Water Safety and Health: A WHO Priority

On the eve of the 2023 World Conference on Drowning Prevention taking place in Perth, Western Australia, it is timely to consider the importance attached to water safety by the World Health Organization (WHO). Rated the third leading cause of unintentional injury death globally, the WHO describes drowning as “one of the world’s most preventable, neglected and pressing public health issues” [1].

One of the main prevention measures to reduce drowning is learning to swim. This is clearly important to keep children and young people safe, since drowning is the sixth leading cause of death worldwide for children aged 5-14 years. Drawing on emerging evidence that teaching children to swim is a key element in drowning prevention, the WHO recommends basic swim skills and water safety training programs for children aged 6 years or older in high-, low- and middle-income countries [2].

In a recent technical report, the American Academy of Pediatrics (AAP) supports swimming lessons for children older than 1 year, noting that the goal of swim lessons is to reduce the risk of drowning but also to promote and prepare for parent-child activities, exercise, fun, and enjoyment of the long process of acquiring aquatic learning and water competency [3].

Equally important, swimming has a very large range of positive health benefits.

A new report by Sheffield Hallam University prepared for Swim England [4] demonstrates strong links between swimming and social outcomes in physical health, subjective wellbeing, individual development, and social and community development. Some of the highlighted findings are:
A. Physical health
There is evidence to show that, compared to the average population, swimming is associated with being about 6.4% healthier in general, having around 3.1% better mental health and having about 1.4% lower body mass.
B. Subjective wellbeing
There is evidence to show that swimming is associated with higher levels of wellbeing when compared to non-swimmers. This includes:
a) Ability to relax and feelings of mindfulness.
b) Improved mood.
c) Reduced stress and anxiety.
d) Improved body confidence.
e) Improved happiness.
C. Individual development

There is evidence of the impact of swimming on enhancing human capital, in particular through:
a) Improved life skills (water safety skills and water confidence) - potentially leading to a reduction in drowning.
b) Improved confidence in accessing other water-based activities.
c) Improved ability/confidence in setting goals.
d) Improved self-esteem.

D. Social and community development
There is evidence of swimming having a positive impact upon feelings of social inclusion, such as:
a) Reduced feelings of loneliness.
b) Increased feelings of belonging.
c) Higher levels of social trust.

Social and community development is particularly important following the global shutdowns during COVID-19, which saw the closure of many learn to swim programs. In Australia, for example, there were almost two years of swimming lessons disrupted and an estimated 10 million lessons cancelled [5].

This impacts adults as well as children, the Australian Water Safety Strategy 2030 identifying young males (15-29 years) and older people (65+ years) as particularly ‘at risk’ for drowning, and the critical role of water safety across a variety of settings, such as beaches, rivers and lakes, and across activities such as boating, watercraft, fishing, scuba diving and snorkelling. Swimming and water safety skills are a priority area to address these risk factors [6].

Following the landmark Global Report on Drowning: Preventing a Leading Killer [7] the WHO has been very active in drowning prevention and water safety more broadly, developing detailed guidelines, resources and support materials.

In April 2021, the United Nations General Assembly adopted the first-ever Resolution on drowning prevention, which highlighted links to sustainable development, social equity, urban health, climate change, disaster risk reduction, and child health and wellbeing. The Resolution called on WHO to coordinate multisectoral drowning prevention efforts within the UN system and announced 25 July each year as World Drowning Prevention Day [8].

The author declares that he has no competing interests in the drafting of this paper.

1. WHO (2017) Preventing drowning: An implementation guide. Geneva, Switzerland.
2. WHO (2021) WHO guideline on the prevention of drowning through provision of day-care and basic swimming and water safety skills. Geneva, Switzerland.
3. Denny SA, Quan L, Gilchrist J, McCallin T, Shenoi R, et al. (2021) AAP Council on injury, violence, and poison prevention. Prevention of drowning. Pediatrics 148(2): e2021052227.
4. Griffiths K, Davies L (2023) Social value of swimming in England. Literature review: Final report.
5. PwC Australia (2022) Towards a nation free from drowning: The role of learn to swim. Prepared for Royal Life Saving, Sydney, Australia.
6. Australian Water Safety Council (2021) Australian water safety strategy 2030.
7. WHO (2014) Global report on drowning: Preventing a leading killer. Geneva, Switzerland.
8. WHO (2023) Drowning. Key facts. Geneva, Switzerland.