Abstract
BackgroundWhile a downward trend in unintentional drowning deaths in Australia has been observed, little is known about intentional drowning mortality. Limited information on intentional drowning death impedes the planning, implementation, and evaluation of prevention strategies. This study aims to describe rates of intentional fatal drowning in Australia and compare these to other categories of drowning.MethodsData were sourced from the Australian Bureau of Statistics (ABS) over a 9-year period (2006–2014). Rates and trends of intentional drowning were compared with unintentional, water-transport related and undetermined intent drowning. Rates of intentional drowning deaths across gender, age groups, states/territories, remoteness of residence and First Peoples of Australia were calculated. Relative risk (RR) (95% confidence interval [CI]) was calculated, and chi-square tests of independence were performed (p < 0.05).ResultsThe crude mortality rate for intentional drowning deaths in Australia over the study period was 0.23/100000, lower than unintentional drowning (0.89/100000). Males were 1.6 (CI: 1.4–2.0) times more likely than females to intentionally drown, however females made up a significantly larger proportion of intentional drowning deaths (38.2%) compared to unintentional deaths (22.4%) (χ2 = 47.3; df = 1; p < 0.05). A significant linear association between age group and intentional drowning was observed (χ2 = 131.3; p < 0.05), with individuals aged 75 years and over 32.6 times more likely to intentionally drown. Non-Indigenous peoples were 4.1 times more likely to intentionally drown in comparison to First Peoples of Australia. Residents of Inner Regional, Outer Regional, and Major Cities were 4.2 times (CI: 0.6–30.0), 4.1 times (CI: 0.6–29.9), and 4.0 times (CI: 0.6–28.6) more likely to intentionally drown, respectively, compared with residents of Very Remote areas.ConclusionsThis study adds to the limited evidence currently available about intentional drowning rates and trends in Australia. Being male, of older age groups, non-Indigenous, residing in Inner and Outer Regional areas, and Major Cities were risk factors for intentional drowning deaths. Improving data collection systems and furthering understanding of the risk factors of intentional drowning, as well as the development, implementation, and evaluation of prevention programmes, are required to reduce the risk of intentional drowning death in Australia.
Highlights
While a downward trend in unintentional drowning deaths in Australia has been observed, little is known about intentional drowning mortality
To further extend the understanding of the magnitude of intentional drowning in Australia, this study aimed to examine the rates of fatal intentional drowning in Australia, as compared to other drowning classifications, over the period of 2006 to 2014, using data from the Australian Bureau of Statistics (ABS)
Intentional drowning is a little studied issue worldwide, including in Australia, and, while it represents a smaller proportion of drowning deaths in comparison to unintentional drowning, there has been no change in the Australian intentional rate of fatal drowning over the study period, warranting focused attention
Summary
While a downward trend in unintentional drowning deaths in Australia has been observed, little is known about intentional drowning mortality. As a result of development and increased investment in the area of injury prevention and water safety regulation, a decreasing trend in the global incidence of unintentional drowning deaths has been observed [3, 5,6,7,8]. Despite this promising trend, less is known as to whether this downward trend in unintentional deaths is reciprocated by a decline in intentional drowning death rates [9, 10]. A Swedish study over the period of 1992–2009 reported 31% of all drowning deaths in the country were identified as suicidal, with a significantly higher proportion in females (55%, p < 0.001) and the highest incidence in those aged 50–59 and 60–69 years [11]
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