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Am J Public Health. 2012 May;102 Suppl 2:S284-90. doi: 10.2105/AJPH.2011.300524. Epub 2012 Mar 8.

Health in working-aged Americans: adults with high school equivalency diploma are similar to dropouts, not high school graduates.

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Department of Sociology, University of Wyoming, Laramie, WY 82071, USA.



We compared health outcomes for adults with the General Equivalency Diploma (GED) and regular high school diploma to determine whether GED recipients are equivalent to regular graduates despite research that documents their disadvantages in other outcomes.


We used 1997 to 2009 National Health Interview Survey cross-sectional data on high school dropouts, graduates, and GED recipients aged 30 to 65 years (n = 76,705). Five general health indicators and 20 health conditions were analyzed using logistic models.


GED recipients had a significantly higher prevalence of every health outcome compared with high school graduates (odds ratios = 1.3-2.7). The GED-high school differences attenuated but remained evident after controlling for health insurance, economic status, and health behaviors. For most conditions, the 95% confidence interval for GED earners overlapped with that for high school dropouts.


The high school equivalency diploma was associated with nonequivalent health: adults with a GED had health comparable to that of high school dropouts, not graduates. GED recipients were at increased risk for many health conditions, and their health should be viewed as distinct from regular graduates. The findings have implications for health and educational policies.

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