’s increasingly plausible that “student debt might be impacting a lot of things in people’s lives that that could be concerning for employers.”

Grewal would add that the pain is not short-lived, either. Some employees at his client companies have been calling IonTuition’s counselors for advice on repayment plans and budgeting over the course of years, and through various life phases. After all, the estimated average time it takes to eliminate a loan of $20,000 to 40,000 is two decades, and the average loan is now pegged at about $30,000 per person.

Older workers can feel the burden, too

Employers should also take note, it’s not only new grads who are suffering. Walsemann is now looking at the effects of student loan debt on parents who signed up for loans to help a child, and how years of heavy debt will be felt by families through generations. For the same reason, Grewal says companies are making his firm’s student loan benefits available to all, regardless of how recently they finished school.

“You may not be the person with a ton of student loan debt, but if your spouse back home is, or if your child is not able to get into the college they would like [because] you can’t finance that, well, it’s not your student loan debt, but it’s still a stress factor for you and it’s still bringing you down,” he says.

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