Drowning Prevention


Decrease the incidence of fatal and non fatal drowning in Hawaii.

Magnitude of the Problem

Drownings are the 5th leading cause of fatal injuries among Hawaii residents, with an average of nearly 40 deaths a year. Drowning is the only injury cause for which non-residents comprise a majority of victims (53%), and their inclusion increases the average annual number of deaths to 83. Hawaii had the 2nd highest resident drowning fatality rate among all 50 States from 2013 to 2017, behind only Alaska. Within the state, residents of Hawaii County had the highest mortality rates, significantly higher than the rate for residents of Oahu. There was a slight increasing trend in the annual number of deaths; the change from ICD9-CM coding to ICD10-CM coding in October 2015 makes the assessment of trends in nonfatal drownings difficult. Most (84%) of the fatal drownings in Hawaii were in the ocean. Snorkeling was the most common activity, associated with 27% of all ocean drownings and 42% of those among non-residents. A review of EMS records of hospital patients indicated a very similar distribution of activity among victims of nonfatal ocean drownings. Children under 5 years of age comprised 30% (6) of the 20 victims of fatal swimming pool drownings, making this the leading cause of injury mortality among 1 to 4 year-old.

Long-Term Indicators

Mortality and morbidity of Hawaii residents only: County & Totals, annual number and rate (/100,000)


SMART Objective: Decrease the 5-year drowning related mortality rate among Hawaii Residents from 13.02/100,000 in 2013-2017 to 11.72/100,000 by 2018-2022


SMART Objective: Decrease the 5-year drowning related morbidity rate among Hawaii Residents from 40.02/100,000 in 2013-2017 to 36.02/100,000 by 2018-2022

Annual Fatal and Nonfatal Trends

Recommended Strategies

The Emergency Medical Service and Injury Prevention System Branch (EMSIPSB) places a priority on having injury prevention strategies recommended by a community-driven action plan or informed by key implementing partners. Because a multitude of factors influence individual behavior, the strategies in the below table target risk and protective factors, framed across the individual, relationship, community, and policy levels.

Key Partners