Keep young children in sight near water; wear life jackets when boating or swimming

12. Keep young children in sight near water; wear life jackets when boating or swimming

Cost: Life jackets cost between 50 and 200 yuan. Additionally, parents must dedicate constant attention to watching their children.

In plain terms: Wearing a life jacket while in the water cuts the risk of drowning to roughly half compared to not wearing one. Drowning remains the leading cause of death among children aged 1–14 in China. The drowning mortality rate in rural areas is roughly twice that in cities.

Benefit: Research using U.S. Coast Guard data compared similar groups of people. For individuals who fell overboard while boating recreationally, wearing a life jacket lowered their drowning risk by about half. The unadjusted RR was 0.51, with a 95% CI of 0.35–0.74. In China, the drowning mortality rate among people under 20 fell from 6.60 per 100,000 in 2013 to 3.28 per 100,000 in 2021; rural rates remained roughly twice those in cities. Drowning continues to be the top cause of death for children aged 1–14. In 2021, drowning accounted for 31.1% of all injury-related deaths among those aged 0–19, while road traffic injuries accounted for 27.9%.

Evidence grade: A

Sources: Cummings P et al. (2011). Association between wearing a personal floatation device and death by drowning among recreational boaters. Injury Prevention. <https://doi.org/10.1136/ip.2010.028688>; Li Z et al. (2023). Unintentional Drowning Mortality Among Individuals Under Age 20 — China, 2013–2021. China CDC Weekly. <https://doi.org/10.46234/ccdcw2023.198>; Zhou J et al. (2024). Injury Mortality of Children and Adolescents Aged 0–19 Years — China, 2010–2021. China CDC Weekly. <https://doi.org/10.46234/ccdcw2024.057>

Notes: The Grade A rating applies only to the protective effect of life jackets. The practice of keeping children within sight is widely accepted but only qualifies for a Grade C rating due to lack of randomized trials; no such trials are expected in the future. In China, drowning deaths occur most often in rural areas during summer months, and among males aged 15–19.