Drowning Is Preventable but We Need Evidence to Understand What Works
Author
June 2026
Targeted, real-world research is key to furthering water safety education and reducing drowning risk.
As a public health researcher, few things keep me up at night more than the persistence of drowning deaths. Drowning is preventable, yet in the United States an average of 11 people die from drowning every day. For children ages 1 to 4, it’s the leading cause of death. For children 5 to 14, it’s second only to motor vehicle crashes. For people with Autism Spectrum Disorder (ASD), the risk is even higher, with children bearing the greatest risk.
The problem is getting worse. After decades of declines, U.S. drowning deaths rose in 2020–2022, with more than 4,500 deaths annually. Compared with an overall drowning fatality rate in 2019 of 1.2 per 100,000 persons, rates in the next three years increased 9 percent to more than 13 percent. The highest rates are among young children, older adults, and American Indian and Alaska Native (AI/AN) and Black communities. About 15 percent of U.S. adults report not knowing how to swim, and only 45 percent report having taken a lesson.
The American Academy of Pediatrics recommends that children develop water safety competency, including basic swimming skills, and a recent review of 33 studies found that teaching children to swim can reduce drowning risk. Despite this, many families face substantial barriers to participation in water safety education, including limited access to pools or aquatics facilities, affordability of swim lessons, and experiences at aquatics facilities that feel unwelcoming or culturally misaligned.
Reducing drowning risk requires building communities in which water safety is a shared norm with accessible, effective swimming education. When families have affordable, nearby instruction that reflects their needs and contexts and clear guidance they can use outside the pool, water safety becomes achievable, especially for those at highest risk.
“Reducing drowning risk requires building communities in which water safety is a shared norm with accessible and effective swimming education.”
What NORC Is Learning from Real‑World Evaluations
In my water safety research at NORC, we try to move beyond “does it work?” to “how and why does it work?” Three insights are emerging across our projects:
1. Context matters as much as content.
Drowning rates for AI/AN people are among the highest of any racial and ethnic group in the United States. Evidence shows swimming lessons and water safety education are important strategies to reduce drowning deaths, but AI/AN communities face several barriers to accessing swim lessons.
To better understand how swim lessons can be implemented and sustained in AI/AN communities, NORC evaluated the American Red Cross water safety instructor and lifeguard courses at aquatics facilities serving AI/AN communities (the Red Cross is a major provider of swim education in the United States).
Many AI/AN adolescents and young adults express interest in becoming swim instructors or lifeguards, so we sought to understand factors that support recruitment, training, and retention of instructors and lifeguards at these facilities. NORC used a culturally responsive evaluation design that included building trust with Tribal partners, engaging in a flexible and respectful approach, and tailoring the evaluation design to local contexts and norms. This work resulted in a practical toolkit with strategies to help AI/AN-serving aquatics facilities recruit, train, and retain instructors and lifeguards from the surrounding community.
2. Communication is the key to engagement.
When the YMCA of the USA (Y-USA) learned that many of its local YMCAs were struggling to engage parents and families in water safety education, Y-USA developed and distributed a set of communication tools for local YMCA aquatics program implementers to use to assess the unique needs of their communities, tailor their programming, and provide actionable information about water safety. NORC then partnered with Y-USA to understand how effective these communication tools are.
Specifically, we evaluated how well these tools help YMCAs plan programs, engage parents and caregivers, and deliver clear and actionable water-safety information to their communities. We found that these tools facilitate community-responsive programming and engagement, yet some barriers remain. Both parents and caregivers, as well as local YMCA leadership, discussed opportunities to increase the accessibility of communication tools by including culturally relevant examples, age-specific content, and translation of materials in multiple languages. This work underscores the importance of not only what information is delivered, but also how it is delivered.
3. Swim lesson modality and environment may shape learning for children with ASD.
NORC’s most recent water safety project focuses on children with ASD, a group with an elevated risk of drowning. Although we know that swim lessons can improve skills and reduce drowning risk, few studies have examined what works best for children with ASD given their unique sensory and behavioral needs.
With Y-USA, NORC is evaluating whether individual or group swim instruction better supports skill development for children with ASD and under what conditions. Our ongoing evaluation compares one-on-one and group formats within the Safety Around Water curriculum across multiple YMCAs, integrating caregiver surveys, instructor skill assessments, and implementation data to understand which approach works best and for whom. Results from this effort will be presented in future reports and publications.
Together, our work in drowning prevention and water safety makes a compelling case for the use of implementation science. We need to study delivery models, engagement strategies, and local adaptations with the same rigor we apply to evaluating content and behavioral outcomes.
Main Takeaways
Building evidence to understand which interventions work, for whom, and why can help organizations implement and sustain effective water safety programming for everyone. Our findings suggest they need:
- Targeted research on effective delivery models for populations with greater risk
- Implementation science-based approaches that are community-centered and responsive to local contexts
- Systems and policy change that make water competency a norm
Suggested Citation
Greene, N.K. (2026, June 4). Drowning Is Preventable but We Need Evidence to Understand What Works. [Web blog post]. NORC at the University of Chicago. Retrieved from www.norc.org.
