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Walter Menaker, M.D., M.P.H.
JAMA. 1960;174(10):1346-1347. doi:10.1001/jama.1960.03030100114033.
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To the Editor:—  The paper by Schroeder on mortality from cardiovascular disease in relation to treated water supplies (J. A. M. A.172:1902 [April 23] 1960) does not state the magnitude of the difference in mortality rates for white men ( aged 45 to 64 years ) living in hard water and soft water states. The 12 states with softest water (lowest quartile) show a death rate for cardiovascular diseases that is only 10% higher than the 12 states with hardest water (when each state's population is given due weight). Furthermore, the 12 softest water states show an average death rate for these diseases (if each state is given equal weight) barely above the national average. Six of these 12 states are below the national average in mortality rate for these diseases. Such facts do not lend support to the hypothesis that soft or softened water increases cardiovascular mortality; indeed, the


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