More Education Does Not Erase Racial Disparities in Health Coverage

Differences in Uninsured Rates by Race and Ethnicity Persist Even Among Those With Higher Educational Attainment

March 08, 2023

Written by:

Breauna Branch

Research has shown that uninsured rates are lower for people with more education but an analysis of U.S. Census Bureau data shows that racial and ethnic disparities in health insurance coverage persist even among the more educated.

A recent brief that uses data from the 2021 American Community Survey (ACS) showed that the uninsured rate across race and Hispanic origin groups ranged from 5.7% for White, non-Hispanic people to 18.8% for those identifying as non-Hispanic American Indian and Alaska Native.

Those without a high school diploma had among the highest uninsured rates within each race and Hispanic origin group and those holding a bachelor’s degree had the lowest.

The ACS 1-year estimates show that educational attainment varied widely by race and Hispanic origin (Figure 1). For example, about 60% of Asian, non-Hispanic adults ages 25 to 64 held a bachelor’s degree or higher compared with 16.5% of non-Hispanic American Indian and Alaska Native adults in that age group.

Other race groups with high rates of people with at least a bachelor’s degree included: Some Other Race, non-Hispanic (42.3%), and White, non-Hispanic (41.5%).

Figure 1. Percentage of Adults Ages 25 to 64 With a Bachelor's Degree or Higher by Race and Hispanic Origin: 2021

Uninsured Rates by Educational Attainment

In 2021, 11.9% of adults ages 25 to 64 years did not have health insurance coverage. However, the uninsured rate varied by educational attainment, ranging from 30.4% among those with less than a high school education to 4.7% among those with a bachelor’s degree or higher.

The uninsured rate of those with a bachelor’s degree or higher was lower than the national average of 11.9%.

There were also differences in the uninsured rate by educational attainment between and within race and Hispanic origin groups.

Those without a high school diploma had among the highest uninsured rates within each race and Hispanic origin group and those holding a bachelor’s degree had the lowest.

Among those with a bachelor’s degree, adults ages 25 to 64 years in most race and Hispanic origin groups — all except non-Hispanic White adults and non-Hispanic Asian adults — had uninsured rates that were higher than the national average for adults with this level of educational attainment (4.7%).

The uninsured rate for non-Hispanic American Indian and Alaska Native adults with an undergraduate college degree (12.5%) was more than three times higher than that of non-Hispanic White adults (3.5%).

Regardless of educational attainment, some groups had high uninsured rates.

For example, those identifying as American Indian and Alaska Native, non-Hispanic or Hispanic, had the highest uninsured rates at all education levels.

This suggests that differences in insurance coverage by race and Hispanic origin stem partly from racial disparities, including inequities in educational attainment and unequal returns on the educational attainment achieved.