The Nonequivalent Health of High School Equivalents


  • The author will share all data and coding for replication purposes.



Millions of U.S. adults are recipients of the high school (HS) equivalency (General Education Development [GED]) diploma. Virtually nothing is known about the health of this large group, although literature suggests GED recipients are considerably worse off than HS graduates in numerous economic and social outcomes. We analyze general health among working-age adults with a HS diploma, GED recipients, and HS dropouts.


Ordered and binary logistic models of self-rated health and activity limitations were estimated using data from the 1997–2009 National Health Interview Surveys (N = 76,703).


GED recipients have significantly and substantially worse health than HS graduates, among both sexes. In fact, the GED recipients’ health is generally comparable to that of HS dropouts. Health behaviors and economic factors explain a large proportion of the difference but the gap remains significant.


In terms of health, adults with a terminal GED are not equivalent to HS graduates. GED recipients report considerably worse general health and activity limitations. The disadvantage is only partly due to the worse economic outcomes and health behaviors; a significant difference remains unexplained and may be due to other, unobserved pathways, or to selection mechanisms.