Head and neck squamous cell carcinoma (HNSCC) is the most common type of cancer in the head and neck, including oral cavity, pharynx, larynx, nasal cavity, and other head and neck sites. In the United States, Black patients had a 20% higher death rate of HNSCC than Whites. Barriers to health care access among racial minorities may delayed diagnosis, advanced tumor stage, suboptimal treatment, and poor survival. Different from the disparity in the U.S. general population, the Department of Defense’s (DoD) Military Health System (MHS) provides universal health care access to all its beneficiaries with various racial background and socio-economic status. This study compared overall survival of non-Hispanic White and non-Hispanic Black patients in the MHS and the U.S. general population, respectively. We hypothesized that Blacks and Whites with HNSCC had similar survival in CCR, while Blacks had worse survival than Whites in SEER. As racial disparity of oropharyngeal cancer is heavily influenced by human papillomavirus (HPV), which also exhibits racial disparity, we further performed analysis for oropharyngeal and non-oropharyngeal sites, separately. The MHS patients were identified from the DoD’s Central Cancer Registry (CCR) and the patients from the U.S. general population were identified from the National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER) program. For each patient cohort, a retrospective study was conducted comparing the racial groups in overall survival. All patients were diagnosed with HNSCC between January 1, 1998, and December 31, 2014. The study outcome was all-cause death. Patients were followed up to death or December 31, 2015, the last year of the data. Patients who were alive by the end date of the data were censored. Kaplan-Meier (KM) survival curves were constructed and compared between White and Black patients using log-rank test for each cohort. Further, Cox proportional hazard models were used to estimate hazard ratios (HRs) and their 95% confidence intervals (95% CI) for Black patients compared to White patients within MHS and SEER, respectively, with adjustment for confounders. Results showed that there was no survival difference in KM curves between Black and White patients in the CCR cohort (Log-rank p=0.336), while among patients from the SEER cohort, Blacks showed significantly worse survival than Whites (Log-rank p<0.0001). In Cox regression models sequentially adjusting for confounders, Blacks and Whites in the CCR cohort had similar survival in all modes (HR=1.04; 95% CI=0.81-1.33 in the final model). In contrast, Blacks in the SEER cohort exhibited significantly worse survival than Whites in all models adjusting for the same sets of confounders (HR= 1.47; 95% CI= 1.43-1.51 in the final model). All results remained similar in stratified analysis by oropharyngeal and non-oropharyngeal sites. Our study findings suggest that health care access might play an important role in racial disparity among HNSCC patients in the general population. Equal access to health care, as that in the MHS, could reduce the survival disparity among HNSCC patients in the U.S. general population.