Analysis of Accidental Drowning Rates in Taiwan

Over the past several years I have been collecting data from the ministry of health and the National Fire Association (NFA) on all accidental drownings that occur in Taiwan.  I then sent this data to an epidemiologist, or public health scientist (my dad), in the united states who analyzed it and came up with some findings regarding drowning risk in Taiwan.  (中文版:台灣意外溺水率分析)

 

Dr .Jack Leiss PhD, UNC
 


 In this video I will go over those findings, talk about the trend of drownings to see if it is increasing or decreasing, break down drowning deaths by age group, and make determinations about who is at risk, where they are at risk, and try to come up with some recommendations for how to reduce the rate of drownings in Taiwan.

Drowning Rate By Age, 2014-2018
 

This graph shows the age-adjusted drowning rate for men and women in Taiwan.  The blue line represents males, while the red females.  It’s no surprise that men have more accidents, we aren’t as smart as women.  I expect most people guessed that. But the real interesting data here is showing that drowning rates are very low for men under 35.  Contrary to public perception. It starts to climb rapidly after that, and there is a huge spike after 65 years old.  A 65 year old male is 4 times more at risk of drowning than a 20 year old male. An 80 year old is 8 times at risk.  For women it’s less pronounced. The incidence rate is low and steady until 65.  

Knowing who is at risk is important, because that’s the first step toward prevention. In this case that’s older people, which is very interesting to me because almost everyone I talked to guessed this wrong. In an informal survey I did on the street, about 90 percent of respondents guessed that children, teenagers or people in their low twenties were most at risk. Public perception seems to be the opposite of what the data displays.  Children are the least at risk age group of drowning in Taiwan. 

It’s easy to see how this perception came about though.  As recently as last month, in articles reporting on drownings during Dragon Boat Festival, newspapers were citing a 2007 Taipei Times article that in turn was reporting on data from 1994-2001 study, saying that drowning is the 2nd largest cause of accidental death among children aged 0-14. 

Much has changed in the last twenty years though.  The drowning rate in children is 2/3rds what it used to be, and the overall drowning rate is down 80 percent in 30 years.  That’s right.  Only 1/5th the amount of total drownings happen today as compared with 30 years ago.That’s an incredible achievement.      

 

Drowning Rate By Age, 2014-2018
 

Public perception is a little more accurate with the general trend of drowning.  When I interviewed people prior to presenting this data, the answers were split pretty evenly between increasing, decreasing, or remaining stable. 

In this graph, we can see a very steady decline from 1990 until about 2011, where it levels off at around 1.5 deaths per 100,000 population. If we zoom in you can see that the last five years were relatively stable, with men making up about 80 percent of drowning deaths.

 

Drowning Rate By Age, 2014-2018

Drowning Rate By Age, 2014-2018

In real terms, this means a reduction in drowning deaths of more than 1200 per year.  From over 1500 drownings in the late 1980s, to around 300 today.  That is a significant public health achievement.  And one that I am not quite sure how was achieved. 

Instinct says that increased swimming education in youths have decreased drownings in Taiwan, and there is some evidence to suggest that.  When we compare the average of the last 5 years to the previous 5 years before that, we can see that the youth drowning rate has decreased more among youths than older people. This suggests that the swimming education initiative which started 15 years ago may indeed be working to reduce deaths.  But to prove that would require studying individualized data. I think it’s likely a contributing factor, and something worth following up on.

 

Drowning Rate By Age, 2014-2018
 

I also collected from the NFA which is very interesting.  It includes not only drowning deaths, but also successful rescues.  It has columns for location (river, pier, ocean, lake, swimming pool etc,) and how it happened (fishing, playing in the water, slip and fell, boat overturning, scuba diving, etc), and even if the victim knew how to swim or not. But the data is too incomplete to make any real conclusions about the risks of certain areas or activities.  

Even after really simplifying the data by combining all river and lake type accidents into one group, and all pier, harbor, beach, and boat accidents into another group, we still can’t really analyze it because 60% of all accidents are listed as unknown.

 

Drowning Rate By Age, 2014-2018

We get similar results for what activities lead to accidents and the victims swimming ability.  These variables would really give us a clear picture of what and where people are at risk for drowning, but the data isn’t complete enough. To follow up on this will require better data.  

Conclusion

The main takeaway here is that elderly are far more at risk of drowning than young people.  To reduce drowning deaths, steps should be taken to protect elderly near water, such as providing life jacket stations in busy areas or increasing the amount of rescue rings.

Another finding is that drowning does not appear to be a major public health crisis.  It makes up only 5 percent of total accidental deaths behind accidental poisoning (is that mostly drugs? I’m not sure), falls, and overwhelmingly traffic accidents, which make up more than half of all accidental deaths.

 

Drowning Rate By Age, 2014-2018
 

This is especially pronounced in young people.  Over 70% of accidental deaths for males aged 10-29 are vehicle accidents, while 6 percent are drownings.    

Drowning Rate By Age, 2014-2018

Regardless of drowning not being a major cause of accidental death in Taiwan, every death is still a tragedy and we should find ways to prevent them.  The 326 deaths a year are still nearly a death a day.  Further research should be done (funded research to a university in Taiwan, there’s only so much science you can do without a budget) and I personally think that more resources should be directed towards teaching people how to swim.  Elderly people are the most at risk.  Programs to reduce this risk could include publicly available life jackets to borrow, or subsidized swimming lessons.  Swimming is also a good cardio workout, which may also lead to decreases in other illnesses like heart disease.

Lastly I would like to point out that in addition to the 326 accidental drownings, there were also 275 intentional drownings (out of 3875 total suicides) last year.  Considering the many unknowns involving drowning cases, it’s likely that some accidental cases were actually suicides as well.  Mental Health is Health, and mental health care is very expensive in Taiwan. Psychotherapy and counseling are not covered under the National Health Insurance. Including mental health care with physical health care may help to reduce drownings and others deaths further. It’s not really the focus of this article, but it’s something to think about.

DATA:
(Combined Data (drowning only))

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The information on this page is for reference only. Your safety and following all the regulations in Taiwan are your own responsibility. For each outing, pay attention to the weather and do not go into the rivers after heavy rains or when there is a chance of heavy rain. Each person needs to prepare equipment and safety gear according to the conditions and their own abilities. Always look out for slippery surfaces, unstable ground, landslides and falling rocks. Be aware of the water depth, and be extra vigilant around fast flowing water. Be cautious you will have amazing adventures. Thank you for taking all your garbage out with you.