Abstract / Summary
Abstract Background Drowning is the leading cause of death during flooding events. Due to the way death certificates are coded, flood deaths related to drowning are not included in drowning statistics. The objective of this study was to estimate the percentage of flood deaths related to drowning in the United States. Methods Flood deaths from the National Vital Statistics System from 2018 to 2024 were identified if International Classification of Disease 10th Revision (ICD-10) code X38 (“victim of flood”) was listed as the underlying cause of death. Flood deaths were considered drowning-related if one of the 20 possible multiple causes of death fields contained an unintentional drowning ICD-10 code. Results Of the 334 flood deaths identified from 2018 to 2024, 93.4% were drowning-related. All flood deaths among people aged 15 to 24 and 25 to 34 years, non-Hispanic Asian, and non-Hispanic Black people were drowning-related. Among urban residents, 97.3% of flood deaths were drowning-related compared to 88.6% among rural residents. The percentage of flood deaths related to drowning ranged from 70.9% in 2022 to 100.0% in 2018, 2020, and 2024. Conclusion Most flood deaths were drowning-related. Excluding flood deaths in drowning surveillance efforts underestimates the burden of drowning, especially among populations where all flood deaths are drowning-related. Including flood deaths in drowning statistics and prevention efforts is especially important as major flooding events are projected to become more frequent. Researchers assessing the burden of drowning may consider including deaths with a flood-related underlying cause in their analysis.