Disparities in and characteristics of drowning deaths in India: findings from a population-based mortality study

We report on sociodemographic inequalities in drowning mortality rate and characteristics of drowning deaths in India.

Verbal autopsy interviews were undertaken for a nationally representative sample of deaths of all ages between 2019 and 2022 in 1 million population across nine Indian states. Details about drowning were documented from the adult most knowledgeable about the event.

Data were available for 26 964 deaths (92.1% participation). Drowning deaths accounted for 0.48% all deaths with the highest proportion in the lowest wealth index. It accounted for 8.8% of unintentional injury deaths at an annualised drowning mortality rate of 3.2 (95% CI 2.1 to 4.3) per 100 000 population. This rate was 3.3 times significantly higher in males than in females. The age-specific mortality rate was the highest for 50-76 years (4.1 per 100 000) followed by 10-14 years (3.9 per 100 000). The mean age at death was 59.1 years irrespective of the cause of death and was 30.9 years for drowning deaths. Bathing, followed by playing near a waterbody and crossing a waterbody, was the most common activities at the time of drowning with variations documented by type of waterbody, age, sex and state. 23 deceased (17.7%) were found alive post-drowning, but 11 (55.0%) had died before reaching a healthcare provider. 53 (40.8%) of drowning deaths were likely not reported to the police, with significant state and urban-rural variations.

These findings can facilitate targeted drowning prevention strategies under the National Strategic Framework for Drowning Prevention of India.