Access to health care alone isn't the great equalizer you might think it is.

Analyzing 2011 data among Kaiser Permanente of North California patients, researchers at the Virginia Commonwealth University Center on Society and Health found that even when people have access to the same kind of care, educational achievement still played a huge role in whether people are in good health.

Self-reported health data aren't always the most reliable, but you can see a clear difference in reported health status in the following chart. Adults ages 25-64 who graduated college are more than twice as likely to say they're in very good health when compared to those who didn't complete high school. Even the difference between graduating college and attending some college amounted to 16 percentage points in that age group.

Similarly, the VCU research, supported by the Robert Wood Johnson Foundation, found adults in the same age group who didn't graduate high school were almost three times as likely to report having physical health problems interfering with daily activities when compared to college graduates.
There's a number of factors at play here. People with more education have lower disease risk factors, such as smoking and obesity; better education means better jobs with higher earnings and health insurance; and it means better access to healthy food and other services enabling healthier lifestyles. Past research shows that white men and women with 16 or more years of education have a life expectancy about at least 10 years longer than those who didn't graduate high school.

The lesson here, VCU researchers say, is that equal access to care isn't enough to eliminate the disparities in our health-care system.

"Health care reform must be accompanied by changes in social and economic policies that are a 'win-win': creating economic opportunity for families while also saving lives (and costs) from medical illnesses," they write.