Racial Disparities in US Infant Birth Outcomes: A Protective Effect of Military Affiliation?

Research has been unable to determine why African Americans have higher infant mortality and preterm birth prevalence than whites, even taking into account measurable social and economic differences. This is, in part, due to the difficulty of adequately measuring the impacts of racial inequality and residential segregation. As an alternative approach, this paper comparatively examines infant outcomes among military-affiliated and civilian black and white women. The military setting provides higher-than-average economic equality and universal healthcare access. Although military-affiliated populations are usually left out of most major datasets, we construct a new variable that allows us to identify military affiliation using the CDC's PRAMS survey data. Multinomial logistic regression analyses show that there is a negative association between adverse birth outcomes and military affiliation for both white and black women. Thus, the black-white infant mortality gap persists in the military even though black affiliates experience significant improvement in outcomes relative to their same-race civilian counterparts. Nevertheless, the black-white disparity among military-affiliated women is somewhat lessened compared to the black-white civilian disparity.