Fatal pediatric drownings decreased early this century. They've crept back up, and racial disparities persist.

Pediatric drowning. A very tough topic. But an important one. As a nation, we truly can eliminate just about all fatal pediatric drownings, if we choose to do so.

I got to thinking about this because the New York Times’ Mara Gay has a great new essay on the modern history of drowning deaths in the United States. Unsurprisingly, there are disparities here. The reasons that non-Hispanic Black children in the US drown more than any other race/ethnicity are probably multi-factorial, but can’t be too far afield from the uncomfortable reality that droves of public pools closed down in the mid-20th century rather than integrate.

A vast majority of these deaths occur in swimming pools. Changes in building codes and public safety campaigns are thought to have saved lives since the 1980s. If there’s any doubt that public policy and public health aren’t intricately intertwined, the numbers around fatal drownings should end the debate.

Inspired by the Times essay, I took a look at accidental drowning deaths among children ages 14 and under in the US over time.

Point #1: Pediatric drowning deaths decreased early this century. But in the last 10 years, deaths have crept back up a tad.

Data (ages 0-14): CDC. Image: Inside Medicine

Did the pandemic change anything? It’s hard to say. Only one month looks to have had an obvious deviation from historical norms, and that was June of 2020 (see below). That month, there were approximately 15% to 30% fewer pediatric drowning deaths than a typical June (Note: I’m estimating this based on a couple of different metrics). But in 2021 and 2022, pediatric drowning deaths did creep up compared to prior years. Did the pandemic cause a few trips to the pool and swim lessons to get cancelled in the spring and early summer of 2020, thereby causing an immediate small rebound effect (later summer of 2020) and an eventual downstream uptick in this type of mortality in 2021 and 2022? I can’t say for sure, but it sure looks like a possibility to me when I look at the data.

Data (ages 0-14): CDC. Image: Inside Medicine

Point #2: Black children have the highest rates of pediatric drowning in the US. Hispanic and White children have the lowest. On average, the annual rate of fatal drownings in Black children was 173% that of their White counterparts, and 247% that of their Asian counterparts (2018-2022).

Data (ages 0-14): CDC. Image: Inside Medicine

In my view, virtually every pediatric drowning death is preventable.

Here are the steps we can take to prevent pediatric drowning:

1. Make swim lessons free for everyone. Make learning water safety a priority.

2. Encourage the building of fences around pools in private homes.

3. Adult supervision must be absolutely continuous. No lapses.

4. Any child near a pool should have access to a flotation device of some kind (caveat: leaving kids alone in or near a pool because there’s a Floatie or other safety device can backfire).

5. Know CPR.

6. Share this list.