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A National Action Plan for Child Injury Prevention:
Reducing Drowning Injuries in Children

Photo: children in a pool

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Unintentional drowning killed 1,027 U.S. children in 2010.1 More children ages 1-4 die of drowning each year than of any other cause except birth defects.2,3 Drowning rates also vary by race; black children 5-14 years old drown at three times the rate of white children.3 This difference is even greater, five times the rate of white children, when looking just at swimming pools, usually the safest place for recreational swimming.4

Half of all patients treated for drowning in emergency departments require hospitalization or transfer for further care and many are left with permanent disabilities from brain injuries.3,5,6 Hospital care does not substantially change the outcomes of drowning, which is why prevention is critical.5

Most drowning deaths and injuries are predictable and preventable.

A National Action Plan

The Centers for Disease Control and Prevention (CDC) is committed to preventing child injury by supporting solutions that will save lives. The National Action Plan for Child Injury Prevention (NAP) was developed by CDC and more than 60 stakeholders to spark action across the nation. The overall goals of the NAP are to raise awareness about the problem of child injury and the effects on our nation, offer solutions by uniting stakeholders around a common set of goals and strategies, and mobilize action to reduce child injury and death.

The NAP contains six domains that include goals and actions based on what we know, where we need to go, and how we can get there. See below for examples of what we can do to further reduce drowning deaths and injuries among children.

Data and Surveillance—includes the ongoing and systematic collection, analysis, and interpretation of child health data for planning, implementing, and evaluating injury prevention efforts.

  • Implement data systems, such as Child Death Review, to collect more detailed information on the circumstances of drowning to better design intervention programs.
  • Analyze  local, state and national level data and information to monitor the effect of drowning prevention efforts.

Research—includes research gaps and priorities in risk factor identification, interventions, and program evaluation, and dissemination strategies needed to reduce injuries.

  • Conduct research to determine which water safety messages motivate belief and behavior change.
  • Conduct research to determine how to motivate at-risk populations to seek out and learn water safety and survival skills.

Communication includes effective strategies to promote injury prevention to target audiences through designing messages and information and delivering them through relevant channels.

  • Collaborate with police and media to use child injury news stories to relay drowning prevention messages such as the importance of learning to swim, installing pool fencing and knowing CPR.
  • Disseminate drowning prevention messages through multiple channels, including water safety campaigns, day care centers, schools, faith-based organizations and pediatricians’ offices.

Education and trainingincludes organized learning experiences for increasing knowledge, attitudes, and behavior change conducive to preventing injuries.

  • Encourage universal “learn to swim” initiatives among preschool and school-aged children, especially in minority communities.
  • Encourage widespread CPR training for older children, parents, and pool owners.

Health systems and health careincludes the health infrastructure required to deliver quality care and clinical and community preventive services.

  • Counsel parents on the importance of pro-active water safety strategies at all well-child exams.
  • Promote CPR training among parents, caregivers and other lay people as a proven intervention to improve outcomes of drowning.

Policy—includes laws, regulations, incentives, administrative actions, and voluntary practices that enable safer environments and decisions making.

  • Support evidence-based practices and policies to provide environments and activities that reduce the risk of drowning. Examples include requiring pools to have surrounding barriers and promoting swimming lessons, CPR training, and lifejacket use.
  • Translate, implement and evaluate policies to make proven interventions (such as survival swimming classes) accessible to the public.

Moving Forward Together

Everyone—including parents, health care providers, educators, and community members—can take steps to prevent injury where they live, work, and play. We all have a part to play in the NAP and in protecting our children—America’s future.

To learn more about CDC’s work in child injury prevention, find references, or get your copy of the National Action Plan, visit


  1. Gilchrist J, Ballesteros M, Parker E. Vital Signs: Unintentional Injury Deaths Among Persons Aged 0–19 Years — United States, 2000–2009. MMWR 2012;61:270-6.
  2. CDC. Web-based Injury Statistics Query and Reporting System (WISQARS). Atlanta, GA: US Department of Health and Human Services, CDC; 2009. Available at Accessed May 13, 2012.
  3. Laosee OC, Gilchrist J, Rudd R. Drowning 2005-2009. MMWR 2012; 61:344-347.
  4. CDC. WONDER [Database]. Atlanta, GA: US Department of Health and Human Services, CDC; 2011. Available at Accessed May 13, 2012.
  5. Cummings P, Quan L. Trends in Unintentional Drowning: The Role of Alcohol and Medical Care. JAMA. 1999;281:2198-2202.
  6. Gilchrist J, Gotsch K, Ryan G. Nonfatal and Fatal Drownings in Recreational Water Settings --- United States, 2001—2002. MMWR 2004;53:447-52.
  7. Spack L, Gedeit R, Splaingard M, Havens PL. Failure of aggressive therapy to alter outcome in pediatric near-drowning. Pediatric Emergency Care 1997; 13(2):98-102.
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