Comparing rivers to lakes: Implications for drowning prevention

Yarning about river safety: A qualitative study exploring water safety beliefs and practices for First Nations People

ISSUE ADDRESSED

Water is vital to Australian First Nations Peoples' connection to country and culture. Despite this cultural significance, and epidemiological studies identifying elevated drowning risk among Australian First Nations Peoples, extremely limited qualitative research explores water safety beliefs and practices of First Nations Peoples. This study addressed this knowledge gap via qualitative research with Wiradjuri people living in Wagga Wagga, New South Wales.

METHODS

Under Aboriginal Reference Group guidance, a local researcher recruited participants using purposive sampling for yarning circles across four groups: young people aged 18-30 years, parents of children under 5, parents of older children and adolescents and Elders. Yarning circles were audio recorded, transcribed and thematically coded using an inductive approach.

RESULTS

In total, 10 First Nations individuals participated. Yarning led to rich insights and yielded five themes: families as first educators; importance of storytelling, lived experience and respect for knowledge holders; the river as a place of connection; historical influence on preference for river over pool and river is unpredictable and needs to be respected.

CONCLUSIONS

This study demonstrates the importance of First Nations culture to water safety practices, particularly around the river. To reduce drowning risk among First Nations populations, knowledge holders need to be embedded in the design and delivery of community water safety education. SO WHAT?: Co-designing water safety initiatives with First Nations Peoples will have dual benefits; developing culturally appropriate and locally relevant water safety education, while also continuing First Nations culture across generations.

Disadvantaged by More Than Distance: A Systematic Literature Review of Injury in Rural Australia

Rural populations experience injury-related mortality and morbidity rates 1.5 times greater than metropolitan residents. Motivated by a call for stronger epidemiological evidence around rural injuries to inform prevention, a systematic review of peer-reviewed literature published between January 2010 and March 2021 was undertaken to explore the epidemiology of rural injury and associated risk factors in Australia. A subsequent aim was to explore definitions of rurality used in injury prevention studies. There were 151 papers included in the review, utilizing 23 unique definitions to describe rurality. People living in rural areas were more likely to be injured, for injuries to be more severe, and for injuries to have greater resulting morbidity than people in metropolitan areas. The increase in severity reflects the mechanism of rural injury, with rural injury events more likely to involve a higher energy exchange. Risk-taking behavior and alcohol consumption were significant risk factors for rural injury, along with rural cluster demographics such as age, sex, high socio-economic disadvantage, and health-related comorbidities. As injury in rural populations is multifactorial and nonhomogeneous, a wide variety of evidence-based strategies are needed. This requires funding, political leadership for policy formation and development, and implementation of evidence-based prevention interventions.

Analysis of fatal unintentional drowning in Australia 2008-2020: implications for the Australian Water Safety Strategy

OBJECTIVE

To examine temporal trends in drowning in Australia against targets set in the Australian Water Safety Strategy (AWSS) 2008-2020 and to inform the development of the next iteration of the Strategy.

METHODS

A national analysis of unintentional fatal drowning rates per 100,000 population over 16 years (2004/05-2019/20) was conducted. Baseline rates (three-year average 2004/05-2006/07) were compared to the current three-year average (2017/18-2019/20) by sex, age group, drowning location and jurisdiction.

RESULTS

The overall rate of unintentional fatal drowning during the period decreased by 28%. Substantial reductions were observed in children 0-4 years (-63%) and 5-14 years (-56%). Progress has been less pronounced among people aged 75 years and over (-11%) and 15-24-year-olds (-14%). All locations and jurisdictions recorded reductions, aside from rocks (+46%).

CONCLUSIONS

Although the strategy fell short of its aspirational target of a 50% reduction in drowning by the year 2020, this target was exceeded in key age groups, including children. Implications for public health: The AWSS is a powerful tool to align drowning prevention sector actions to agreed objectives. Forthcoming strategies must take into consideration demographic and social change, areas where limited progress has been made and the latest evidence to guide future priorities.

Exploring the Impact of Remoteness and Socio-Economic Status on Child and Adolescent Injury-Related Mortality in Australia

Injuries are a leading cause of harm for children. This study explores the impact of determinants of health on children (0-19 years) injury-related mortality (namely remoteness and socio-economic disadvantage, calculated using the index of relative socio-economic advantage and disadvantage (IRSAD)). Cause of death data from the Australian Bureau of Statistics were sourced for children in Australia between 1 July 2007 to 30 June 2017. Fifteen injury categories (ICD-10-AM external cause codes) were used. Burden and trends by injury mechanism were explored. A total of 5153 children died; with road traffic incidents (3.39 per 100,000 population), intentional self-harm (2.46) and drowning (0.72) being the leading mechanisms. Female fatality rates in very remote areas (8.73) were nine times higher than in major cities (Relative Risk [RR] = 8.73; 95% Confidence Interval [95% CI]: 4.23-18.00). Fatality rates increased with remoteness; very remote areas recording an injury-related fatality rated six times (RR = 5.84; 95% CI: 3.76-9.12) that of major city residents. Accidental poisoning and intentional self-harm fatalities were more likely in high IRSAD areas, while road traffic fatalities were more likely in low and mid socio-economic areas (X2 = 69.1; p < 0.001). People residing in regional and remote areas and from low socio-economic backgrounds already face significant health and lifestyle challenges associated with disadvantage. It is time to invest in injury prevention interventions for these populations, as well as upstream policy strategies to minimize any further preventable loss of life.