NDPA and AAP Share Life-Saving Insights on Childhood Drowning Prevention

On the heels of the CDC’s latest Vital Signs report which found an increase in childhood drowning deaths between 2019 and 2023, the National Drowning Prevention Alliance (NDPA) teamed with the American Academy of Pediatrics (AAP) during a virtual panel discussion on Tuesday, May 21 to brief families on what they need to know to best protect children.

Moderating the conversation was Adam Katchmarchi, Ph.D., Chief Executive Officer of the NDPA, who was joined by Ben Hoffman, M.D., FAAP, President of the AAP; Blake and Kathy Collingsworth, parent advocates and founders of the Joshua Collingsworth Memorial Foundation; and Julie Gilchrist, M.D., FAAP, Medical Director of the NDPA.

“With the start of water recreation season upon us and following the CDC’s recent report citing increases in drowning rates, especially among children, it is an important time for us to all to reflect on where we are as a country with regard to water safety and also get the word out as broadly as we can about how to keep families safer around the water,” said Katchmarchi.

Added Dr. Hoffman, who has spent 30 years as a pediatrician working on injury prevention initiatives, “We know that unintentional injury has long been the leading cause of death for kids across the board and it receives relatively little attention. And if unintentional injuries have been underrepresented in terms of how we think about child health, drowning has been left out to an even greater degree.”

With the focus of the briefing centered on the misperceptions and myths about water safety, each speaker shared eye-opening insights for parents as they consider what drowning prevention strategies are most important for their families.

Childhood Drowning: A National Problem with Local Implications

According to Adam Katchmarchi, NDPA, “Drowning is a complex public health issue, and a multi-sectoral one that requires a coordinated effort between the public and private sector to fully address - from parents and pediatricians to the pool and spa industries, to aquatics facilities, to emergency response and lifeguards, to federal, state, and local authorities.”


However, as Dr. Hoffman pointed out, “The risk around the water depends upon the water that you are around. Drowning is a local phenomenon. In Portland for example, where there are relatively few swimming pools, the risk is among younger kids having access to natural bodies of water such as lakes and ponds, whereas in Arizona, the risk is almost entirely swimming pools. Meanwhile, in a state like Florida it's all the above.”

Exposure to Water, Equity and Access


Among the CDC Vital Signs report findings were disparities in drowning rates by race and ethnicity. The highest drowning rates were among non-Hispanic American Indian or Alaska Native and non-Hispanic Black persons. The CDC also reported over half of adults in the U.S. have never taken a swim lesson. More than 1 in 3 (36.8%) of Black adults reported they do not know how to swim, compared to 15% of all adults. The CDC notes in its report that infrastructure disruptions during the pandemic, including limited access to supervised swimming settings, may have affected drowning rates and risks.

In analyzing the findings, Dr. Gilchrist said, “What’s evident and most worrisome from the data is the direct correlation between water competency and risk when we look at those who have access to swimming lessons vs. those with lower participation. This tells us what we need to focus on, and that is creating greater equity and access to what is not a recreational activity but a life-saving skill.” 

Added Dr. Hoffman, “Much of the disparity in water safety revolves around access to swimming lessons because for so many communities there is just not the opportunity, whether it’s due to a lack of swimming pools, or whether we are talking about minoritized or marginalized groups. This is an area that we need to be thinking about and solving for.”

Taking a Progressive Approach: Mapping Risk and Prevention Strategies to Age

All panelists concurred that it’s important for parents to understand that the risk of drowning varies by age. With infants for example, the greatest threat is bathtubs when you consider that it only takes two inches of water for drowning to occur. For toddlers, the greatest risk comes from backyard pools; while older, school-aged kids are at risk in more open water environments such as lakes and beaches.

Added Dr. Gilchrist, “Water safety is not a one-size-fits-all, it changes and is progressive with the age of the child, their level of water competency, and the water sources they have access to.”

The Importance of Multiple Layers of Protection

According to Blake Collingsworth, when he and his wife lost their child Joshua 16 years ago, they thought they were doing everything right with pool coverings and a security camera system in place. “We ended up being one of the statistics among the leading cause of death to children ages one to four in the time it takes to prepare a hot dog,” he said. The Collingsworth family has since become advocates for teaching children water competency and basic survival skills.

“Water is a constant fascination for children,” said Dr. Hoffman. “If they can get to water, they will. And if they get to water when there aren't barriers in place to prevent access, tragedy can ensue. Thinking about how to build a water protection plan for your family and your local community is essential because we know drowning prevention requires layers of protection. There is no one simple thing that we can do to prevent it.” 

NDPA, AAP and other water safety advocates are united in recommending the five layers of protection to prevent drowning, which include barriers and fencing; close, constant and capable adult supervision; water competency; life jackets; and emergency preparedness, including CPR with rescue breaths.

Shedding Light on Common Drowning Myths

“Each drowning is different and given the many ways and environments where drownings can occur, the issue is most certainly a complex one,” said Katchmarchi. “What’s most important for parents to know however, is that drowning is preventable. But there is still a lot of work to be done to reverse some of the long-standing myths and misperceptions associated with drowning.” Specifically, the panel discussed the following:

Myth: I Didn’t Know, Drownings are Rare, It Can’t Happen to Our Family – The number one thing NDPA hears from parents who have lost a child to drowning are the words, “I didn’t know” – they didn’t know the statistics, didn’t know the safety steps to take. Added Katchmarchi, “If a parent doesn't understand and perceive the true risk that drowning presents to their families, they can’t be expected to know how to take the right safety steps, including how to prioritize things like barriers, swim lessons, life jackets and supervision.”

Myth: Drowning Usually Happens During Swim Time – In fact, 70% of toddler drownings occur during non-swim times when a child is not expected to be around the water. “This is why we emphasize the use of barriers and fencing as the first layer of protection,” said Dr. Hoffman. “The use of barriers and fencing can decrease the risk of drowning by as much as 50%.

Myth: I Need to Wait Until My Child is Older to Enroll in Swim Lessons – According to pediatricians and water safety advocates alike, there is a distinction between recreational swimming lessons and water competency, which can be started at a young age. According to Blake Collingsworth, “The basic skill of learning how to flip and float is lifesaving and can be taught to a child as young as one. By teaching children what to do if they fall into the water, how to float and get air, and reach for the side of the pool, we can help avoid having an accident turn into a tragedy.”

Myth: If Someone is Drowning, I’ll See and Hear Them– Drowning can occur in as little as 20 to 60 seconds, and as Katchmarchi pointed out, “A distressed swimmer that is still able to call out and keep their head above water, is not a drowning victim. Thanks to Hollywood and the movies, many parents have been trained to think that drowning is a loud and pronounced event, and that if their child is in trouble in the water, they will be able to hear them and spring into action. But that is simply not the case, which is why close, constant and capable adult supervision any and all times a child is in or near water is so important, even if there is a lifeguard present.”

In wrapping up the briefing, Dr. Hoffman reinforced the importance of the layers of protection and community leadership saying, “Communities need to examine what drowning looks like for them because tragically, drownings occur at the local level and will look different from one community to the next. With the help of parents, families and local organizations working together, we can best address the equity issues around access to water competency and age-appropriate swimming lessons, high-quality emergency medical services, the installation of barriers and fencing, and the availability of personal flotation devices for anyone and everyone looking to enjoy and recreate in the water.”


This summer, the National Drowning Prevention Alliance continues its efforts to raise awareness around the five layers of protection, with an added focus on water competency. On May 1, NDPA launched #FirstSport with the debut of a public service video (click here to view/download) on social media. The campaign brings together athletes, advocates, parents, partners, and hundreds more who have pledged their support to help keep kids safe by sharing the video and its message that swimming is the only sport that teaches kids lifesaving skills.