The new report sheds light on the health disparities that continue to exist by gender, geography, socioeconomic status, race and ethnicity, and educational attainment.

Prior to COVID-19, the U.S. made progress in several health measures, but wide disparities have persisted and even worsened in other areas, according to America’s Health Rankings Health Disparities Report 2021.

The inaugural report, which builds on over three decades of data and reporting from America’s Health Rankings, aims to document the breadth, depth, and persistence of health disparities throughout the country to provide objective data to further health equity. The health measures evaluated in the report are indicators of four drivers of health: social and economic factors, physical environment, clinical care, and behaviors, all of which impact the fifth measure, health outcomes.

“Achieving the highest level of health for all people will require communities, states and the nation to understand and identify how disparities impact the health of everyone,” the report stated. “Race and ethnicity, gender, geography, educational attainment and income level should not decide one’s access to health care, or the determinants and outcomes that contribute to our holistic well-being.”

According to the study, the U.S. made some progress in the rate of uninsured, Black infant mortality, and the rate of severe housing problems, but the progress has varied across states and gaps remain between different population groups.  

The RISE Population Health Summit

Other disparities, however, have persisted or worsened in recent years, and educational attainment played a key role in several areas. For example, maternal mortality rates increased by 22 percent among Black mothers between 2005-2009 and 2015-2019. Black mothers had a maternal mortality rate 3.4 times higher than Hispanic mothers.

Food insecurity rates have worsened as well, particularly among American Indian/Alaska Native households where rates increased 39 percent between 2003-2007 and 2015-2019. Educational attainment was a strong determinant of food insecurity as insecurity rates were six times higher in households headed by an adult without a high school education than households headed by college graduates. Since 2003-2007, food insecurity rates increased 15 percent in households headed by adults with less than a high school education and increased by 19 percent in those headed by college graduates.

The study also found wide disparities in mental and behavioral health and chronic disease persist, and in some cases worsened, by gender, educational attainment, and race and ethnicity.

Here’s a breakdown of additional report findings:

  • The uninsured rate declined by 37 percent among all subpopulation groups from 2010-2014 to 2015-2019, however, gaps remained between different population groups. Uninsured rates were higher among those with only a high school degree (13.6 percent) compared to college graduates (3.9 percent) as well as among Hispanic (18.5 percent) and American Indian/Alaska Native populations (20.2 percent) than white populations (6.2 percent).
  • Maternal mortality rates increased 55 percent for white mothers, 23 percent for Hispanic mothers, and 22 percent for Black mothers.
  • The infant mortality rate among Black infants decreased 19 percent from 2003-2006 to 2015-2018, however, Black infants had the highest mortality rate in 2015-2018.
  • In 2017-2019, adults with less than a high school education had a rate of frequent mental distress that was 123 percent higher than college graduates. Females had a 70 percent higher rate of depression compared to males. The rate of depression was three times higher for multiracial and American Indian/Alaska Native adults.
  • The percentage of adults with multiple chronic conditions in 2017-2019 was six times higher for American Indian/Alaska Native adults, four times higher for multiracial adults, and three times higher for Black adults than for Asian/Pacific Islander adults.