1. Starfield B. Primary care and health: a cross-national comparison. JAMA. 1991; 266:2268-2271. 2. Lurie N, Ward NB, Shapiro MF, Gallego C, Vahiwalla R, Brook RH. Termination of medical benefits: a follow-up study one year later. N Engl J Med. 1986;314:1266\x=req-\ 1268. 3. Fihn SD, Wicher JB. Withdrawing routine outpatient medical services: effects on access and health. J Gen Intern Med. 1988;3:356-362. 4. Calkins DR, Bums LA, Delbanco TL. Ambulatory care and the poor: tracking the impact of changes in federal policy. J Gen Intern Med. 1986;1:109-115. 5. Starfield B. The Effectiveness of Medical Care: Validating Clinical Wisdom. Baltimore, Md: The Johns Hopkins University Press; 1985.
Neonatal Homicide Following Roe v Wade To the Editor.\p=m-\Theletter by Dr Lester1 in JAMA entitled, "Roe v Wade Was Followed by a Decrease in Neonatal Homicide" is a beautiful example of how statistics can be manipulated to support whatever view one holds on an issue. While it may be true that numbers don't lie, they can be distorted. Lester claims "neonatal homicide is accurately recorded," but then goes on to say that "in 1980, for example, only 48% of the infants who died under the age of 1 year were autopsied." If less than half of infant deaths were followed by autopsies, then surely our "accurate records" on neonatal homicide must be viewed with at least a little suspicion. His article includes a table that illustrates that while homicide rates of persons less than 28 days old significantly decreased in the first 10 years after Roe v Wade, the homicide rates for all those less than 1 year old showed no significant change. If this is true, then one could just as easily conclude that Roe Wade was associated with an increased rate of infant homicide in the 2- to 12-month-old age group. The table further illustrates that there was a significant increase in homicide for the 1- to 4-year-old age group. Does this then incriminate Roe Wade as the cause? Perhaps Roe Wade led parents to conclude that since it was legal to murder their children before birth, then homicide before kindergarten was also justifiable? Lester's concluding statement that "neonatal homicide was reduced by Roe Wade" is ludicrous, for even if this were true, it has been at the expense of a staggering increase in the total number of homicides for the age group conception to 28
days.
Steve M. Skinner, MD University of Texas Health Science Center San Antonio 1. Lester D. Roe
v
1992;267:3027-3028.
Wade
was
followed
by a decrease in neonatal homicide.
JAMA.
To the Editor.\p=m-\Theletter entitled "Roe v Wade Was Followed by a Decrease in Neonatal Homicide"1 by Dr Lester is a sad example of misinterpretation of data for the sake of ideology. Lester's conclusion that neonatal homicide was reduced by Roe v Wade is contradicted by his own data and other published information. The statistically significant decrease in the newborn homicide rate from 1963 through 1972 was halted after Roe v Wade, when the number of abortions in the United States increased explosively. A detrimental effect of legalized abortion on infant homicide is thus identified. If this were not true, then the newborn homicide rate should have continued its decline. After Roe v Wade, the overall US homicide rate increased significantly by 39% and the rate for children 1 to 4 years of age increased by 73% (P
Neonatal Homicide Following Roe v Wade To the Editor.\p=m-\Theletter by Dr Lester1 in JAMA entitled, "Roe v Wade Was Followed by a Decrease in Neonatal Homicide" is a beautiful example of how statistics can be manipulated to support whatever view one holds on an issue. While it may be true that numbers don't lie, they can be distorted. Lester claims "neonatal homicide is accurately recorded," but then goes on to say that "in 1980, for example, only 48% of the infants who died under the age of 1 year were autopsied." If less than half of infant deaths were followed by autopsies, then surely our "accurate records" on neonatal homicide must be viewed with at least a little suspicion. His article includes a table that illustrates that while homicide rates of persons less than 28 days old significantly decreased in the first 10 years after Roe v Wade, the homicide rates for all those less than 1 year old showed no significant change. If this is true, then one could just as easily conclude that Roe Wade was associated with an increased rate of infant homicide in the 2- to 12-month-old age group. The table further illustrates that there was a significant increase in homicide for the 1- to 4-year-old age group. Does this then incriminate Roe Wade as the cause? Perhaps Roe Wade led parents to conclude that since it was legal to murder their children before birth, then homicide before kindergarten was also justifiable? Lester's concluding statement that "neonatal homicide was reduced by Roe Wade" is ludicrous, for even if this were true, it has been at the expense of a staggering increase in the total number of homicides for the age group conception to 28
days.
Steve M. Skinner, MD University of Texas Health Science Center San Antonio 1. Lester D. Roe
v
1992;267:3027-3028.
Wade
was
followed
by a decrease in neonatal homicide.
JAMA.
To the Editor.\p=m-\Theletter entitled "Roe v Wade Was Followed by a Decrease in Neonatal Homicide"1 by Dr Lester is a sad example of misinterpretation of data for the sake of ideology. Lester's conclusion that neonatal homicide was reduced by Roe v Wade is contradicted by his own data and other published information. The statistically significant decrease in the newborn homicide rate from 1963 through 1972 was halted after Roe v Wade, when the number of abortions in the United States increased explosively. A detrimental effect of legalized abortion on infant homicide is thus identified. If this were not true, then the newborn homicide rate should have continued its decline. After Roe v Wade, the overall US homicide rate increased significantly by 39% and the rate for children 1 to 4 years of age increased by 73% (P
