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Adults Without College Degrees Are Much Less Healthy Than They Were Two Decades Ago

The benefits of education on a person’s health are well-documented. Adults with a high school diploma or less, when compared to peers with college degrees, tend to have lower life expectancy, increased risk for chronic conditions, and worse health overall. A recent report from the Urban Institute, a think tank focused on social and economic policy research, looks at how this discrepancy has changed over the past two decades, which saw the implementation of the Affordable Care Act between 2010 and 2014.

Based on data from the National Health Interview Survey among other sources, the study focused on adults between 19 and 64 years old and divided the sample by whether they had a high school degree or less versus a college degree or more. It also separately analyzed trends for non-Hispanic white, non-Hispanic black, and Hispanic adults, as well as for those living in urban and rural areas.

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Overall, the rates of self-reported fair or poor health among less-educated adults, regardless of their racial, ethnic or geographic group, worsened from 12.8 percent in 1997 to 16.8 percent in 2017. Obesity rates in this group grew from 23.4 percent in 1997 to 36 percent in 2017.

In addition, less-educated adults were 7.7 percent more likely than more-educated adults to report being in fair or poor health in 1999, compared to 9 percent in 2017. The findings also suggested that middle-age mortality for white adults with a high school degree or less is increasing, compared with decreasing middle-age mortality for all other racial, ethnic, and education groups.

Between 1997 and 2017, whites without a high school degree or less saw worse health outcomes, which narrowed the gap with black adults of the same educational level — and widened the gap with whites who had some college experience or more. Another key finding, researchers said, was the discrepancy between less and more educated black adults, as well as less and more educated adults in rural areas. While, the gap within each demographic narrowed, they were still very much present in 2017.

The report also found the ACA played a modest role in narrowing such health disparities since 2011. With the increased access to affordable health care, many people were able to obtain treatments that foster a healthier lifestyle. Still, the research shows obtaining health insurance isn’t enough to eliminate health disparities based on education.

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To conclude, the authors note that real change will likely only come from improving access to education, health-related and beyond. Some solutions put forth include federal funding for community colleges, online learning opportunities, apprenticeship programs, and alternative credentialing for those without a college degree.

Education and Health: Long-Term Trends by Race, Ethnicity, and Geography, 1997-2017, Robert Wood Johnson Foundation.

Last updated on 10/2/19.

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