A focus on sex differences in drowning deaths in Australia: the need for reporting on sex and gender in drowning research

Aim: An evidence gap exists on sex and gender differences in drowning with previous research neglecting females. Drowning studies have largely focused on accidental drowning and submersion, excluding other classifications such as intentional, water transport-related, and undetermined drowning. This study examined all external causes of drowning deaths over a 13-year period in Australia disaggregated by sex. Drowning deaths were compared by sex with drowning classification, year, month, age, place of death, Indigenous status, socioeconomic, and visitor status. Subject and methods: This retrospective total population study included all females and males who died from drowning in Australia from 2006 to 2019. Data was extracted from the Australian Bureau of Statistics Cause of Death Unit Record Files. Australian population data were extracted to calculate the crude death rate and relative risk for drowning. Results: There were 4007 drowning deaths recorded, and females represented 25.2% of drowning fatalities. Females were less likely than males to drown, including by drowning classification, year, month, state, remoteness and visitor status, age, socioeconomic, and Indigenous status. The highest proportion of female drowning deaths were from intentional drowning, fall into swimming pools, and in natural water. Drowning deaths among females increased as age increased. Conclusion: There is a clear need for improved disaggregation of sex and gender in drowning research. Without the detailed exploration of females in drowning statistics there will be limited knowledge translation specific to females. The development of drowning prevention strategies targeted to females is required to reduce the incidence and risk of drowning