History of drowning deaths in a developing community - the Victorian experience

Background: It is estimated that, annually, there are at least 300,000 deaths due to drowning across the globe,with the majority of these deaths occurring in developing communities. While in recent years, information about the factors contributing to drowning deaths in developing communities has become available, this is still relatively limited, and there is no information about the process of drowning reduction over the course of a community’s development. Objective: The Australian state of Victoria was identified as an example of a community that, over the period of its development, transformed from a community of high drowning mortality to one of low mortality. Using Victoria as a case study, the research program aimed to describe the factors contributing to drowning deaths and identify processes contributing to the reduction of drowning mortality in an historical developing community. Additionally, it aimed to provide information pertinent to drowning prevention in contemporary developing communities. Methods: The studies employed an historical epidemiological approach and sought to identify • Mortality trends – Historical mortality and population statistics were employed to identify patterns of drowning death for the period 1861 to 2000. • Factors contributing to drowning deaths – Records of coronial inquests held into 1162 drowning deaths were accessed and the factors associated with the deaths were identified.• Factors contributing to drowning death reduction – An investigation of historical resources was conducted to identify the processes that were associated with the reduction of drowning deaths during Victoria’s development. Results: Drowning mortality, in Victoria, showed a step wise pattern of reduction over the period of 1861 – 2000, with a major decline in drowning rates occurring by the end of the 19th century. Males were found to have higher drowning mortality than females, with males aged less than 10 years in the 19th century experiencing the highest levels of mortality. The main factors contributing to drowning deaths in Victoria in its early development were the lack of supervision of children, the presence of unprotected hazards in the immediate environment, alcohol intoxication of adult males, the lack of protective physical and organisational infrastructure, and the lack of water survival and rescue skills. It was found that reduction of drowning mortality in Victoria co-occurred with a number of factors - urbanisation of the population, increased hazard awareness, removal of hazard, development of physical and organisational infrastructure, increased water safety skills and improved supervision of children. Conclusions: The findings reported in this thesis suggest that reduction of drowning mortality during the development of a community is a combination of indirect and direct factors. Indirectly, the general development of a community, its built environment, societal changes, and changes in the population’s interaction with the environment can be expected to have some consequences for drowning risk. Direct strategies, specifically targeting drowning death reduction, are also an important component in reduction of drowning mortality in a developing community.