Education and Health: Long-Term Trends by Race, Ethnicity, and Geography, 1997-2017

A speaker talks to college students in a classroom.

Despite expanded health care coverage, health disparities for less-educated individuals persist.

The Issue

Health disparities between adults with and without a college education have persisted over the past two decades, with only slight narrowing among some demographic groups since 2011. The research suggests that the Affordable Care Act may have played a modest role in narrowing health disparities between less and more educated adults since 2011, but significant gaps remain.

Key Findings

  • Racial disparities in health outcomes between black and white adults with a high school degree or less declined between 1997 and 2017, but steeper declines in health for white adults drove those reductions.

  • Disparities in health outcomes between white adults with a high school degree or less and their more-educated white counterparts widened over time.

  • Health disparities facing black adults and rural adults with a high school degree or less narrowed slightly relative to their more-educated counterparts since 2011.


Experts have long recognized that adults with a high school degree or less face significant health disparities compared with those who attended or completed college. The report shows worsening health for less-educated adults from all racial, ethnic, and geographic groups from 1997 to 2017. Further, report authors note that ending health disparities among the less-educated will take new investment in higher education and skill-building opportunities that allow more people to realize the health and economic benefits associated with more education.


About the Urban Institute

The nonprofit Urban Institute is dedicated to elevating the debate on social and economic policy. For nearly five decades, Urban scholars have conducted research and offered evidence-based solutions that improve lives and strengthen communities across a rapidly urbanizing world. Their objective research helps expand opportunities for all, reduce hardship among the most vulnerable, and strengthen the effectiveness of the public sector. Visit the Urban Institute’s Health Policy Center for more information specific to its staff and its recent research.