Annual Report on Nation’s Health Shows Continued Disparities

Press Release

For Release June 22, 1995

Gaps in educational attainment are likely to result in gaps in overall health status, according to the Federal Government’s annual report on the Nation’s health, released by the Department of Health and Human Services.

Health, United States, 1994, prepared by the National Center for Health Statistics (NCHS), shows that among persons aged 25-64 years, those with less than a high school education had more than double the death rate as those with at least one year of college.

“We see better health outcomes for the more educated right from the start, ” said Assistant Secretary for Health, Philip R. Lee, M.D., the head of the U.S. Public Health Service. “Women who don’t finish high school are almost eight times as likely to smoke during pregnancy as women who are college graduates, and low birthweight and infant mortality decline as the mother’s educational level goes up.”

Overall, the percent of women who smoked during pregnancy dropped from 20 percent in 1989 to 17 percent in 1992. When the latter year is broken down to reflect education, only 4 percent of college grads smoked during pregnancy but 31 percent of high school dropouts did. Cigarette smoking among all adults aged 25 years and over ranged from 14 percent for college graduates to 36 percent for those with less than a high school education.

Educational attainment was also associated with the use of mammography. In 1993 levels of recent mammography were 35 percent lower among women with less than 12 years education than among women with more than 12 years education.

The report also shows effects of family income on health and health care. Vaccination levels for nonpoor children continue to exceed levels for poor children. In 1993 vaccination levels for diphtheria, tetanus, pertussis (DTP) were 13 percent higher for nonpoor than poor children. Vaccination levels for measles were 11 percent higher for nonpoor children than poor children.

Overall, childhood vaccination rates improved. In 1993 two out of three children aged 19-35 months (67 percent) had received a combined series of four doses of DTP vaccine, three doses of polio vaccine, and one dose of measles-containing vaccine. This represented an increase from 55 percent in 1992. However, the combined series vaccination levels were 20 percent higher for nonpoor than for poor children.

“Immunization is very effective prevention tool and one that should be available to each and every child, ” Dr. Lee said. “The Clinton administration had put special emphasis on vaccinations for all children. Our Childhood Immunization Initiative is a nationwide, comprehensive drive to achieve the right immunizations at the right time for American children, poor and nonpoor alike.”

During 1991-93, nonpoor children under 15 years of age received more ambulatory care than poor or near poor children. The average number of physician contacts per year for nonpoor children was 23 to 26 percent greater than for poor or near poor children.

The report also spotlights the issue of access to health care. Over 17 percent of the under-65 population — or 40 million Americans — had no health care insurance in 1993. Black Americans were significantly more likely than white Americans to lack health insurance.

Hispanics were more than twice as likely to have no coverage as white persons. Among Hispanic groups in 1993, the age-adjusted percent of persons who were uninsured ranged from 17 percent of Cubans and 21 percent of Puerto Ricans to 40 percent of Mexican-Americans.

Meanwhile, health care expenditures continue to rise, totaling $884.2 billion in 1993, or $3,299 per person. The one-year rise in health spending was the smallest since 1986, but was still 2.4 percentage points higher than the growth of the Gross Domestic Product.

Between 1991 and 1994, private employers’ health insurance costs per employee-hour worked increased by 24 percent to $1.14 an hour. In comparison, wages and salaries per employee-hour worked increased by 9 percent during the same period.

“Health, United States, 1994,” can be downloaded from the National Center for Health Statistics’ (NCHS) Home Page. NCHS is part of the Centers for Disease Control and Prevention, HHS.

Health, United States, 1994. 307 pp. (PHS) 95-1232. GPO stock number 017-022-01295-2 price $20.00 [PDF – 2 MB]

For more information, please contact NCHS, Office of Public Affairs (301) 458-4800, or via e-mail at