My statement that drowning has become an accident of affluence was not intended to imply that drowning is "limited to wealthy whites," as Baca et al assert. The statement was to be understood in a global context. Swimming pools must be considered a luxury item and are a major source of drowning and near-drowning accidents only in wealthy countries. In third world countries, natural bodies of water and natural disasters are responsible for the vast majority of drowning accidents.1,2 Baca et al support this assertion of an association with national affluence with their own statements that 63% of drownings with minority victims occur in swimming pools and that swimming pools exist in even the poorest neighborhoods in their community. In 1977, there were an estimated 4 million home swimming pools in the United States,3 and that number exceeds 5 million now (personal communication, National Pool and
Orlowski JP. Affluent Drowning Victims; Manacled Minds-Reply. JAMA. 1988;260(23):3438. doi:10.1001/jama.1988.03410230056027
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