Trends in Unintentional Drowning Mortality Among U.S. Adults Aged ≥25 Years, 1999–2024: A U.S. Surveillance Analysis

BACKGROUND/OBJECTIVES: Drowning is a leading preventable cause of unintentional injury death, yet U.S. prevention efforts have largely focused on children. Despite international declines in pediatric drowning mortality, adult trends remain poorly characterized. We examined long-term trends and disparities in unintentional drowning mortality among U.S. adults aged ≥25 years from 1999 to 2024. METHODS: Using CDC WONDER Multiple Cause of Death data, drowning deaths were identified using ICD-10 codes W65-W74, V90, and V92. Age-adjusted mortality rates (AAMRs) per 100,000 were computed by direct standardization to the 2000 U.S. standard population. Joinpoint regression estimated the annual percent change (APC) and average annual percent change (AAPC). Three sensitivity analyses assessed transport-related code exclusion, pandemic-era restriction, and multiple cause-of-death coding. RESULTS: < 0.001). Non-Hispanic AI/AN adults had the highest rates (3.47-5.44 per 100,000), and non-metropolitan areas consistently exceeded metropolitan rates. CONCLUSIONS: A significant upward trajectory has persisted since 2013, with marked disparities by age, sex, race/ethnicity, and geography. Adult-focused, equity-driven prevention strategies aligned with USNWSAP implementation are needed to address this underrecognized burden.