DIVERGENT TRENDS IN CHILDHOOD DROWNING RATES, 1971 THROUGH 1988

Objective.-To examine national age-, race-, and sex-specific trends in unintentional drowning rates among US children aged 0 through 19 years. Design.-National mortality data published by the National Center for Health Statistics and population data from the US Bureau of the Census were used in calculating age-, race-, and sex-specific drowning rates for 1971 through 1988. Time trends were analyzed using Poisson regression techniques. Setting.-United States, 1971 through 1988. Main Outcome Measure.-Rates of death due to unintentional, non-boat-related drowning. Results.-From 1971 through 1988, there were 45 680 unintentional, non-boat-related drowning deaths among 0- through 19-year-olds in the United States. Drowning rates declined sharply in older children (-5.8% per year in 10- through 14-year-olds and -5.4% per year in 15- through 19-year-olds), declined only slightly in toddlers (-1.6% per year in 1- and 2-year-olds), and actually increased in infants (+1.6% per year in those children younger than 1 year). Conclusion.-Drowning rates in toddlers have changed little over time despite the availability of effective prevention strategies such as pool fencing. In older children, drowning rates have declined dramatically despite the lack of clear preventive initiatives. Prevention interventions targeted specifically at the infant and toddler age groups should receive priority.