Over the past 2 decades, deaths among children and teens from accidental drowning dropped substantially, researchers with the National Center for Health Statistics (NCHS) reported.

From 1999, when more than 1,100 youths ages 0-17 drowned to death, the annual figure declined steadily in the succeeding 20 years, reaching 756 in 2019, according to Merianne Rose Spencer, MPH, and colleagues in an NCHS Data Brief.

Those figures worked out to an annual rate of 1.6 per 100,000 in 1999 versus 1.0 per 100,000 in 2019 — a 38% decline.

Data for the analysis came from the CDC’s National Vital Statistics System, in which 2019 is the latest year with full reporting. The system records ICD-10 codes, with W65-W74 specifying accidental deaths by drowning or immersion in various locations.

Substantial differences in rates and in drowning locations were noted by age group. Almost all drownings among infants occurred in bathtubs, while swimming pools were the most lethal for children ages 1-4. Older children were about equally like to drown in pools and in natural water bodies, whereas the latter were responsible for most drowning deaths among teenagers.

Rates were highest for 1- to 4-year-olds, at 3.2 per 100,000 in 1999 and 2.4 per 100,000 in 2019. The lowest rates were seen in children ages 5-13, starting at about 0.9 per 100,000 in 1999 and reaching 0.5 per 100,000 by 2019.

Race was also a factor in accidental drownings. The highest rates were among non-Hispanic Black youth throughout the study period, at 2.7 per 100,000 in 1999 and 1.6 in 2019; the sharpest decline was from 1999 to 2003, after which there was almost no change. Rates for Hispanic and white youth differed little, declining slowly during the study period. By 2019, they were about half the level seen in Black children and teens.

Other findings included:

• Rural youth suffered higher rates of accidental drowning than kids living in urban areas
• Boys were more than twice as likely than girls to die by drowning

Spencer and colleagues offered no explanations for the trends they identified, as the vital statistics data don’t address risk factors such as use of pool fencing or parent education on infant bathing. Given the known association between alcohol and drowning, the decline in deaths among 14- to 17-year-olds during the study period is especially perplexing, since there is little to suggest that teen drinking has decreased.