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Swimming Lessons: A Lesson on Disparities in Water Safety Education

December 9, 2022

Parental experiences and preferences shape those of their children. This is a universal truism in pediatrics and is one reason why the consequences of past discrimination continue to impact the health and well-being of children and adolescents. One aspect of this is highlighted in “Learning to Swim and Swimming Skills Among a Diverse Population of Parents and Their Children Over 4 years of Age in Chicago” published in this month’s Pediatrics (10.1542/peds.2022-058867). In this article, Rajeh et al explore correlations between swimming skills in parents with those of their children, and discuss how this may contribute to widening racial and ethnic disparities in drowning deaths in the US. 

These disparities were highlighted in a 2021 article in the CDC’s Morbidity and Mortality Weekly Report,1 that reported drowning rates one and a half times higher for Black persons, and twice higher in American and Alaskan Native populations, as compared to white persons. Although awareness of drowning deaths has taken a backseat to COVID-19 pandemic- and gun-related deaths, it is important to remember that water can be deadly. According to the CDC, in the US:2

  • Drowning is the leading cause of death in children 1–4-years-old.
  • Drowning is the 2nd leading cause of unintentional injury death in children 5–9-years-old.
  • There are 11 drowning deaths per day.
  • There are 4,000 unintentional fatal drownings per year, and at least twice as many non-fatal drownings.

Rajeh et al report 35% of parents in this cohort are comfortable with basic water skills (floating, swimming) with significant disparities by race and ethnicity (ranging from less than 25% in Hispanic/Latiné parents to 56% in white parents). Parental assessment of their child’s ability to swim and float mirrors this as well, with only 44% of parents reporting that their child can swim and float. These numbers illustrate the high level of drowning risk in this cohort, and I encourage you to check out Table 1 in their article for further details.

For many, exposure to swimming is limited by family experiences and cultural barriers. Rajeh et al emphasize the value of intergenerational and culturally tailored educational programs in helping to eliminate these drowning disparities.  Consider asking families in your practice specifically about swimming ability and having information on hand regarding community resources that provide swimming instruction. For families that don’t swim, directing them to local and appropriate “learn to swim” programs not only opens the door for a whole host of new (and fun!) fitness and recreational activities, but may also save their lives. 

 References:

  1. Clemens T, Moreland B, Lee R. Persistent Racial/Ethnic Disparities in Fatal Unintentional Drowning Rates Among Persons Aged ≤29 Years — United States, 1999–2019. MMWR Morb Mortal Wkly Rep. 2021;70:869–874. DOI: http://dx.doi.org/10.15585/mmwr.mm7024a1
  2. CDC-Injury Center. Drowning Facts. https://www.cdc.gov/drowning/facts/index.html. Updated Oct. 22, 2022.  Accessed December 4, 2022.
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