Racial Disparities in Victim Compensation Program Claim Approvals for Adult Survivors of Sexual Assault: 18 US States, 2015-2023.

<b>Objectives.</b> To examine racial/ethnic disparities in victim compensation claim approval rates for adult survivors of sexual assault. <b>Methods.</b> We analyzed administrative data from 18 US state victim compensation programs (2015-2023), covering 45 934 claims from adult sexual assault survivors. We used multivariable linear probability models to examine predictors of claim approval, adjusting for survivor age and state and year fixed effects. <b>Results.</b> Of all claims, 93.4% were from women; 41.7% were from White, 20.8% were from Latina, and 15% were from Black applicants. Black and Indigenous women's claims were less likely to be approved than were White women's (<i>P</i> < .001). The most common denial reason was lack of evidence that a crime had occurred (34.4%). Racial/ethnic disparities appear to be driven by administrative paperwork burdens. Approval rates varied widely, from 29.4% in Illinois to 94.1% in New Hampshire. Claims referred by hospitals or law enforcement had higher probabilities of approval than did those referred by other sources. <b>Conclusions.</b> Racial disparities exist in victim compensation claim approvals. <b>Public Health Implications.</b> Removing police reporting requirements and simplifying application processes could reduce racial disparities in access to compensation for survivors of sexual assault. (<i>Am J Public Health</i>. 2026;116(3):380-386. https://doi.org/10.2105/AJPH.2025.308304).