Financial and medical woes tend to travel together, a relationship that a former University of Pennsylvania researcher believes deserves more attention from both physicians and credit counselors.

Craig E. Pollack, an internal-medicine doctor who studied research techniques at Penn as a Robert Wood Johnson Foundation Clinical Scholar, last year surveyed 250 Philadelphia-area homeowners facing foreclosure who sought help from Consumer Credit Counseling Service of the Delaware Valley Inc.

He found extremely high levels of major depression: 37 percent compared with the 12 percent typically found in poor populations. Plus, nearly 60 percent of the distressed homeowners said they had skipped or delayed meals because they could not afford food, and almost half said they had failed to fill a prescription in the last year because they did not have enough money. Since the foreclosure, they also said, they had started smoking and drinking more.

Nine percent said a medical problem in the family was the primary reason for the foreclosure.

"Housing and health go hand-in-hand, and policymakers need to think about what some of the health implications of this foreclosure [crisis] might be," said Pollack, whose findings were published online this week in the American Journal of Public Health.

Foreclosure rates are now at historic highs, he added. "We're in the middle of the crisis, and we've barely begun to address the health ramifications of it."

Pollack, who recently began working at Rand Corp., said people in foreclosure were dealing with the end of their dream of homeownership, and all that implies in this society. They are also facing concrete, day-to-day dilemmas that are stressful.

"I think the high rate of people skipping their doctors' appointments and people skipping their medications is incredibly important," he said. "What you worry about is people are making really hard decisions here. They're making really hard trade-offs. As a physician, I worry that these are going to hurt people's health."

He said he thought doctors should ask patients about their financial worries and be prepared to steer them to mortgage counselors, if necessary. And mortgage counselors should know where public-health clinics are located and have information on hand about programs such as food stamps and Medicaid.

Recognizing that both doctors and financial experts already feel "pinched for time," Pollack said there should be incentives to change their behavior, but he had no specific ideas about what those should be.

Anthony Orman, vice president for client programs at Consumer Credit Counseling Service, said clients rarely talked about their medical problems. The study, he said, was a way to "prove what we kind of knew in our gut."

His employees can do only so much, Orman said.

"Our counselors are financial counselors," he said. "They're not medical counselors."

The agency is considering hiring a social worker to meet medical-counseling needs. The big question is how it would pay for that.

Contact staff writer Stacey Burling at 215-854-4944 or sburling@phillynews.com.