One in three people you pass on the street are carrying something around that you can’t see. It’s not a disease but delinquent debt.

According to a new study from the Urban Institute, 77 million Americans have debt and bills that have been reported to collection agencies for nonpayment. Consumers have fallen behind on credit card bills, hospital bills, mortgages, auto loans, and student loans. Gym memberships, cell phone contracts, and even overdue library book fees are in collection. The debt in collections averaged $5,178.

Spending on healthcare-related bills accounts for 37.9 percent of the debts collected according to another study. With the introduction of ObamaCare, it will be interesting to track whether this share rises or falls. A quarter of debt is student loan debt and credit cards make up 10.1 percent. Debts to local governments, retailers, telecoms, and utilities comprise the remainder of debt in collections.

There are geographic differences in the rates of delinquency as well with higher concentrations in the South and West.

The Associated Press reports:

The study points to a disturbing trend: The share of Americans in collections has remained relatively constant, even as the country as a whole has whittled down the size of its credit card debt since the official end of the Great Recession in the middle of 2009.

As a share of people's income, credit card debt has reached its lowest level in more than a decade, according to the American Bankers Association. People increasingly pay off balances each month. Just 2.44 percent of card accounts are overdue by 30 days or more, versus the 15-year average of 3.82 percent.

Yet roughly the same percentage of people are still getting reported for unpaid bills, according to the Urban Institute study performed in conjunction with researchers from the Consumer Credit Research Institute. Their figures nearly match the 36.5 percent of people in collections reported by a 2004 Federal Reserve analysis.

The delinquent debt is overwhelmingly concentrated in Southern and Western states. Texas cities have a large share of their populations being reported to collection agencies: Dallas (44.3 percent); El Paso (44.4 percent), Houston (43.7 percent), McAllen (51.7 percent) and San Antonio (44.5 percent).

Almost half of Las Vegas residents— many of whom bore the brunt of the housing bust that sparked the recession— have debt in collections. Other Southern cities have a disproportionate number of their people facing debt collectors, including Orlando and Jacksonville, Florida; Memphis, Tennessee; Columbia, South Carolina; and Jackson, Mississippi.

The factors contributing to debt in collections are not too surprising. Retirees living on fixed income rack up debt (especially medical) but lack the means to pay for them. Many workers have low-paying jobs in construction and services that don’t provide enough for even a small extra expense much more than money to pay off debt and save. And related to this are stagnant incomes that have barely tracked with inflation. As we reported this morning, incomes have not moved despite the economic recovery – leaving workers doing more with the same income or less.

When we talk about the economy and positive news about the recovering recession, there are many factors that don’t make the headlines or talking points coming out of Washington.

Reports like these and the individual stories behind the numbers of Americans still struggling to make ends meet remind us that we are not out of the woods yet.