New Health Disparities Report Reveals Urgent Need to Address Maternal Mortality, Mental and Behavioral Health, and Food Insecurity in the U.S.

June 29, 2021 | 4 min Read
  • Widespread health disparities persisted across racial, ethnic, gender, geographic and educational lines before COVID-19 pandemic, according to America’s Health Rankings Health Disparities Report.

The United Health Foundation, the philanthropic foundation of UnitedHealth Group (NYSE: UNH), released its inaugural America’s Health Rankings Health Disparities Report, highlighting persistent and widening gaps in health and well-being by race and ethnicity, gender, geography and educational level.

The report, and associated interactive website, builds on more than three decades of data and reporting from America’s Health Rankings®, and provides a comprehensive portrait of the breadth, depth and persistence of disparities in population health over time, in an effort to spark meaningful dialogue and action to advance health equity. Importantly, the report focuses on pre-pandemic data, providing an in-depth baseline measure of the magnitude of health disparities.

UnitedHealth Group plans to use the findings of this report as a critical source of information to fulfill its mission of making the health system work better for everyone.

Key findings of the report at the national level include:

  • Deep and persistent disparities in mental and behavioral health by gender, educational attainment, and race and ethnicity, which have worsened for certain groups, particularly those without a high school education and females. For example, in the 2017-2019 time frame, adults with less than a high school education had a rate of frequent mental distress that was 123% higher than college graduates, and females had a 70% higher rate of depression compared to males.
  • Persistent and growing disparities in maternal mortality, including ongoing disparities among Black mothers who face a maternal mortality rate that is 3.4 times higher than Hispanic mothers. Rates of maternal mortality increased 55% for white mothers, 23% for Hispanic mothers, and 22% for Black mothers between 2005-2009 and 2015-2019.
  • Wide and growing disparities in household food insecurity, most notably for American Indian/Alaska Natives. In fact, this subpopulation experienced a 39% rate increase between 2003-2007 and 2015-2019.
  • A strong link between educational attainment and health, with those without a high school education facing the greatest social, economic and health challenges, and the largest health disparities.

“Race and ethnicity, gender, geography, educational attainment and income level should not limit one’s access to health care, or the determinants and outcomes that contribute to our overall well-being,” said Dr. Rhonda Randall, chief medical officer of UnitedHealthcare Employer and Individual, part of UnitedHealth Group. “Our 330,000 team members are dedicated to addressing health disparities and closing gaps in care for the most vulnerable populations.”

The broad range of disparities, across multiple factors, is indicative of the work ahead to achieve more equitable health outcomes. In addition to national findings, America’s Health Rankings includes state highlights where progress has been made and challenges persist, allowing local health officials and policymakers to better focus their efforts.

 “The America’s Health Rankings Health Disparities Report is an excellent pre-pandemic baseline report for health and elected officials, and other stakeholders,” said Georges C. Benjamin, MD, executive director of the American Public Health Association. “It provides actionable data that is relevant to leaders, not only in public health, but also across many sectors.”

State-specific findings illustrate the vast differences across populations and states. For example:

  • Child poverty rates varied widely, with South Dakota – the state with the highest disparities – exhibiting child poverty among American Indian/Alaska Natives at more than 10 times the rate than white children in Connecticut.
  • In Hawaii – the state with lowest disparities in child poverty – Hispanic children had a nearly 2 times higher rate of poverty than white children.
  • Food insecurity in North Dakota among Black households was nearly 20 times higher than white households in the District of Columbia.
  • In 2015-2019, Georgia, South Dakota, Tennessee, Utah and Wyoming (all five states without Medicaid expansion prior to 2020) had the highest racial and ethnic disparities in rates of uninsured within their states, while Hawaii, Massachusetts, Michigan, New York and Vermont (all five states that expanded Medicaid in 2014) had the lowest disparities.
  • Many states with high rates of Black infant mortality have not made meaningful improvements. In particular, Black infants in Alabama, Oklahoma and West Virginia had an infant mortality rate that was 2.2 times higher than the national average in 2015-2018 – rates that have largely remained unchanged.
  • The states with the lowest rates of infant mortality are located in the Northeast and on the West Coast. However, even within these states, Black infants continue to face wide disparities, including rates that are 2 to 3 times higher than infants with the lowest rate in each state.

“The America’s Health Rankings Health Disparities Report provides a unique, data-driven analysis that identifies disparities not only according to race and ethnicity, but also gender, geography and education level. Through new analyses, this report provides public health officials and lawmakers with state-specific findings on their state’s largest disparities so they can plan better strategies to address them,” said Judy Monroe, MD, president and CEO, CDC Foundation. 

The America’s Health Rankings Health Disparities Report draws on data across 30 measures of health, including social, economic and environmental determinants of health as well as health outcomes, to demonstrate the progress achieved and the challenges faced by a variety of population groups at the national level, and in all 50 states and the District of Columbia.

UnitedHealth Group and America’s Health Rankings

For more than 30 years, UnitedHealth Group has used findings from America’s Health Rankings reports, along with additional data and insights from the organization’s 330,000 employees, to devise and deliver targeted, meaningful solutions that address America’s health disparities — in health care, insurance, clinical expertise and financial support. UnitedHealth Group partners with national and local organizations, government agencies, experts and lawmakers to further improve and better target these solutions, and help all people live healthier lives. In the past decade alone, UnitedHealth Group has invested nearly $23 million in new and emerging strategies to address maternal mortality, and in 2020 donated nearly 70 million meals to national and state-based organizations to address acute needs brought on by the pandemic. Learn more about UnitedHealth Group’s commitment to building a sustainable health care system in the company’s annual Sustainability Report.

About America’s Health Rankings

For over three decades, America’s Health Rankings has assessed the nation’s health and provided data-driven insights to support better health outcomes and build healthier communities. Produced by the United Health Foundation, America’s Health Rankings evaluates a comprehensive set of health, environmental and socioeconomic data to illuminate both health challenges and successes, determine national and state health benchmarks, and enable stakeholders to take action in improving health.

About the United Health Foundation

Through collaboration with community partners, grants and outreach efforts, the United Health Foundation works to improve our health system, build a diverse and dynamic health workforce and enhance the well-being of local communities. The United Health Foundation was established by UnitedHealth Group (NYSE: UNH) in 1999 as a not-for-profit, private foundation dedicated to improving health and health care. To date, the United Health Foundation has committed more than $500 million to programs and communities around the world. To learn more, visit