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November 15, 1985

Reducing Black Neonatal Mortality

Author Affiliations

Deaconess Hospital University of Oklahoma Health Sciences Center Oklahoma City

JAMA. 1985;254(19):2735. doi:10.1001/jama.1985.03360190041007

To the Editor.—  The important article by Binkin et al1 has added the most convincing evidence to date that black newborns have lower mortality rates in all weight-specific groups under 3,000 g. Because there has been recent criticism that studies performed years ago should not be relied on,2 the authors' results, which confirm and extend the 1960 linked birth—cohort study, are timely.Were it possible to include all births, deaths, weights, and gestational ages and to complete all linkages in vital statistics information, the differences in weight-specific mortality between blacks and whites of low birth weight could be greater than the authors report, and all mortality rates could be higher, particularly in the very-low-birth-weight groups (500 to 1,499 g). It is in the very-low-birth-weight groups, numbering less than 1% of all live births, that approximately 30% of all neonatal deaths occurred in California. It is also in these