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May 1986

Health–III Health in the Rich and the Poor

Author Affiliations

Department of Tropical Pathology School of Pathology of the University of the Witwatersrand and the South African Institute for Medical Research Johannesburg, South Africa

Am J Dis Child. 1986;140(5):409. doi:10.1001/archpedi.1986.02140190019008

Sir.—Recent inquiries have stressed the higher morbidity and mortality rates of child populations in lower compared with higher socioeconomic classes. At a conference in 1982, it was stated, "Although infant mortality rates (IMR[s]) in the USA have fallen in both blacks and whites, blacks' 90% excess IMR in 1900 remains unchanged."1 In the United Kingdom as late as 1972, the IMR in social class V was more than double that of class I.2 From an investigation titled "Racial and Socioeconomic Disparities in Childhood Mortality in Boston,"3 it was found that:

Childhood mortality was significantly higher among black children and low-income children....If the death rate among the poorest group of children had been similar to that among the wealthiest, then more than one out of every three deaths in the poorest group would not have occurred....These data suggest that despite access to tertiary medical services, substantial social