NIH-funded study highlights the financial toll of health disparities in the United States
New research shows that the economic burden of health disparities in the United States remains unacceptably high.
The study, funded by the National Institute on Minority Health and Health Disparities (NIMHD), part of the National Institutes of Health, revealed that in 2018, racial and ethnic health disparities cost the U.S. economy $451 billion, a 41% increase from the previous estimate of $320 billion in 2014. The study also finds that the total burden of education-related health disparities for persons with less than a college degree in 2018 reached $978 billion, about two times greater than the annual growth rate of the U.S. economy in 2018.
Key findings from the study included:
Economic burden by racial and ethnic minority groups
National estimates
- Most of the economic burden for racial and ethnic disparities was borne by Black/African American population (69%) due to the level of premature mortality.
- Native Hawaiian/Pacific Islander ($23,225) and American Indian/Alaska Native ($12,351) populations had the highest economic burden per person.
- Most of the economic burden was attributed to premature deaths for Native Hawaiian/Pacific Islander (NHPI) (90%), Black/African American (77%), and American Indian/Alaska Native (AI/AN) (74%) populations. For Asian (55%) and Hispanic/Latino (43%) populations, most of the burden was from excess medical care costs and lost labor market productivity, respectively.
State estimates
- Five states with the highest burden of racial and ethnic health inequities were among the most populous and diverse states: Texas ($41 billion), California ($40 billion), Illinois ($29 billion), Florida ($27 billion), and Georgia ($21 billion).
- Black/African American people had the highest economic burden of racial and ethnic health inequities in most states (33), followed by Hispanic/Latino (nine states), American Indian/Alaska Native (eight states), and Native Hawaiian/Pacific Islander (one state) individuals.
- The burden of racial and ethnic health disparities relative to each state’s GDP varied from 0.14% (Vermont) to 8.89% (Mississippi). Seventeen states had a burden higher than the annual growth rate of the U.S. economy in 2018.
Economic burden by educational levels:
National estimates
- Per person, adults with a high school diploma had the highest burden ($9,982), followed closely by adults with less than a high school diploma ($9,467) and then adults with some college ($2,028).
- Although most of the burden of education-related health inequities was borne by adults with a high school diploma/GED (61%), a disproportionate share was borne by adults with less than a high school diploma/GED—they were only 9% of the population but bore 26% of the burden.
- Across all educational levels, most of the burden was attributable to premature deaths (66%), followed by lost labor market productivity (18%) and excess medical care costs (16%).
State estimates
- Per person, the economic burden of health disparities varied substantially across states by educational levels. For adults with less than a high school diploma, the burden ranged from $3,152 (California) to $21,372 (Kentucky). For adults with a high school diploma, it ranged from $6,201 (West Virginia) to $25,555 (South Carolina), and for adults with some college, it ranged from $1,072 (Illinois) to $8,374 (South Carolina).
- In 31 states, adults with less than a high school diploma/GED had the highest economic burden of education-related health inequities. In 20 states, the burden was greatest among adults with a high school diploma/GED. Adults with some college had the lowest burden of education-related health inequities in all 50 states and the District of Columbia.
- The burden of education-related health inequities relative to each state’s GDP varied from 1.90% (District of Columbia) to 18.29% (South Carolina). Forty-six states had a burden higher than the annual growth rate of the U.S. economy in 2018.
