Americans cumulatively have $854 billion in revolving loan (mostly credit card) debt, according to the Federal Reserve. The amount has actually declined since the Great Recession, as credit card issuers tightened their lending standards, borrowers became more cautious, and strong and effective consumer protection laws went into effect, producing substantial savings for households. Still, $854 billion is no small matter, and its source is worth considering. Why do some people stagger under a mountain of credit card debt, paying high interest rates on their outstanding balances and never seeming to come out ahead, while others rarely if ever carry debt for long, despite pulling out their plastic on a regular basis?

That's the question I set out to answer in a new study, which compares two groups of low- and middle-income households with working age adults. The households are statistically indistinguishable in terms of income, racial and ethnic background, age, marital status and rate of homeownership-yet one group carries credit card debt, while the other has credit cards but no debt. The study builds on Demos' 2012 national survey of a statistically representative sample of 1,997 low- and middle-income households with and without credit card debt.

One clear finding is that credit card debt is closely correlated with the absence of health coverage: households in which a member has gone without health insurance at some point in the last three years are 20 percent more likely to be carrying credit card debt than households in which no one has been uninsured. This suggests a potential benefit of the Affordable Care Act that is seldom discussed-by increasing the number of Americans with health coverage, Obamacare may cut our credit card debt.

Yet the most complete insurance coverage can leave households with steep costs for premiums, co-payments and deductibles-expenses that the majority of households with credit card debt say contribute to their outstanding balance. Even with health care reform in place, getting sick or managing a chronic condition can lead to ongoing debt burdens.

It's no surprise that losing income can make it hard to pay bills and all-too-easy to accumulate debt. So it made sense to find a strong association between households that had credit card debt and those that had experienced unemployment. What was unexpected was the duration of this effect: Households where someone had been unemployed for at least two months are 14 percent more likely to be carrying credit card debt than households that were not hit by joblessness-even if the unemployment spell was as long as three years ago.

Households with more education, and more assets to draw on, were also far less likely to be carrying credit card debt. This finding corresponds to the larger body of research on the role of wealth and assets: when a family has assets, they gain a measure of stability in times of economic stress. In contrast, when households don't have assets to fall back on, they may turn to credit cards and other forms of borrowing to meet basic expenses when an unforeseen crisis hits. The reliance on revolving credit further increases a household's economic vulnerability and the probability that they will need to rely on credit cards in the future. Borrowers can get trapped in a vicious cycle.

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So what doesn't correlate with credit card debt? Contrary to popular belief, there's little evidence that households with credit card debt are less responsible in their spending habits than households that do not have accumulated debt. Instead, among similarly situated low- and middle-income households, unemployment, education, health care coverage and the value of assets households have to fall back on are the major predictors of credit card debt.

Public and business policies have yet to catch up to this reality. For example, nearly half of all employers persist in reviewing personal credit history-including credit card debt-when hiring new employees. That's largely because companies peddling "credit background checks" assert that a credit report will reveal the inner recesses of a job applicant's character and sense of personal responsibility-when in fact, it's says more about the quality of the job-seeker's health coverage. Similarly, when auto insurance companies factor credit scores into their decisions about their charges, they may really be making judgments that hinge on whether the driver's spouse was out of work last year. In terms of public policy, efforts to increase health care coverage, boost the creation of high-quality jobs, and shore up the public safety net so that households without assets have more of a financial cushion are likely to make a greater impact on our level of credit card debt than attempts to teach households to be financially responsible.