Wikipedia:Ageism
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![]() | This page in a nutshell: This is a new essay on Ageism that probably should be retitled "Ageism in the United States" to avoid confusion with the first essay. The argument for discriminating against adolescents in ways that would not be acceptable if applied to adults rests in the same dubious non-science once applied to race and requires infusion of dynamic new information. A modest effort is provided here. |
Ageism — as defined by adults who control the debate — denies the individuality of a person under a certain age while enshrining the individuality of a person over that age. The individuality accorded adults and the de-individualizing of young people, as will be shown, have created a prejudicial climate against adolescents in the absence of scientific evidence linking adolescent age to undifferentiated, immature behavior. Not only is individuality a far more important factor, what we call immature teenage behavior is linked to the same conditions that produce immature behavior in adults.
There are two reasons that arguments supporting ageism should be viewed skeptically. The first is that prejudice often provides substantial legal, social, and psychological advantages to the controlling group. A wide array of interests, from law enforcement, “culture war” entities, and politicians to liberal program advocates, benefit from ageism, as do adults in general. Americans tolerate imposing high levels of poverty (15% to 20%) on adolescents[1] at the same time we expend great public resources through private and public allocation systems to prevent poverty in the middle-aged and elderly. As we document at YouthFacts.org[2] from systematic fact-checking, lower standards of political rhetoric, academic discussion, author veracity, and journalism are applied to youth issues, leading to prejudicial statements that would not be acceptable — in fact, would be considered hate speech — if applied to other groups such as races or ethnicities. Our review of expressions toward adolescents in general by journalists and their sources on "teenage brain" issues revealed an ugly stream of name-calling: “stupid,” “crazy,” “reckless,” “immature,” “irrational,” “troubling,” “exasperating,” “mindlessly hormonal,” and even “alien”[3]. It is because prejudices such as ageism offer such a wide range of benefits and conveniences to the prejudiced that they require rigorous scrutiny—and also why they so often fail to receive it.
The second is that defining adolescents as fundamentally different from adults requires invokingbiodeterminism: the theory, applied to establishing racial, ethnic, and gender hierarchies in the past now applied to declare adolescents inescapably limited by immutable biological flaws. Thus, ageist arguments demand special rigor to establish, which they do not so far display. Many of the controversies cited in this counter-commentary are detailed in one of the few balanced discussions of the issue, in the January 2010 Journal of Adolescent Research[4].
Arguments based on convenience and tradition
Arguments for ageism based on culture, tradition, and personal impressions require the same strict analysis afforded traditional/cultural racism and sexism. Traditional coming-of-age rituals, including Bar Mitzvah, coincided with puberty or even earlier milestones, not with arbitrarily elevated, and often contradictory, ages of adulthood found in the United States. If cultural tradition is to be the guideline, most cultures denied basic adult rights to females and minority races in their power as well. We cannot assume denying rights to young people is based on any loftier thinking.
A paradoxical outgrowth of ageism is the requirement that teenagers must display more mature, mistake-free behaviors than adults. Teenagers are expected, and often legally required, to invoke the self-discipline to completely abstain from drinking, smoking, any form of sexual expression, accessing certain items and media, and public presence. For example, it has been noted that senior editors at Wikipedia who placed confidence in teenaged editors and authors would face greater condemnation if an error occurred than if they relied on adults. In an analogous situation, allowing a Muslim to write an article about Christianity might subject editors to more condemnation if a mistake occurred than allowing a Christian to write about Islam. The problem, of course, remains the mistake, not the demographics of the author. The convenience of imposing super-standards on adolescents is that adults entitle ourselves to lower expectations and standards.
We also hear arguments for ageist discrimination based on adults’ negative “personal experience” with and impressions toward adolescents, often phrased (as in a recent Supreme Court decision[5]), “...as every parent knows…” This, again, is a manifestation of self indulgence and power, not science. A mature analysis would note that adolescents put up with parents’ 50% divorce rates (for all the alleged adult-teen conflicts, parents get along with their teens much better than they get along with each other), family conflicts, hundreds of thousands of substantiated violent, sexual, and pyschological abuses, widespread, rising crises of drug abuse, criminal arrest, imprisonment, and community and family disarray caused by midlife adults, and high levels of poverty. Maturity would demand that adults face the problems we cause teenagers, not pretend innocence, perfection, and victimization by youth.
Arguments based on laws and customs
Laws, policies, customs, and court rulings regarding minority rights have liberalized over time, not in response to more sophisticated scientific inquiry and evolving legal reasoning, but simply to gains in power by previously oppressed groups[6]. If minorities do not manifest power sufficient to punish those who discriminate against them, authorities still favor the powerful over the powerless[7]. Once a group attains power, liberalized science and policy will follow. Even Supreme Court decisions regarding minority rights reflect unevolved attitudes of an era that often do not stand the test of time, as a review of Plessy v Ferguson[8] would show. Aegist laws and customs regarding adolescents are based on logic very similar to that found in Plessy.
Many are under the misimpression that "minor" is a protected status in the United States and cite rare exceptions to justify this view. For example, the Supreme Court’s rulings exempting juveniles from the death penalty[9] and life in prison without parole under narrow circumstances[10] might affect one or two youths per year. These must be set against a backdrop of dozens of anti-youth Court decisions that simultaneously deny rights and inflict harsher treatments and penalties on young people solely because of their age. In the US, adolescents as a class may be subjected to house arrest (curfews) for all but a couple of hours per day (the US Supreme Court refused to hear a 1991 challenge to the Dallas, Texas, youth curfew), forced to bear children against their will[11], held indefinitely without bail on any charge[12], subjected to violent punishments and discipline that would be considered “cruel and unusual” if inflicted on adults[13], subjected to unlimited censorship of expression and consumption[14], denied any and all constitutional rights based on little more than authoritative whim[15], and forced to prove “mature minor” exceptions where adults’ maturity is simply assumed[16], among other afflictions.
Those who advocate for ageist discrimination against adolescents should acknowledge that in the United States, the most general result will not be protective, but harsher treatment of young people. The Office of Juvenile Justice and Delinquency Prevention[17] and Center on Juvenile and Criminal Justice[18] analyses find that offenders under age 18 typically serve longer periods of incarceration for the same offenses than adults do (“do adult crime...do more than adult time,” as OJJDP words it (p. 178)), with juvenile courts meting lengthier sentences than adult criminal courts. The reason is that youths are forced to give up crucial rights, including the right to presumption of innocence, trial by jury, cross examination, transcript, and appeal, which weakens their defense options and exposes them to more severe punishments than adults receive.
In another example, alcohol regulation, some 500,000 teenagers are arrested for “underage” alcohol violations every year[19]. Yet, the same safety advocates who justify this massive arrest policy have failed to acknowledge Fatality Analysis Reporting System data showing that drunken driving by adults ages 21 and older kills more than 400 teenagers — the sixth leading cause of death among U.S. teens — and injures another 40,000 every year[20]. This is far larger than the toll drunken teen drivers extract on adults. The dual sacrifice teens are forced to make—punishment and exclusion from legal alcohol privileges on one hand, deaths and injuries from adult enjoyment of alcohol on the other—enables more relaxed standards for adult drinking characteristic of the U.S.
A similar pattern of youth-crackdown, adult-leniency is evident with regard to drugs, where draconian tactics toward teens (including mass drug testing of students and multiagency punishments for mere suspicion) have enabled a burgeoning, officially unadmitted middle-aged drug abuse crisis to erupt, which in turn subjects teens to household disruption and community violence. Centers for Disease Control data reveal a drug abuse fatality crisis centered in middle-aged white adults, who now account for well over half the 37,000 illict-drug deaths every year[21]. US middle agers, the age group most likely to be parenting teens, is six times more likely to die from illicit drug poisonings than their counterparts in other western nations, World Health Organization mortality statistics show[22].
The examples of anti-youth ageism rebounding to downplay and promote leniency toward deadly behaviors by grownups are endless. For yet another example, gun regulation, which strictly bans persons under age 21 while allowing adults in most states to obtain and possess firearms with little regulation, accompanies statistics showing three-fourths of murdered adolescents and children (at least 500 per year) are killed by grownups, not by peers[23]. The unique risks of American culture are due in large measure to the failure to develop customs and laws imposing strict behavior standards on adults, a failing enabled by the unique over-emphasis on enforcing draconian prohibitions on adolescents.
Arguments based on psychological differences
Even when American adults’ risky behaviors are acknowledged, the argument quickly follows that they’re carryovers from excesses in adolescent years, once again shifting the focus away from holding adults responsible for their behaviors and back to the need to control teens. This argument is both questionable (today, serious behavior problems are developing in adulthood) and misdirected, in that age-based behavior risks go both ways (risky teen behaviors reflect those of adults around them). For example, where adults have high rates of alcohol and drug use, drunken driving crashes, criminal arrest, homicide, suicide, accidental deaths, unplanned pregnancy, HIV and other sexually transmitted disease, smoking, and otehr ills, teenagers display correspondingly high rates[24]. Even if teenagers' super-responsibility to engage in absolute, clean living amid an adult party culture is accepted, it would require acknowledgment of a distinct developmental advantage of the teenage brain: the greater flexibility to change destructive behaviors than are found in more rigidly structured older brains[25].
The history of dubious “scientific” claims that inevitably affirm existing racial, religious, ethnic, gender, etc., hierarchies should give pause to the latest round of biodeterminist assertions regarding adolescents[26]. Any biological difference, real, exaggerated, or imagined, between the “superior” and “inferior” classes—in this case, modest differences in a few small-sample studies of brain physiology using experimental functional magnetic resonant imaging (fMRI) technology—is interpreted as demonstrating the latter’s innate inferiority. Whether the population being posited as biologically inferior is Africans, Native Americans, and other “savage races” in the 1890s, Algerians in the 1950sThe Wretched of the Earth, Mexicans and other “hot blooded peoples” in the 1940s[27], or adolescents today, the process of postulating its inferiority follows a set pattern and employs a predictable set descriptors.
The negative traits attributed to the inferior population (and, by implication, absent in the superior population) follow a centuries-long pattern. In each case, the population designated as inferior is described as impulsive, pathologically aggressive, emotionally volatile and reactive, prone to take risks while disregarding future consequences, hypersexual (tones of envy may creep into deplorings of this trait), vulnerable to group mentality, and incapable of higher order thought. In each case, the flaws of the “superior” group are systematically ignored amid conceits of moral, intellectual, and behavior perfection.
In each case, the flaws of the “inferior” group are attributed to its own internal biology and attraction to base cultural manifestations while differing external conditions and environments are ignored. In each case, differences in theoretical physiology and actual risk-behavior outcomes between groups that hold more political power — such as men versus women, or different races — are downplayed even though they are much more profound than those dividing adolescents from adults.
And in each case, after decades of discriminatory and damaging policies, the “science” upholding racist and ethnicist notions is discredited. We are only seeing the latest phase of dubious biodeterminism. In fact, as will be shown, adults and adolescents act in strikingly similar manner when evaluated under the same conditions. Rates of teenage crime, violent death of every type, unplanned pregnancy, firearms mortality, drunken driving, and other key risks can be predicted with compelling accuracy not from some unfounded theories of “adolescent risk taking,” but from the practical measures of the corresponding risk outcomes of adults around them and youth poverty levels.
Drawing conclusions from the very primitive stage of brain research, especially from the newer techniques of magnetic resonant image scanning, represent little more than commentators' prejudicial guesswork. Brain research is not even nearly at a stage at which physiology can be linked to behavior[28]. If it was, the deteriorations in memory and learning genes in over-40 brains[29] should be a subject of the most "developmental" concern at present, given the manifestly risky behaviors displayed by midlife American adults absent sociological explanations. The “adult brain,” far from representing an apex of developmental and evolutionary maturity, actually displays rigidities and deteriorations that become quite pronounced after age 40, including difficulties in reversing destructive behaviors and prejudicial impulses.
Claims of unique adolescent rashness, lack of impulse control, and lack of forseeability are further contradicted by a wealth of risk research that consistently shows that adults, not youths, overestimate their invulnerability and make riskier decisions[30] — one of the many incovenient findings omitted from ageism discussion. It should be noted that the interpretation of otherwise uninterpretable brain scans, psychological findings, and developmental manifestations ultimately have been organized into a theory of "adolescent risk" by the overrepresentation of older teens in certain behavior outcome statistics, another questionable approach.
Arguments based on risk-behavior statistics
The argument that adolescents represent a class distinctly inferior to adults rests in selective statistical data that functions as a measure of risk. I will examine the three risk behaviors most often cited, which on their face might appear compelling. First, per mile driven, drivers age 16-19 suffer fatal traffic crash rates approximately 4.3 times higher than the safest adult group, age 45-54. Second, teens age 14-17 experience arrest rates for Part I (felony violent and property) offenses more than five times higher than middle-aged adults. Third, firearms homicide levels are four to five times higher among older teenagers than among middle-agers. My review with the help of numerous authorities and journal editors found that so-called "scientific" assumptions about "adolescent risk taking" have been made without comparing teenagers and adults under the same socioeconomic conditions, a crucial failing as will be discussed.
I call these measures "selective" because other measures such as suicide rates or illicit-drug mortality rates, both key measures of risky behavior for which adolescents and young adults show distinctly lower rates than do older adults[31], are omitted from discussion. In addition, even larger differences in, say, fatal traffic crash rates among Native Americans, Mississippians, and men compared to other races, Connecticuters, and women; criminal arrest and firearms homicide among African Americans compared to Whites or Asians; and suicide and drug abuse among older whites compared to older Latinos[32] are not now cited as proof of innate racial and gender-based differences in risk taking, though scientists did in the past. Rather, when confronted even with large race, gender, ethnic, or geographic discrepancies in risk outcomes, modern scientists cite differences in external conditions, not inner biologies, as explanations.
The fact is that American adolescents occupy a sociodemographic environment that is distinctly different than that of middle-aged adults. Compared to older adults, teenagers are substantially more likely to be male (51%) and black, Hispanic, Native, or of mixed race (47%). More important, teens and young adults are twice as likely to live in households below the poverty line (18%) and 2.5 times more likely to live in destitute households (incomes less than half the poverty threshold, 10%) than are the middle-aged adults (9% and 4%, respectively)[33] to which their risks are typically compared.
Poverty is a known elevator of most serious risks across the age span. Responsible, modern social scientists do not compare the mortality, crime, or other risk behaviors of different populations without first controlling for external social and economic factors. So, enlisting the help of several authorities and journal editors, we searched for studies that directly compare adolescents to adults under equivalent conditions. Bluntly, we found none. There was no evidence that what we call “adolescent risk taking” is anything more than a function of the higher poverty rates of youths compared to adults, in the same way that the even higher risk outcomes of African Americans reflect their higher poverty rates compared to whites.
So, I undertook preliminary studies to assess whether teenage risk is simply “poverty risk” of the type that produces riskier behaviors in adults as well. In a series of studies based on Fatality Analysis Reporting System and National Center for Health Statistics data and published in the Journal of Safety Research, Journal of Adolescent Research, and Californian Journal of Health Promotion, we found that teenagers’ much higher likelihood of living in environments of poverty explains all of what we call "adolescent risk taking" in traffic crashes per mile driven, gun mortality rates, and criminal arrest rates of every type.
Specifically, when the state, county, and zipcode poverty rates are held constant, there is no difference between the risk of a 17-year-old and a 45-year-old in terms of causing or dying in a fatal traffic accident, arrests for serious or petty crime, or firearms fatality. Where middle-aged adults are subjected to the same high levels of poverty typical of American youths (15% to 20%), middle-aged adults display similarly high levels of risk behaviors and outcomes.
For example, compared straight across, the number of fatal traffic crashes per 100 million miles driven for California drivers age 16-19 (50) is nearly four times the rate of drivers age 45-54 (14), the safest adult age. But when compared at equivalent poverty levels, the fatal crash rate for 16-19 year-olds (34 per 100 million miles) closely resembles that of 45-54 year-olds (32). For another example, compared straight across, the violent crime arrest rate per 100,000 population for Californians age 15-19 (1,151) is more than triple that of age 45-54 (361). But when compared at an equivalent poverty level, the violent crime arrest rate for age 15-19 (676) is actually below that of age 45-54 (842). Leveling the economic playing field dramatically alters teenage versus adult risks.
Where age-based discrepancies remained, they cut both ways. For example, higher rates of teenage arrest for robbery persisted even after controlling for poverty, while middle-agers suffered excessive arrest rates for assault and drug offenses. While new research directions require more replication, it is astonishing that these kinds of direct youth-adult comparisons had never been made before in the literature.
Unless carefully controlled studies establish a consistent pattern of adolescent risk outcomes absent any similar pattern in adults after controlling for diverging demographic and economic conditions—studies that are not now in evidence—claims that teenagers are uniquely prone to impulsive, thoughtless, peer-driven, and otherwise risky behaviors remain unfounded. Such studies would have to explain why, if teenagers innately are unable to control their impulses, what we call “adolescent risk taking” is not spread evenly across the population but is highly concentrated in those suffering externally-imposed disadvantage.
Yet, noted authorities with the approval of others make patently ridiculous statements about teenagers, such as Dr. Peter Ash point that, “It's one thing to say teens don't control their impulses, but another to show that they can't.”[34]. Yet, more affluent youths—such as those in Western nations and the U.S. who enjoy low poverty rates similar to those of middle-aged Americans—display very low rates of risk similar (and in many cases lower than) those of middle-agers. For a salient example, we examine why Marin County, California, adolescents, despite having "teenage brains," driving far more miles per year, engaging in substantially higher rates of sexual activity, and reporting higher rates of a wide array of "adult" behaviors than teens elsewhere, consistently display the lowest rates of traffic fatality, violent death, self-inflicted death, unplanned pregnancy, sexually transmitted infection, criminal arrest, and other ills of young people anywhere, lower even that older California grownups. The reasons are the same that produce low risks among older adults: Marin teens enjoy low poverty rates, driver newer-model safer cars, have safer road conditions, value education and future success, have access to good health services, and an array of other advantages we middle-aged and elder Americans award to ourselves but deny to millions of teenagers. It is not age, or brains, or peers, or race, but favorable conditions that produce lower risks.
Reversing ageism
What are the elements of “maturity”? Is the designation awarded simply based on attaining an arbitrary age, as Americans practice? Or does it embody difficult-to-achieve qualities necessary to handle rights, responsibilities, and power?
One would expect that a mature discussion would frankly acknowledge the flaws of grownups, weigh those against adolescent shortcomings in an objective manner, and arrive at a fair and reasoned conclusion about relatives strengths and risks by age. This maturity is nowhere in evidence. I’ve taken in dozens of scholarly essays, reports, commentaries, and press articles on the “teenage brain,” “adolescent risk taking,” and comparative pieces on youths and adults. Using deeply biased techniques and illogic, they all (with one exception, see below) attribute a set of negative qualities to teenagers and—more tellingly—depict older grownups as the epitome of perfection, enjoying cognitive flawlessness and behavior perfection.
Instead of engaging difficult counter-arguments and facts in a mature and scientific manner, commentators on adolescent-versus-adult issues consistently avoid them. That functional magnetic resonant imaging techniques also show serious deficiencies in middle-aged and older brains, that parents display high levels of divorce and family conflicts, that middle-agers are suffering explosions in drug abuse and crime, and that when subjected to poverty levels characteristic of teenagers, older adults show risks similar to teens—all of these are issues simply banished from discussion. There are more.
Rather than manifesting the maturity and high-order reasoning its advocates attribute to grownups, the arguments for ageism violate fundamental standards of scientific inquiry and indulge primitive stereotypes long rejected in discourse on racial or gender issues. In the reality of hard behavior-outcome statistics, the biggest problems are not teenage immaturity, but the failure of older generations (who are now the richest in history) to equitably share resources with younger generations and to better control increasing troubles among modern adults—which means first acknowledging them.
Perpetuation of ageism requires suppressing striking realities that challenge the myths that adults are mature and teenagers are fundamentally different from adults. For some stark examples among many, drunken driving by adults 21 and older is the sixth leading cause of death of teenagers in the United States. The fastest-growing rates of drug abuse (which now costs nearly 40,000 lives annually), criminal arrest (some 3 million adults ages 40-59 were arrested in 2009), HIV infection (nearly four in 10 new cases), and imprisonment (more than 600,000 in 2010) are middle-aged adults; teen and young adult rates generally have been falling. Three-fourths of murdered juveniles are killed by adults, not by peers. A large majority of “teen” pregnancies involve post-teen men, not peer boys (a point sometimes admitted, then left out of most “teen sex” discussion). African Americans in their 40s suffer homicide arrest and death rates four to five times higher than white teenagers and young adults.
This article is a work in progress and will be updated, with references.
- ^ US Bureau of the Census, Poverty
- ^ http://www.YouthFacts.org
- ^ Males, Mike (2006). More dangerous than anyone thought. Extra!, September/October 2006. At: http://www.fair.org/index.php?page=3061
- ^ Arnett, Jeffrey (editor) (2010). Special section on the adolescent brain and risk taking. Journal of Adolescent Research, 25(1)
- ^ Roper v Simmons, 2005, 543 U.S. 551
- ^ Kairys, David (edit) (1982). The Politics of Law. New York: Pantheon.
- ^ Black, Donald (1993). Sociological Justice. Oxford University Press.
- ^ Plessy v Ferguson, 1896, 163 U.S. 537
- ^ Roper v Simmons, 2005, 543 U.S. 551
- ^ Graham v Florida, 2010
- ^ Hodgson v Minnesota, 1990, 497 US 417
- ^ Schall v Martin, 1984 104 SCt 2403
- ^ Ingraham v Wright, 1977, 430 US 651
- ^ Hazelwood School District v Kuhlmeier, 1988, 484 US 260; Bethel School District v Fraser, 1986, 478 US 675
- ^ Ralston v Robinson, 1981, 454 US 201; Stanford v Kentucky, 1989, 492 US 361; Thompson v Oklahoma 1988, 487 US 815, 848; Vernonia School District v Acton, 1995, 515 US 646
- ^ Cruzan v. Director, Missouri Department of Health, 1990, 497 US 263
- ^ Snyder, Howard, and Sickmund, Melissa (1999). Juvenile Victims and Offenders: A National Report. Office of Juvenile Justice and Delinquency Prevention, US Department of Justice
- ^ Teji, Selena, and Males, Mike (2011). An analysis of direct adult criminal court filing 2003-2009: What has been the effect of Proposition 21? Center on Juvenile and Criminal Justice, August 2011. At: http://www.cjcj.org/files/What_has_been_the_effect_of_Prop_21.pdf
- ^ FBI (2011). Uniform Crime Reports for the United States, 2009. US Department of Justice. Table 38 (adjusted for report population coverage).
- ^ Males, Mike (2010). Traffic crash victimizations of children and teenagers by drinking drivers age 21 and older. Journal of Studies on Alcohol and Drugs, 71(3): 351-356
- ^ Paulozzi, Leonard (2008). Trends in unintentional drug overdose. Testimony to Congress, Centers for Disease Control and Prevention, March 21, 2008. At: http://www.hhs.gov/asl/testify/2008/03/t20080312b.html
- ^ World Health Organization (2011). WHO mortality database. United Nations. Accidental poisoning is a surrogate for drug mortality. At: http://www.who.int/healthinfo/morttables/en/. Preliminary analysis of comparative international drug (poisoning) statistics can be found in, Males, Mike (2010). Drug abuse is now California's leading cause of premature death. Center on Juvenile and Criminal Justice, April 18, 2010. At:http://www.cjcj.org/post/alternatives/incarceration/drug/abuse/now/california/s/leading/cause/premature/death
- ^ FBI (2011). Uniform Crime Reports, 2009. Expanded homicide data, table 5. At: http://www2.fbi.gov/ucr/cius2009/offenses/expanded_information/data/shrtable_05.html
- ^ For a fuller discussion and references, see Males, Mike (2010). Teenage Sex and Pregnancy: Modern Myths, Unsexy Realities. Praeger.
- ^ Sercombe, Howard (2010). The gift and the trap: Working the “teen brain” into our concept of youth.Journal of Adolescent Research, 25(1), 31-47
- ^ For one of the only discussions of the "teen brain" issue to present both sides, see the five papers in, Arnett, Jeffrey (editor) (2010). Special section on the adolescent brain and risk taking. Journal of Adolescent Research, 25(1).
- ^ McWilliams, Carey (2001). Fool's Paradise. Heyday Books
- ^ PBS (2002). Inside the teenage brain. How much do we really know about the brain? At: http://www.loni.ucla.edu/~thompson/MEDIA/PNAS/pbs_brain_interview.html
- ^ Lu, T, et al (24 June 2004). Gene regulation and DNA damage in the ageing human brain. Nature, 429, 883-891.
- ^ For a comprehensive review of the literature and replication, see Quadrel MJ, Fischhoff B, and Davis W. (1993). Adolescent (in)vulnerability. American Psychologist, 48(2), 102-116. At:http://www.ncbi.nlm.nih.gov/pubmed/8442566
- ^ A useful reference is Centers for Disease Control and Prevention (2011), WISQARS, Fatal injury data, which allows custom retrieval of both numbers and population-adjusted rates for all types of external injuries. At:http://www.cdc.gov/injury/wisqars/fatal.html
- ^ Ibid
- ^ US Census Bureau (2011). Current population survey, 2009. Annual social and economic supplement. US Department of Commerce. At: http://www.census.gov/hhes/www/cpstables/032010/rdcall/2_000.htm
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