Project Summary This project focuses on whether the COVID-19 pandemic has put the well-established Hispanic infant health advantage in peril. The U.S. Hispanic population has been one of the hardest hit by the COVID-19 pandemic with some of the highest rates of hospitalization, death, and illness, due in large part to overrepresentation in frontline occupations. The adult mortality impact on the Hispanic American population has been stark—Hispanic life expectancy experienced the largest decline across all racial/ethnic groups, with the exception of non-Hispanic American Indian and Alaska Native populations. The impact on infant health, however, is not yet known. We leverage U.S. Natality data (2015-2022) to first determine whether Hispanic perinatal outcomes have been impacted by the COVID-19 pandemic, for the overall population and disaggregating by three critical sources of heterogeneity in the Hispanic population—nativity, region-of-origin, and maternal education level. Second, given pronounced temporal and geographic variation in the pandemic’s progression, we determine whether impacts vary at the county-level and by county-level disease burden. Third, we assess whether either county poverty level and/or Hispanic concentration moderates the identified impacts. Determining if, for whom, and in what context, the Hispanic birth advantage has been impacted by the pandemic is critical for determining where to focus resources, not just at birth, but also at other stages of child development. Establishing these patterns is a fundamental piece of a full accounting of the extent of the pandemic’s toll on our country, particularly how it altered the health of such hard-hit U.S. sub-populations as Hispanic Americans.