How youth-led action is helping tackle America's medical debt crisis

Medical debt is one of the most pervasive financial crises in the United States. It is the leading cause of bankruptcy in the United States and nearly half of Americans report skipping medical care because they are more afraid of the bill than the illness.

It is a crisis that does not discriminate by zip code, profession or political affiliation and yet, for decades, it has been treated as a private failure rather than a systemic one.

One project, which began in one city, has spread nationally. Shred the Debt started within the World Economic Forum's Global Shapers community when Gustavo Garcia, a Global Shaper whose own family had been directly uprooted by medical debt, decided that a personal crisis was, in fact, a collective one.

In partnership with Undue Medical Debt, a US-based non-profit that pioneered the model of purchasing medical debt portfolios for pennies on the dollar and abolishing them on behalf of families, Global Shapers began organizing their network to fundraise at scale.

A successful pilot cleared over $2 million in medical bills. Today, the project spans more than 20 hubs across the United States and the families it reaches will never see those bills again.

The campaign’s rapid expansion was no accident; it tapped into a shift in how young people respond to economic pressure and civic action.

The World Economic Forum's Youth Pulse 2026, which surveyed thousands of young people across regions, offers a revealing picture. Financial strain is the foremost source of stress for this generation, with inflation and economic instability ranking as the greatest personal threats to their lives.

Young people are now channelling that pressure into purpose. Across regions, young professionals increasingly prioritize societal impact over traditional measures of career success, including salary and job security.

At a time when many institutions are rethinking how to engage the next generation, these findings point to a different question: not whether young people are ready to drive change but what conditions allow their efforts to scale.

This shift extends directly to how young people view trust and leadership. Community leaders receive the strongest trust ratings among young people, while national political figures and institutions score significantly lower. Young people are not disengaged from change, they are seeking out the structures where their contribution feels most tangible and they are not doing it alone.

Ninety-five percent of respondents say that belonging to an intentionally designed community provides a critical space for learning, growth and dialogue.

The growth of Shred the Debt was driven by three conditions:

The Global Shapers Community is built on the premise that young people are already driving systemic change. Shred the Debt offers one example of what is possible when young people are trusted with the space, resources and agency to lead.

The opportunity for institutions is to create the conditions that allow youth-led solutions to emerge, grow and scale.

Young people are not waiting for permission to tackle the systemic challenges of our time. The Youth Pulse 2026 data confirm this: more than one in three say they are likely to run for political office. They are also leading the adoption of digital tools for community organizing and social entrepreneurship as new ways to drive civic impact.

As more young people step forward to address complex challenges, institutions have an opportunity to support this momentum through infrastructure, co-ownership of the agenda and sustained investment in the community structures that enable long-term impact.

A generation ready to act already exists. The opportunity now is to build the conditions that allow its ideas, leadership and solutions to scale.