Repairing your car, replacing a broken appliance or making an emergency visit to the dentist can be bothersome for some - for many Americans, it is impossible.

Four in 10 American adults would struggle to handle an emergency expense as small as $400, a new Federal Reserve survey reveals.

Currently, about 27 percent of the people surveyed would have to borrow money or sell something to cover the bill, while 12 percent could not pay for the expense at all.

Still, overall, Americans are better off financially than they were five years ago, when about half of the population could not handle such a bill.

Unsurprisingly, health-related out-of-pocket spending is often the thing that is costly for Americans. The most frequently skipped treatments are dental care appointments, at 17 per cent, visiting a doctor, 12 per cent, and prescription medicine, 10 per cent.

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Demographic disparities persist: people living in rural areas, as well as black and Hispanic adults are more widely represented in the category of people who would struggle to meet ends in such a situation. Those with bachelor degrees or more education are also more likely to be able to pay for these bills. “Racial and ethnic minorities of each education level are even less able to handle a financial setback,” the study finds.