Infant mortality among moderately low birth weight infants in Alabama, 1980 to 1983

A previous study of postneonatal deaths among normal birth weight infants in Alabama indicated that rural residence increased the risk of postneonatal death, the magnitude of the excess risk in the black population, and the risk of death from preventable causes. To determine whether this pattern persisted in a group presumably at higher than usual risk of infant death, patterns of mortality among infants weighing 1500 to 2499 g at birth and born in Alabama between 1980 and 1983 were examined by race, residence, and cause of death. Neonatal and infant mortality rates were higher for black infants; postneonatal mortality rates were higher for black infants. Neonatal mortality was highest for white infants from the rural part of the state; post-neonatal mortality was highest for black infants from the rural part of the state. There was little variation in the proportion of preventable postneonatal deaths by race or residence (17.6% for all) but almost twice as many white deaths were not preventable as black ones (39.0 vs 21.9%). It is posited that rural residence may actually be a surrogate measure for lack of access to health services.