Data Driven Strategies for Drowning Prevention April 12, 2017 - PowerPoint PPT Presentation

Data Driven Strategies for Drowning Prevention April 12, 2017

About the National Center The National Center for Fatality Review and Prevention is a resource and data center that supports child death review (CDR) and fetal and infant mortality review (FIMR) programs around the country. It is funded in part by Cooperative Agreement Number UG7MC28482 from the U.S. Department of Health and Human Services (HHS), Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB).

The Center aligns with MCHB priorities and performance and outcome measures such as: • Healthy pregnancy • Child and infant mortality • Injury prevention • Safe sleep

HRSA’s overall vision for the Center • Through delivery of data, training, and technical support, the Center will assist state and community programs in: – Understanding how CDR and FIMR reviews can be used to address issues related to adverse maternal, infant, child, and adolescent outcomes – Improving the quality and effectiveness of CDR/FIMR processes – Increasing the availability and use of data to inform prevention efforts and for national dissemination Ultimate goal: improving systems of care and outcomes for mothers, infants, children, and families

Webinar Goals Participants will: • Gain a general understanding of childhood drownings – Highlight age, race, gender and differences • Understand evidence based prevention strategies in three settings: – In and around the home – Swimming pools – Open bodies of water

Speaker Panel Elizabeth Diane Pilkey, ‘Tizzy’ Health Resources Bennett, and Services Seattle Administration Children’s Hospital Linda Potter, Angela Steel, NCFRP Safe Kids Q&A portion Worldwide of today’s webinar

Housekeeping • Webinar is being recorded and will be available with slides in a few days on our website: www.ncfrp.org. The Center will notify participants when it’s posted • All participants will be muted in listen only mode • Questions can be typed into the Question Window. Due to the large number of participants, we may not be able to get to all questions in the time allotted. The Center will answer all questions and post the answers on the NCFRP web site: https://www.ncfrp.org/

Data Driven Strategies for Drowning Prevention Angela Steel, BSN, CPN, MPH Injury Epidemiologist, Safe Kids Worldwide 8

Dangerous Waters: Profiles of Fatal Childhood Drownings in the U.S. 2005-2014 Background on Drowning Deaths: What does the data show? 9

Collaborations and Acknowledgments • This research was conducted in collaboration with the National Center for Fatality Review and Prevention and with the support of Nationwide’s Make Safe Happen program. • SKW would like to acknowledge the input and support of the following individuals in the development and completion of the two reports referenced in this presentation: • Julie Gilchrist, Division of Unintentional Injury Prevention, National Center for Injury Prevention & Control, Centers for Disease Control and Prevention • Diane Pilkey, Emergency Medical Services for Children and Injury Prevention Branch, Maternal and Child Health Bureau, Health Resources and Services Administration, U.S. Department of Health & Human Services • Teri Covington, National Center for Fatality Review and Prevention at the Michigan Public Health Institute • Heather Dykstra, National Center for Fatality Review and Prevention at the Michigan Public Health Institute 10

Methodology • Conducted in-depth data analysis to explore national trends and circumstances surrounding fatal drownings among children ages 0- 17 years of age for the years 2005 to 2014. • National fatality data from the National Child Death Review Case Reporting System (CDR-CRS) • Supervision, pool barriers, rescue and resuscitation and emergency services. • State and national fatality data from the Centers for Disease Control and Prevention’s WONDER Online Database • Conducted a survey of 1,000 parents of children 1-12 years to understand attitudes, beliefs and behaviors of parents related to water safety. 11

Comparison of CDR-CRS and CDC Drowning Data Demographics Datasets Proportion (%) CDR-CRS WISQARS Age (N=3,328) (N=9,772) • Timeframe: 2005 to 2014 <1 year 7.8 6 1-4 years 50 52.8 • Age range: 0 to 17 years 5-9 years 14.4 13.8 • National Child Death Review Case 10-14 years 11.8 11.4 Reporting System (CDR-CRS) 15-17 years 16 15.9 Gender • Supervision, pool barriers, rescue and Male 68.9 71 resuscitation and emergency services. Female 30.5 29 • Centers for Disease Control and Race White 65 72 Prevention’s WONDER Online Database Black 19.8 23.8 • State and national fatality data Native Hawaiian, Pacific Islander, Asian 3.8 3.9 American Indian 1.4 <1 Multi racial 2.3 Missing 7.4 7.4 12

Fatal Drownings Among Children From 1985 to 2014 1 1985-1994 1995-2004 2000 1886 30% Number of fatal drownings 1500 29% 20% decrease 1000 60% reduction in decrease 892 the number of 500 drowning deaths in 30 years 0 Year 13

Proportion of Fatal Drownings by Age and Location From 2005 to 2014 1 Bathroom Pool Natural Water < 1 year 85% 11% 4% 1-4 years 10% 68% 22% Age group 5-9 years 5% 47% 47% 10-14 years 8% 25% 67% 15-17 years 4% 14% 82% 15

Age is a key determinant 16

DROWNINGS IN AND AROUND THE HOME 17

Drownings In and Around the Home • Infants are at greatest risk for drowning in this setting • Buckets, wells, cisterns, septic tanks, decorative ponds, toilets and bathtubs common hazards • Bathroom– bathtub– accounts for most deaths 18

Bathtub Drownings 1 • Number of deaths over time: 54% 2 Years 7% reduction for infants, 26% increase for children 1-14 years. 3-4 Years 1 year 9% • Children under 2 years drown at 13 28% times the rate of those over 2 < 2 years 5-9 Years 62% years. 7% < 1 Year • 85% occurred in child’s own home 34% 10-14 Years • Inadequate supervisions a factor in 9% 75% of deaths. 15-17 Years 6% • CPR initiated in 83% of cases and 2005-2014, n=854 911 called in 88% of cases. 19

DROWNINGS IN POOLS 20

Fatal Drowning Rate Among Children In Pools From 2004 to 2013 1 0-4 Years 5-9 Years 10-14 Years 15-17 Years Pool Drowning Fatality Rate per 100,000 Children 1.20 1.19 1.2 1.0 0.8 18% INCREASE in fatality rate for 0.6 kids 5-9 years 0.4 0.22 0.26 0.2 0.17 0.14 0.11 0.13 0.0 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 Year 21

Age and Gender Affect Risk in Pools 1 • Fatality rate for children 1-2 years : • 8 times higher than 5-9 years 0 years - 1% 5-9 years • 15 times higher than 15-17 years 15% 1 years - 23% • 23 times higher than infants 0-4 years • Boys more likely to drown than girls 73% 2 year - 26% and gender gap widens with age: 10-14 years 7% • Boys under 10 years have twice the risk 3 years - 15% of girls the same age. 4 years - 8% 15-17 years • Boys 10-17 years have three times the 5% risk of girls the same age. 2005-2014, n=3,434 22

Racial Disparities in Pool Drownings 1 Caucasian boys 1.71 Caucasian boys under 5 and • Among those under 5 , Caucasian African-American children drown at higher rates. 1.5 African Fatality rate per 100,000, 2005-2014 boys 5-17 at American boys • Among those 5-17 years , African- greatest risk. Caucasian girls American children drown at 4.5 times 0.95 0.94 0.93 1.0 higher rates. 0.74 • Among African-Americans , the 0.71 fatality rate is 2.6 times higher for 0.56 0.5 boys than girls. 0.37 0.23 • Among Caucasians , the fatality rate is 0.18 0.11 0.11 0.10 0.08 only 1.9 times higher for boys than 0.05 0.04 0.0 girls. 0-4 years 5-9 years 10-14 years 15-17 years 23

Circumstances Surrounding Pool Drownings 1 Location of Fatal Drowning by Age Group From 2005 to 2014 12% 18% 39% 41% 29% Children ages 5-9 29% Proportion of all fatal pool years were equally 8% likely to drown at a 17% friend’s home as drownings their own. 59% 53% 53% 42% 0- 4 years 5-9 years 10-14 years 15- 17 years (n=1009) Age group Friend's House Relative's House 24

Barriers Around Pools 1 Proportion of all pool drownings where a barrier to access was in place and breached (n=1,466) Fence 27% Gate 22% Door 19% Almost half of all pool drowning fatalities involved the failure of at Alarm 2% least one physical barrier. Pool 2% cover 25

Supervision 1 Proportion of Fatalities With No Supervision • Almost HALF of the By Age Group time, they were not supervised by an adult. 90% • If they were supervised, 77% 80% in HALF of these cases 70% the supervision was not Proportion (%) 60% 50% adequate due to drugs, 50% alcohol or other 40% distractions. 24% 30% 14% 20% Children 1-4 years of age 10% were least likely to be 2% supervised at time of pool 0% drowning death. Under 1 year 1-4 years 5-9 years 10-14 years 15-17 years 26

Swimming ability 1 Could not swim Could swim 50% Proportion of children 56% Almost half of kids 10- 17 years who drown in 85% pools reportedly could 98% swim. 50% 44% (n=1085) 15% 2% 0-4 Years 5-9 Years 10-14 Years 15-17 Years Age Group 27