Persistent Racial/Ethnic Disparities in Fatal Unintentional Drowning Rates Among Persons Aged ≤29 Years - United States, 1999-2019

Abstract

During 1999-2019, a total of 81,947 unintentional drowning deaths occurred in the United States (1). Drowning is one of the three leading causes of unintentional injury death among persons aged ≤29 years and results in more deaths among children aged 1-4 years than any other cause except birth defects (2). Drowning death rates have decreased since 1990 (declining by 57% worldwide and by 32% in the United States) (3). However, because of racial/ethnic disparities in drowning risk, rates remain high among certain racial/ethnic groups, particularly American Indian or Alaska Native (AI/AN) persons and Black or African-American (Black) persons (4). To assess whether decreasing drowning death rates have been accompanied by reductions in racial/ethnic disparities, and to further describe these disparities by age group and setting, CDC analyzed U.S. mortality data during 1999-2019. The drowning death rate among persons aged ≤29 years was 1.3 per 100,000 population. The rate per 100,000 among AI/AN persons (2.5) and Black persons (1.8) was higher than among all other racial/ethnic groups and was 2.0 and 1.5 times higher than among White persons (1.2). Racial/ethnic disparities in drowning death rates did not significantly decline for most groups, and the disparity in rates among Black persons compared with White persons increased significantly from 2005-2019. Drowning death rates are associated with persistent and concerning racial/ethnic disparities. A better understanding of the factors that contribute to drowning disparities is needed. Implementing and evaluating community-based interventions, including those promoting basic swimming and water safety skills, among disproportionately affected racial/ethnic groups could help reduce drowning disparities.

FIGURE

Five-year moving average* fatal unintentional drowning^† rates and rate ratios^§ among persons aged ≤29 years, by race/ethnicity^¶ — United States, 1999–2019 Abbreviations: AI/AN = American Indian or Alaska Native; A/PI = Asian or Pacific Islander; ICD-10 = International Classification of Diseases, Tenth Revision; MA = moving average. * Because of high interannual variability in drowning rates, 5-year MAs in rates and rate ratios were calculated to visualize temporal trends; annual rates and rate ratios are reported in text. For the study period (1999–2019), the first year for which a 5-year average can be calculated is 2001, and the last year for which a 5-year average can be calculated is 2017. 
^† ICD-10 underlying cause of death codes W65–W74, V90, and V92. 
^§ Rate ratios use White persons as the comparison group. 
^¶ Persons identified as Hispanic might be of any race. Persons identified in the other categories (AI/AN, A/PI, Black, or White) are all non-Hispanic.