Response to Dr. Kleinman's Further Comments on 'State Trends in Infant Mortality

lem. Although small numbers do limit the utility of follow-up studies, such studies need not be confined to trend analysis. Contrary to her statements, there are methods available for sub- group analysis of infant mortality rates and there have been several examples of such analyses providing practical guidance for health programs.' Dr. Zemach's final concern is that "This is not the way State health officials study and use IMRs.''" I agree with her statement and, in fact, this is one of the major reasons I wrote the article. The purpose ofthe article was to present a relatively simple statistical method for analyzing trends in IMRs and point out that the power to detect changes in trend at the State and local level is limited. The method emphasizes the need to assess random error and avoid the pitfall of highlighting a single year's increase (or decrease) without consideration of the long-term trend. The method was proposed as a useful addition to, not a substitute for, other methods that are used to study IMRs

Environmental health · Infant mortality · Population · Sociology · Birth, Development, and Health · Demography · Medicine · Psychology

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• State trends in infant mortality, 1968-83

  J C Kleinman•American Journal of Public Health•1986

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