Identifying a gap in drowning prevention: high-risk populations

Abstract

IntroductionSome populations have been less susceptible to reductions in drowning than others. It has been hypothesised that this is due to prevention strategies failing to account for the influence of social determinants (such as ethnicity, socioeconomic status). Populations such as ethnic minorities have been over-represented in injury statistics, however this is not well explored in drowning. This study aims to identify high-risk populations for drowning, risk factors and prevention strategies.MethodsA literature review undertaken systematically using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses approach was conducted of peer-reviewed literature in English, published between 1990 and 2018 from high-income countries. Search terms included drowning, water safety, ethnic minority, migrant, and culturally diverse.ResultsIn total, 35 articles were included. High-risk populations identified were: ethnic minorities, First Nations/Aboriginal people, migrants and rural residents. Over half (51%) focused on children (0–18 years). Risk factors included social determinants, swimming ability and knowledge, attitudes and behaviour. Four intervention studies were found; two focused on upskilling adults from high-risk populations to increase employment opportunities within the aquatic industry; an evaluation of a 10-year rock fishing safety education project and a learn-to-swim programme for minority children. Proposed prevention strategies included education, practical skills, research, policy and engagement.DiscussionLimited literature exists pertaining to drowning among adults from high-risk populations. There is a need to increase the sophistication of drowning prevention strategies addressing the disparities in drowning from a culturally appropriate perspective. Acknowledging the role of the social determinants of health in drowning prevention is essential in order to improve drowning outcomes for high-risk populations globally.

Dying to help: Fatal bystander rescues in Australian coastal environments

“…Although most of the bystander rescue fatality incidents involved Australian residents, Asian-born victims (particularly those born in China and India) were at proportionally higher risks of fatal bystander rescue incidents ( Table 2 ). Recently there has been increased attention regarding improving the understanding of water safety within culturally and linguistically diverse (CaLD) communities, who are often considered to be high-risk groups in terms of drowning [ 2 ]. Poor swimming ability, fewer opportunities to participate in water safety training (leading to less water safety skills), and less exposure to coastal hazards and environments (leading to lower risk perception) have previously been identified as key risk factors within Asian communities living in Australia [ 38 ].…”

“…With an estimated 360,000 annual drowning deaths worldwide, drowning is the third leading cause of unintentional injury death globally [ 1 ] and is also a multi-faceted and complex issue involving a range of social, cultural and environmental determinant factors [ 2 ]. The World Health Organisation [ 3 , 4 ] has identified six evidence-based interventions to approach the problem of drowning prevention, one of which is to ‘train bystanders in safe rescue and resuscitation’.…”

Preventing Child Drowning in the Philippines: The Need to Address the Determinants of Health

“…The Philippines is a multicultural nation with many ethnic minorities. Such groups are shown to be at higher risk of drowning and have unique needs when it comes to reducing this risk [ 48 , 49 ]. Understanding the unique needs of these groups will be vital to ensuring the effective implementation of drowning prevention strategies.…”

Adolescent Water Safety Behaviors, Skills, Training and Their Association with Risk-Taking Behaviors and Risk and Protective Factors

“…Language spoken at home is a proxy for immigrant status, a variable rarely collected. Many countries have reported increased drowning risk among their immigrant populations [ 26 ]. In fact, Canada has focused its drowning prevention program on its “new Canadians” which includes a linguistic approach [ 27 , 28 ].…”