Overlooking Infant Mortality

I was disappointed in your article on the top 10 health stories for 1991 {Cover, Jan. 1}, which stated ". . . the U.S. can claim its superpower status in health." The article made no mention of the plight of children in America, which is hardly a demonstration of superpower status.

While American adults may now have a life expectancy that is higher than ever, the future for America's children is becoming grimmer each year. The United States ranks 22nd among nations in child mortality and 29th in the world in low birthweight babies, who are 20 times more likely to die. Iran and Bulgaria have lower percentages of low birthweight babies.

Of the 71 nations attending the World Summit for Children last September, nearly all have signed the United Nations' Convention of the Rights of the Child -- except for the U.S. Marilyn Kodish Gaithersburg Health Care as a Right

In discussing the politics of expanding health care coverage as one of the 10 top health stories for this year, the president of the Health Insurance Association of America is quoted as saying that the "key step is cost containment."

Wrong. The key step is becoming mature and civilized enough to recognize medical services as a right, an essential ingredient of Jefferson's pursuit of happiness. Then we can control cost equally, as has Canada. Too long have we allowed the insurance industry to manipulate us with irrelevant arguments. John Abernethy Washington Removing Birthmarks

The description of a successful treatment of a port-wine stain with the tunable dye laser {Children's Health, Jan. 8} is accurate, but the accompanying photograph shows a child with a mark more closely resembling a strawberry birthmark than a typical port-wine stain. This gives the impression that the tunable dye laser therapy is currently being successfully used for the strawberry stain, which it is not.

The port-wine stain is initially a flat, pink to red birthmark that may occupy up to one-half the surface area of the face. This lesion does not fade with time, and the component blood vessels are small and superficial enough to be within the effective penetration depth of the tunable dye laser.

The mark shown in the photograph is more circumscribed and elevated from the surface of the skin and made up of larger, deeper blood vessels. Treatment of this lesion with any type of surgical intervention, including the laser, is controversial, since the strawberry mark tends to flatten and almost totally disappear spontaneously during childhood. The tunable dye laser would not penetrate to the depth that would destroy the blood vessels that make up this lesion. Other lasers that do penetrate more deeply have been tried, but their use has been associated with significant side effects. Ronald A. Katz, MD College Park President Washington, D.C., Dermatological Society Media's View of Unwed Motherhood

Leave it to The Post to dig up some obscure book on the sexual habits of farm women in the 18th century as a viable remedy for what ails young women today {Second Opinion, Jan. 8}. Who cares what those women did back then? The point being that it wasn't they who established social criteria anyway.

We all know there have been, and always will be, illegitimate births. The difference in our own time, however, is our lack of shame about the condition -- that sense of shame that encouraged fathers long ago to be responsible for their families. One reason our problems keep compounding and do not yield to a remedy is the unwillingness of the media to face facts and accept responsibility for the burden of citizenship itself. Carroll Tracy McLean

Letters must be signed and include a home address and home and business telephone numbers. Letters may be edited. Although we are unable to acknowledge all letters, we appreciate the time and value the viewpoints of those who write. Send letters to Health Section, The Washington Post, 1150 15th St. NW, Washington, D.C. 20071.