Improving accessibility of swimming lessons to reduce childhood drowning rates

Abstract Drowning is a leading cause of preventable death among children in the United States, yet access to formal swimming lessons, shown to reduce drowning by up to 88%, often remains inaccessible. This review explains how racial and socioeconomic barriers, rooted in historical segregation and present-day structural inequities, have limited swimming proficiency among marginalized communities. Informed by literature from public health journals, scholarly databases, historical works, and swimming-related websites, this analysis aims to document these inequities and discuss current intervention strategies. Black and low-income children experience the most significant inequities with long-standing restrictions on pool access, intergenerational fear of water, and financial and logistical barriers that prevent participation in formal swimming lessons. Although countries like Canada, Iceland, and the United Kingdom have successfully reduced drowning rates through school-based swim instruction, the United States lacks such a nationwide strategy. Recommendations include systematically collecting data on race and ethnicity in drowning surveillance, integrating swim education into existing physical education requirements, developing culturally responsive programming, increasing funding for lifeguard training, and/or providing government-funded vouchers to reduce financial burden. Addressing these racial and socioeconomic gaps is necessary to ensure swimming’s accessibility to all children, reducing preventable deaths.