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Social determinants of health can be related to health care spending, and they often reflect material hardships people face. However, research on the relationship between specific hardships and medical care utilization across the US adult population is limited. Using 2010–11 data from the Survey of Income and Program Participation, we study three specific hardships—food insecurity, housing insecurity, and housing quality—and their relationship to annual medical care utilization and out-of-pocket spending. Adults who faced housing quality hardships had higher utilization and spending (14.9 percent more provider visits and 16.9 percent higher out-of-pocket spending), as did adults who faced housing insecurity (22.1 percent more provider visits and 28.5 percent higher out-of-pocket spending). We find less evidence of a relationship between food insecurity and medical care utilization, especially after accounting for the presence of multiple hardships.