Klosky Jill V, Moreland Briana, Clemens Tessa
CDC Foundation, 600 Peachtree St NE, Atlanta, GA 30308 USA; Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Hwy, Atlanta, GA 30341 USA.
Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Hwy, Atlanta, GA 30341 USA.
J Safety Res. 2025 Jul;93:447-450. doi: 10.1016/j.jsr.2025.04.004. Epub 2025 May 14.
Drowning is a major public health problem. There are about 4,500 fatal unintentional drownings in the United States each year, and more children ages 1-4 die from drowning than from any other cause. Some sociodemographic characteristics are associated with increased risk of unintentional fatal drowning. The purpose of this study was to better understand the association between county-level social vulnerability and unintentional fatal drowning.
This study used the 2014 Centers for Disease Control and Prevention and Agency for Toxic Substances and Disease Registry's (CDC/ATSDR) Social Vulnerability Index (SVI) and mortality data from the National Vital Statistics System from 1999 to 2023. Counties were ranked and categorized into tertiles across social vulnerability scores for all indicators of the SVI. Negative binomial regression was used to estimate crude rate ratios (RR) and 95% confidence intervals comparing county-level fatal drowning rates and the SVI indicators.
County-level social vulnerability is associated with unintentional fatal drowning. Counties with high overall social vulnerability had fatal drowning rates 1.59 times as high as counties with low social vulnerability. These associations were most pronounced for the SVI indicators of socioeconomic status (RR = 1.56), disability status (RR = 1.49), and proportion of mobile homes (RR = 1.62).
While the reasons for the associations between indicators of the SVI and higher rates of drowning are not fully understood, counties with high social vulnerability may be associated with reduced access to swimming pools, affordable swimming lessons, and other evidence-based drowning prevention strategies.
Communities can use the SVI and other indicators of risk to support drowning prevention program implementation, ensuring strategies reach and are tailored to populations most at risk of drowning.
溺水是一个重大的公共卫生问题。美国每年约有4500起意外溺水死亡事件，1至4岁儿童死于溺水的人数超过死于其他任何原因的人数。一些社会人口学特征与意外溺水死亡风险增加有关。本研究的目的是更好地了解县级社会脆弱性与意外溺水死亡之间的关联。
本研究使用了2014年疾病控制与预防中心以及有毒物质与疾病登记署（CDC/ATSDR）的社会脆弱性指数（SVI）以及1999年至2023年国家生命统计系统的死亡率数据。根据SVI所有指标的社会脆弱性得分，对各县进行排名并分为三分位数。使用负二项回归来估计比较县级溺水死亡率和SVI指标的粗率比（RR）及95%置信区间。
县级社会脆弱性与意外溺水死亡有关。总体社会脆弱性高的县的溺水死亡率是社会脆弱性低的县的1.59倍。这些关联在社会经济地位（RR = 1.56）、残疾状况（RR = 1.49）和移动房屋比例（RR = 1.62）的SVI指标中最为明显。
虽然SVI指标与较高溺水率之间关联的原因尚未完全了解，但社会脆弱性高的县可能与游泳池使用机会减少、负担得起的游泳课程以及其他循证溺水预防策略的获取减少有关。
社区可以使用SVI和其他风险指标来支持溺水预防计划的实施，确保策略能够覆盖最易溺水人群并针对他们进行调整。
