Infant Mortality Among Hispanics: The Epidemiological Paradox-Reply

In Reply.—  The apparent lack of correlation between the socioeconomic profile of Hispanics in the United States and their health outcome, such as birth-weight distribution and neonatal mortality rates, has been referred to as a "contemporary public health enigma"¹ and an "epidemiological paradox."² Our article confirmed this finding and acknowledged the role of behavioral factors among Hispanics as possible explanations, such as "better nutritional practices, higher regard for parental roles, and lower rates of smoking and alcohol consumption."Our article also provided indirect but strongly suggestive evidence of underregistration of infant deaths among Mexican Americans, especially in the postneonatal period. Infants of Mexican-American descent whose mothers were born in Mexico had worse birth-weight—specific neonatal mortality than Mexican-American infants whose mothers were born in the United States. However, the reverse is true for postneonatal mortality. That is, infants of Mexican-American descent whose mothers were born in Mexico had apparently