The Inspiration Behind this Disturbing Picture of Black American Health Insurance

By Alex Hillsberg

infographic-health-insurance-of-african-americansInfographic authored by Alex Hillsberg and Julia Trello

This infographic is a confluence of earlier projects done on African Americans. Black History month, celebrated in February of each year, was the catalyst that brought this all together. A single “Eureka moment.” Although in reality it wasn’t a moment of crystal-clear realization but rather one of irony.

I was debating with my peers the propriety of the term “Black Americans” and passionately passionate argument was made that the term “African American” was worse. Because, he said, Blacks don’t feel the connection anymore. They’re many generations removed from their ancestors who came over to America as slaves. Additionally, the adjective “African” will always be a reminder of that origin. Not a reminder of geography but of status. A permanent brand: “descended from slaves.”

“There’s absolutely nothing wrong with that!” One of us vehemently responded. “That’s the truth, it should be embraced, and Blacks should be proud that they survived the journey and thrived when they reached their destination.”

And then someone replied, “What destination?” In the land that their ancestors left there was widespread hunger, and obesity was a clear sign of affluence. In the new territories they landed in, after centuries of toiling, after bleeding and dying to be free, African Americans are now the most obese of all ethnic groups. And this, he said, is a clear sign of poverty. Because in this land of plenty the only food that African Americans have plenty of or have access to is cheap and unhealthy highly-processed fast food.

That was our “Eureka moment.” We still couldn’t agree on “African American” vs. “Black American,” but we had a story!

This was also the time when rumblings about the fiscal cliff deal were beginning, with taxes and income right in the epicenter of the tremor. Certainly, there was much discussion about how the Affordable Care Act (ACA) would be funded, and whether it would raise the health insurance costs of poor or near-poor African Americans who could ill-afford it.

We all knew that storyline defining the income household of African American households – the steady rise during the 1990s and the reversal of fortunes when the recession hit. Consider this: compared to just 38.2 percent of Black households in 1970, 57.9 percent of these households had incomes above $35,000 by the year 2000. That looked a lot of people revving up and out of poverty. But when the dust settled, everything had changed dramatically. By 2012 the figure had dropped to 46 percent of Black households earning more than $35,000. More dramatically, the percentage of Black households earning less than $15,000 spiked from just 14.5 percent in 2000 to 25.4 percent in 2012.

Then we were also reminded of the election rhetoric on makers and takers, about the 47 percent who do not pay taxes and impose upon the government the burden of welfare and unemployment support. Specifically, the 47 percent did not pay taxes because they had no income to tax. To us, it looked like they were being blamed for being poor and this argument was affecting deliberations on the provisions on the ACA.

There was also discussion of the early results from the National Health Information Survey at this time and it was clear right from the start that the 47 percent also had the most number of health issues. It looked to us like our story would develop into one on health disparities across ethnic and income groups.

As the see-saw contest between Democrats and Republicans on the ACA provisions was playing out, we pulled data from the National Health Interview Survey of the Center for Disease Control and Prevention and the US Census Bureau to create an infographic that would help us answer the following questions on the health insurance situation of African Americans:

  • Are there more uninsured Americans now and is the percentage of those who can’t afford health insurance rising?
  • Which of the ethnic groups are expected to live in good health?
  • Which groups are more likely to need care for their elderly?
  • Which of them are more likely to be uninsured?
  • What’s the health insurance picture like across income groups?
  • Where are uninsured African Americans clustered?

The answers we found are featured in the above infographic: Uninsured and Unhealthy: The Health Insurance Woes of African Americans. It’s not a pretty picture.

HillsburgAlex Hillsberg is one of the veteran finance authors at He has written for financial websites and hosted a number of blogs dedicated to helping average Americans to pursue their financial goals. Visit his LinkedIn here.

-Julia Trello has four years experience in financial reporting and is part of the editorial team at, where she writes features and tips to promote wealth creation and management for everyone.