Exploring children's participation in commercial swimming lessons through the social determinants of health

Issue addressed: Drowning is a public health challenge, disproportionately impacting children. Social determinants of health (SDH) such as socio-economic disadvantage and geographic isolation increase drowning risk. Swimming and water safety lessons, in part, have reduced drowning in children, while also enabling healthy aquatic participation. Research suggests that some Australian children receive insufficient swimming and water safety education and are not achieving essential skills. Methods: A cross-sectional retrospective analysis of swimming and water safety skills achieved by a cohort of children (5-12 years) attending commercial swimming lessons in three Australian states was undertaken. Variables included participant demographics (age, gender, and the SDH of socio-economic status [SES], and geographical remoteness) and skills being taught and achieved. Skills achieved were analysed against the National Swimming & Water Safety Framework and the National Benchmark. Results Swim schools were more likely to teach freestyle (87%) and backstroke (83%); and less likely to teach water safety skills like treading water (53%), and survival backstroke (46%). Overall, 40% of 12-year-old children failed to achieve the National Benchmark of 50 metres freestyle, fewer were achieving minimum water safety skills. Children from low socio-economic areas and regional locations were less likely to be achieving 50 metres freestyle. Children in this study were commonly from major cities (94%) and of high socio-economic areas (53%). Conclusions: Swimming lessons must incorporate a broad range of swimming and water safety competencies to ensure children have the skills required to reduce drowning, especially for those deemed at increased risk. So what Stakeholders must prioritise holistic drowning prevention education strategies, ensuring all children can access swimming and water safety programs regardless of their socio-economic status or geographical location