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The Presidential Medal of Freedom is similar in name to the Medal of Freedom established by President Harry S. Truman in 1945 to honor civilian service during World War II, but much closer in meaning and precedence to the Medal for Merit: the Presidential Medal of Freedom is currently the supreme civilian decoration in precedence, whereas the Medal of Freedom was inferior in precedence to the Medal for Merit ; the Medal of Freedom was awarded by any of three Cabinet secretaries, whereas the Medal for Merit was ( and the PMOF is ) awarded by the president.
Another measure of the difference between these two similarly named but very distinct awards is their per-capita frequency of award: from 1946 to 1961 the average annual incidence of award of the Medal of Freedom was approximately 1 per every 86, 500 adult U. S. citizens ; from 1996 to 2011 the average annual incidence of award of the Presidential Medal of Freedom was approximately 1 per every 20, 500, 000 adult U. S. citizens ( so on an annualized per capita basis, about 240 Medals of Freedom have been awarded per one Presidential Medal of Freedom ).

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