New data shows that education-related health disparities persist, despite changes to healthcare access policies.
Educational attainment remains a key barrier to health and wellness, despite industry hopes that expanded access to affordable health insurance could close health disparities that vulnerable patients experience, shows a recent study from the Urban Institute.
The medical industry has long observed health disparities between patients with a college education and those with a high school degree or less. These disparities likely stem from socioeconomic limitations that non-college educated patients face, such as jobs without healthcare benefits for low wages that hamper efforts to purchase health insurance, the researchers said.
“Indeed, adults who have attended college are more likely to have health insurance and report better access to care than adults without a college degree,” the researchers reported. “In addition, adults with more education have greater economic resources to support healthy behaviors, like eating nutritious food and exercising.”
The passage of the Affordable Care Act (ACA) presented one opportunity to overcome those hurdles by expanding access to affordable health plans on the ACA exchanges and access to Medicaid coverage.
But although the ACA brought about modest reductions in health disparities, work remains.
“The Affordable Care Act is responsible for a major reduction in the number of uninsured this decade, but expanded access to affordable, quality coverage has not eliminated health disparities facing adults without a college education,” Stacey McMorrow, principal research associate at the Urban Institute, said in a statement emailed to journalists.
The researchers, funded by the Robert Wood Johnson Foundation, looked at health trends among patients with and without college educations between 1997 and 2017 and observed the impact that the ACA had on health disparities.
The researchers found that most disparities between more- and less-educated individuals persisted before and after ACA passage.
Specifically, non-college educated adults in all racial groups have seen declining health since 1997. Those results are most stark when looking at obesity trends. Obesity increased 50 percent among non-college educated patients, from 23.4 percent of adults in 1997 to 36 percent in 2017.
Disparities between less-educated black and white patients did begin to close, but not because the health of any particular group improved, the researchers found. While the overall health of black patients remained consistent, non-college educated white patients saw declines in their health outcomes during the study period.
Disparities between college educated and non-college educated white patients therefore also widened between 1997 and 2017.
The ACA did have positive impacts in some areas, although they were minor, the researchers said. The report revealed a slight decline in health disparities between less-educated black or rural-dwelling adults and their college-educated peers. This was likely a result of ACA coverage expansion through the health plan exchanges and Medicaid.
“Additional analysis of the role of insurance and other factors in explaining these patterns is warranted,” the researchers wrote. “Given the large coverage gains under the ACA for all groups we examined and only modest improvements in disparities for a few groups, our results clearly imply that insurance is not the only solution to the health disparities facing less-educated adults.”
These findings suggest that the medical industry must tap solutions to address other sources of health inequity, including improving health literacy and reducing chronic stress among non-college educated individuals.
Ultimately, making investments in education – especially non-traditional education paths that lay outside of a college degree – will be critical to closing health and wellness gaps.
“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,” said McMorrow.
Such programming could include expanding educational and skill-building opportunities, investments in community colleges, online education courses, apprenticeships, and new credentialing processes for those without a college degree but who have experiences related to a specific job.
“Such investments would allow more people to capture the health and economic benefits that more education offers.”
Date: May 22, 2019
Source: Patient Engagement HIT