Little is known regarding how family racial structure and income intersect to produce health outcomes. We assessed infant health outcomes (weeks gestation and first year infant mortality rates (IMR)) by family racial structure (specific race group affiliation, and whether multiracial), examining the degree to which income (insurance type as proxy) interacts with family racial composition to predict infant health outcomes. This cross-sectional study utilized secondary data analysis of birth records and linked infant birth/death records spanning a 14 year period (2006–2019) for a single U.S. county. Income was dichotomized into low income and high income based upon insurance type. Race and ancestry data from infant, maternal, and paternal sources were combined into six pan-ethnic categories (Black, Asian, White, Native-American, Latino, and Middle Eastern). We used Generalized Estimating Equation to obtain the associations between a composite race x multiracial x income predictor and outcomes (infant death, weeks gestation), accounting for repeated mother births. Findings reveal that infants with Black heritage have the worst outcomes (12.34 IMR). Multiracial infants (20.5% of the population) tend to be from higher income families than monoracial minority infants. Looking further, we find that this translates to better outcomes depending on racial group and multiraciality. Multiracial higher-income Black families have substantially better outcomes (2.85 IMR) than their single Black race (12.63 IMR) or lower income multiracial peers (16.16 IMR). Single race White families also see health gains with higher income (3.60 IMR versus 6.02 IMR). Other minority race families, whether single or multiracial, see little health gain with higher income; instead, whether this group is multiracial or not is the determining feature (being single-race rather than multiracial is associated with better outcomes (0.97 IMR versus 5.39 IMR)).

关于家庭种族结构和收入如何相交以产生健康结果的情况知之甚少。我们通过家庭种族结构（特定种族群体归属，以及是否多种族）评估婴儿健康结果（妊娠周数和第一年婴儿死亡率（IMR）），检查收入（作为代理的保险类型）与家庭种族构成相互作用的程度预测婴儿的健康结果。这项横断面研究利用了出生记录的二手数据分析，并关联了美国一个县跨越 14 年（2006 年至 2019 年）的婴儿出生/死亡记录。根据保险类型，收入分为低收入和高收入。来自婴儿、母亲和父亲来源的种族和血统数据被合并为六个泛种族类别（黑人、亚洲人、白人、美洲原住民、拉丁裔、和中东）。我们使用广义估计方程来获得复合种族 x 多种族 x 收入预测因子与结果（婴儿死亡、妊娠周数）之间的关联，从而解释母亲重复出生。调查结果表明，具有黑人血统的婴儿的结果最差（12.34 IMR）。与单种族少数族裔婴儿相比，多种族婴儿（占人口的 20.5%）往往来自更高收入的家庭。进一步看，我们发现这可以转化为更好的结果，具体取决于种族群体和多种族。多种族高收入黑人家庭的结果（2.85 IMR）比他们的单一黑人种族（12.63 IMR）或低收入多种族同龄人（16.16 IMR）要好得多。单身白人家庭也看到收入更高的健康收益（3.60 IMR 对 6.02 IMR）。其他少数族裔家庭，无论是单种族还是多种族，收入越高，健康收益就越少；相反，这个群体是否是多种族是决定性的特征（单一种族而不是多种族与更好的结果相关（0.97 IMR 对 5.39 IMR））。