Racial and ethnic disparities in unintentional drowning deaths among children and young adults United States, 2010-2020

Briana Moreland, MPH
Neil Ortmann, MPH
Tessa Clemens, PhD

Drowning is the second leading cause of death among children aged 1 to 4 years and the second leading cause of unintentional injury death among children aged 5 to 14 years. American Indian or Alaska Native (AI/AN) and Black or African American (Black) children have drowning death rates consistently higher than White children. Studies comparing nonfatal and fatal injuries in the United States during 2020 to earlier years showed mixed effects of the COVID-19 pandemic. The objective of this study was to describe drowning deaths in 2020 among children and young adults by demographic characteristics and to compare 2020 rates to rates from 2010 to 2019.

Mortality data from the National Vital Statistics System (NVSS) were analyzed to describe unintentional drowning deaths among persons aged ?29 years by age, sex, race/ethnicity, and drowning location in 2020. International Classification of Disease 10th revision codes were used to identify unintentional drowning deaths (V90, V92, W65-W74). Changes in drowning death rates from 2019 to 2020 were compared to the annual percent change over the previous 10 years (2010-2019) using JoinPoint regression analysis.

In 2020, 1,589 persons aged ?29 years died from unintentional drowning. Drowning death rates were highest among children aged 1 to 4 years (2.73 per 100,000), males (1.93 per 100,000), Black persons (2.02 per 100,000), and AI/AN persons (1.97 per 100,000). Drowning death rates among persons aged ?29 years decreased 1.81% (95% CI: -3.02%, -0.59%) per year from 2010 to 2019 and increased 16.79% (95% CI: 8.35%, 25.24%) from 2019 to 2020. The largest increases in unintentional drowning death rates from 2019 to 2020 occurred in Black persons (23.73%), males (19.55%), persons aged 20 to 24 years (44.12%), and drownings in natural water (26.44%).

Drowning rates among persons aged ?29 years increased significantly from 2019 to 2020 during the COVID-19 pandemic; however, the reasons are not well understood. Further research is needed to assess how infrastructure disruptions that occurred during the COVID-19 pandemic (e.g., limited availability of swim lessons), influenced drowning rates among children and young adults. This information can be used to identify and strengthen drowning prevention strategies. Interventions such as learning basic swimming and water safety skills have the potential to reduce drowning deaths among children. CDC is working with partners to better understand disparities in drowning deaths and to increase access to interventions.

1. Identify children and young adult populations with disproportionality higher drowning rates.
2. Describe trends in U.S. drowning rates between 2010 and 2020.
3. Recognize how to develop and evaluate effective interventions that improve access to drowning prevention strategies