Including mortgages, the average American household carries $132,529 in debt. That total comprises $16,000 in credit card debt, $28,500 in auto loans and $49,000 in student loan debt.

A major reason for the increase is that cost of living has outpaced income growth over the past 13 years. Household income has risen 28% since 2003, but medical costs have jumped 57% and food and beverage costs have risen 36%. Overall, the cost of living is up 30% in the 13-year period.

The data were reported earlier this week by researchers at NerdWallet in its annual survey of household debt. Their conclusion:

[I]ncreasing debt loads aren’t just a case of lifestyle creep. The rapid growth in medical and housing costs is dwarfing income growth, making it challenging for many families to make ends meet without leaning on credit cards and loans.

Since 2002, household income adjusted for inflation has risen by 10 percentage points, a far cry from the 38 point spread in 2008.

Education cost increases have dropped to the point where income outpaces the cost increases by two percentage points. Student loan debt rose 186% in the decade since 2003, but increased by just 6.32% between 2015 and 2016.

That does not necessarily indicate that education is becoming more affordable. It is also possible that lower enrollment, particularly in for-profit schools, has played a significant role. Between the fall of 2014 and 2015 for-profit enrollments dropped 13.7%.

Americans with lower incomes may have to borrow to make ends meet, and this costs about $1,300 in interest payment on revolving credit card debt. But as incomes rise so does the cost of debt. NerdWallet’s researchers note:

[A]ccording to our findings, debt loads increase as income does; therefore, annual interest payments are larger. Higher-income people can get higher credit limits more easily, giving them more room to rack up big balances. Low-income earners, on the other hand, don’t have access to a lot of credit.

Households with incomes above $157,479 pay four times more annual credit card interest than households with incomes below $21,432. But the ratio of debt to income is much higher among lower-income households: 18% ($3,611) versus 7% ($10,036).

Wednesday’s announced increase in Federal Reserve’s funds rate also will have an effect on household debt. Variable interest rates on credit card debt will rise, as will mortgage rates. For households with adjustable rate mortgages, the increases are likely to continue through next year as the Fed has indicated it may raise rates three times in 2017.

NerdWallet credit and banking expert Sean McQuay said:

When it comes to credit card debt, the best way to combat rising interest rates is to pay off your balances entirely. Even if it takes time, every cent of debt you can pay off reduces your interest fees. In the least, I suggest doubling the minimum monthly payment, or rounding it up to the nearest hundred dollars. Don’t wait for the Fed to continue increasing rates: Pay off your debt so you can put money in savings and start benefiting from interest increases.

The full report and methodology is available at the NerdWallet website.

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