New research from the National Institutes of Health 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 NIH, 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 people without a college degree in 2018 reached $978 billion, about two times greater than the annual growth rate of the U.S. economy in 2018. Altogether, the overall financial burden exceeds $1.4 trillion. 

The findings from this study by researchers from NIMHD; Tulane University School of Public Health and Tropical Medicine, New Orleans; Johns Hopkins Bloomberg School of Public Health, Baltimore; Uniformed Services University, Bethesda, Maryland; TALV Corp, Owings Mills, Maryland; and the National Urban League were published in JAMA. 

This study is the first to estimate the total economic burden of health disparities for five racial and ethnic minority groups for all 50 states and the District of Columbia using a health equity approach. The health equity approach, derived from the Healthy People 2030 goals, sets aspirational health goals that all populations can strive for. It establishes a standard that can be applied to the nation for all racial, ethnic, and education groups. It is also the first study to estimate the economic burden of health disparities by educational levels as a marker of socioeconomic status. 

“The exorbitant cost of health disparities is diminishing U.S. economic potential. We have a clear call to action to address social and structural factors that negatively impact not only population health but also economic growth,” said NIMHD Director Dr. Eliseo J. Pérez-Stable 

Key findings from the study included economic burden by educational levels. For example, per person, the economic burden of health disparities varied substantially across states by academic level. For instance, 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 results of this study demonstrate that health inequity represents not just unfair and unequal health outcomes, but it also has a significant financial cost,” said lead author Thomas LaVeist, Ph.D., dean of Tulane University School of Public Health and Tropical Medicine. “While it surely will cost to address health inequities, there are also substantial costs associated with not addressing them. Health inequities are a social justice issue, but also an economic issue.” 

While the economic burden of racial and ethnic, and education-related health disparities is significant, the researchers noted that the burden could be reduced if investments are made to address structural contributors to known inequities, including racism and socioeconomic inequalities. They also recommended that federal and state health policymakers and offices of minority health could use these estimates to inform areas where policies and programs are most needed to address health inequities