Socioeconomic status and barriers to swimming participation among children and adolescents: a systematic literature review

Naluri Denay; Pringgo Mardesia

doi:10.32698/03082

Socioeconomic status and barriers to swimming participation among children and adolescents: a systematic literature review

Naluri Denay⁽¹⁾, Pringgo Mardesia⁽²⁾,
(1) Universitas Negeri Padang

Indonesia
(2) Universitas Negeri Padang

Indonesia

Corresponding Author

DOI : https://doi.org/10.32698/03082

Full Text:

Language : en

Abstract

Drowning has been and will continue to be a great source of preventable accidental injuries that people die of and swimming is one among many skills which are strongly linked to the person's level of socioeconomic status. The researchers of this systematic analysis have pooled the most updated pool of the world's knowledge on the topic of how socioeconomic factors influence swimming and water safety programmes for the water plus the reported ways of achieving a better equity. A review based on the methodology laid out by the PRISMA 2020 statement for systematic review and meta-analysis was chosen. In the review a structured Boolean search was used only on studies in the English language in the Scopus database from 2021-2026 period. Initially, 586 records were found and 15 were duplicates (the same paper). After several screening stages (i.e.title and abstract) against the set eligibility criterions, 18 papers were finally chosen for evaluation. Two evaluators independently assessed titles/abstracts and texts, while evaluating the agreement between them by the statistic of Cohen's kappa (κ = 0.91). The combination of search words employed ("socioeconomic status" OR "socioeconomic status") AND ("swimming" OR "aquatic") AND ("access" OR "participation" OR "barriers") resulted in the Boolean search string. Following the thematic analysis, it was carried out by using the coding method in six-phase inductive of Braun and Clarke. To be sure of coding reliability it was cross-checked between two reviewers. Papers have appeared from different authors of Australia (Australia), US, New Zealand, Israel, Belgium, Japan and Indonesia while study techniques employed include qualitative, quantitative, and mixed methods. The analysis by themes found that socioeconomic status plays a role in one's ability to participate and swim lessons and the two main barriers are cost and the lack of availability. Also, the strategies to achieve equality that are most effective are price discounts, programmes delivered by schools, and programmes that are culturally sensitive. Research findings support the area of aquatic activity as well as equip decision-makers with concrete, equity-targeted ways. The research paper advocates longitudinal research on disadvantaged populations, an intersectional perspective, and establishing benchmarks on the measurement of accessibility.

Keywords

Socioeconomic status, Swimming participation, Water safety, Drowning prevention, Health equity

References

Agam, A., Barnea, R., & Godler, Y. (2026). Preventive infrastructure and childhood health equity in Israel: Socioeconomic and ethnic disparities in playground access and swimming instruction. International Journal for Equity in Health. https://doi.org/10.1186/s12939-026-02826-x

Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50(2), 179–211. https://doi.org/10.1016/0749-5978(91)90020-T

Ananthapavan, V., Peden, A. E., Angell, B., & Macniven, R. (2024). Barriers to preschool aged children's participation in swimming lessons in New South Wales, Australia. Health Promotion Journal of Australia. https://doi.org/10.1002/hpja.811

Anderson, K. R., Ramos, W. D., & Schuman, J. T. (2021). The role of permission, supervision, and precipitating events in childhood pool/spa submersion incidents, United States, 2000–2017. International Journal of Environmental Research and Public Health, 18(16). https://doi.org/10.3390/ijerph18168776

Calverley, H. L. M., Petrass, L. A., & Blitvich, J. D. (2021). Alcohol consumption in aquatic settings: A mixed-method study exploring young adults' attitudes and knowledge. Drugs: Education, Prevention and Policy, 28(6), 595–605. https://doi.org/10.1080/09687637.2020.1832962

Carter, B. C., & Koch, L. (2023). Swimming lessons for children with autism: Parent and teacher experiences. OTJR: Occupation, Participation and Health, 43(2), 245–254. https://doi.org/10.1177/15394492221143048

Cenderadewi, M., Franklin, R. C., Fathana, P. B., & Devine, S. G. (2025). Adapting WHO drowning prevention strategies for children in Indonesia: Barriers, enablers, and policy perspectives for LMICs. The Lancet Regional Health – Southeast Asia. https://doi.org/10.1016/j.lansea.2025.100697

Ferrari, G., Rezende, L. F. M., Florindo, A. A., Mielke, G. I., & Peres, M. F. T. (2021). School environment and physical activity in adolescents from São Paulo city. Scientific Reports, 11(1). https://doi.org/10.1038/s41598-021-97671-z

Hamilton, K., Peden, A. E., Smith, S. R., Keech, J. J., Phipps, D. J., & Hagger, M. S. (2026). Socio-structural factors as predictors of parents' intentions to enrol their children in swimming lessons. Health Promotion Journal of Australia. https://doi.org/10.1002/hpja.70183

Hong, Q. N., Pluye, P., Fàbregues, S., Bartlett, G., Boardman, F., Cargo, M., Dagenais, P., Gagnon, M.-P., Griffiths, F., Nicolau, B., O'Cathain, A., Rousseau, M.-C., & Vedel, I. (2018). Mixed Methods Appraisal Tool (MMAT), version 2018. Registration of Copyright (#1148552), Canadian Intellectual Property Office, Industry Canada.

Işın, A., & Peden, A. E. (2026). Is swimming and water safety education associated with greater water safety knowledge and positive attitudes in young adults? Safety, 12(2). https://doi.org/10.3390/safety12020053

Jagnoor, J., Scarr, J., & Gupta, M. (2025). Qualitative exploration of barriers and enablers to migrant access to water safety programmes in Australia. BMJ Open. https://doi.org/10.1136/bmjopen-2025-107233

Klosky, J. V., Moreland, B., & Clemens, T. (2025). Special report from the CDC: The association between social vulnerability and unintentional fatal drowning in the United States, 1999–2023. Journal of Safety Research, 93, 447–450. https://doi.org/10.1016/j.jsr.2025.04.004

Kosak, L.-A., Harandian, K., Bacon, S. L., Fitzpatrick, C., Correale, L., & Pagani, L. S. (2024). Active child, accomplished youth: Middle childhood active leisure fuels academic success by emerging adulthood. Children, 11(9). https://doi.org/10.3390/children11091140

Kye, S. Y., Cho, H., Thao Tran, T. P., Oh, J.-K., & Lim, M. K. (2021). Associations of physical activity at work and household income with obesity: A cross-sectional study among rural adults in Korea. Epidemiology and Health, 43. https://doi.org/10.4178/epih.e2021003

Leavy, J. E., Bona, M. D., Abercromby, M., & Crawford, G. (2022). Drinking and swimming around waterways: The role of alcohol, sensation-seeking, peer influence and risk in young people. PLoS ONE, 17(11). https://doi.org/10.1371/journal.pone.0276558

Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gøtzsche, P. C., Ioannidis, J. P. A., Clarke, M., Devereaux, P. J., Kleijnen, J., & Moher, D. (2009). The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: Explanation and elaboration. PLoS Medicine, 6(7), e1000100. https://doi.org/10.1371/journal.pmed.1000100

López-Cañada, E., Devís-Devís, J., Pereira-García, S., & Pérez-Samaniego, V. (2021). Socio-ecological analysis of trans people's participation in physical activity and sport. International Review for the Sociology of Sport, 56(1), 62–80. https://doi.org/10.1177/1012690219887174

Low, L., Graefe, H. L. M., Willcox-Pidgeon, S. M., & Barnett, L. M. (2026). Exploring the swimming and water safety behaviour among Indian and Vietnamese adults in Australia. Health Promotion Journal of Australia. https://doi.org/10.1002/hpja.70163

Macniven, R., Mead, E., Angell, B., & Peden, A. E. (2025). Population reach and redemption of swimming lesson vouchers for pre-school-aged children in New South Wales, Australia. Public Health. https://doi.org/10.1016/j.puhe.2025.105958

Macy, M. L., Kendi, S., Beale-Tawfeeq, A., Bendelow, A. C., Lennon, T., & Heffernan, M. E. (2024). Barriers to swimming lessons for children. Pediatrics. https://doi.org/10.1542/peds.2024-068122

Matta, P. N., Baul, T. D., Loubeau, K., Sikov, J., Plasencia, N., Sun, Y., & Spencer, A. E. (2021). Low sports participation is associated with withdrawn and depressed symptoms in urban, school-age children. Journal of Affective Disorders, 280, 24–29. https://doi.org/10.1016/j.jad.2020.11.076

Miller, A., Anderson, K. R., & Ramos, W. D. (2024). Barriers: Location, functionality, and method of access in childhood pool/spa submersion incidents, United States, 2000–2017. International Journal of Aquatic Research and Education, 14(3). https://doi.org/10.25035/ijare.14.03.04

Mukherjee, B., Chavan, K. D., Buktar, S. B., & Manjhi, S. (2024). Profile of drowning deaths: A cross-sectional study from Loni, Maharashtra. Indian Journal of Forensic Medicine and Pathology, 17(2), 81–84. https://doi.org/10.21088/ijfmp.0974.3383.17224.2

Nagata, J. M., Wong, J. H., Helmer, C. K., Diep, T., Domingue, S. K., Al-shoaibi, A. A. A., Ganson, K. T., Testa, A., Dooley, E. E., Gooding, H. C., Baker, F. C., & Pettee Gabriel, K. (2025). Social epidemiology of sports and extracurricular activities in early adolescents. Pediatric Research, 98(4), 1313–1322. https://doi.org/10.1038/s41390-025-04099-6

Nicklett, E. J., Sharma, B. B., & Testa, A. (2024). Physical activity and local blue/green space access during the COVID-19 pandemic. American Journal of Health Promotion, 38(7), 970–979. https://doi.org/10.1177/08901171241244892

Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., … Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, 372, n71. https://doi.org/10.1136/bmj.n71

Peden, A. E., Fozard, F., Walker, G., Hone, E., Hanly, M., & Möller, H. (2025). Water skills for life: Assessing population-level coverage of a school-based aquatic program in Aotearoa, New Zealand. Journal of Safety Research. https://doi.org/10.1016/j.jsr.2025.08.010

Peden, A. E., Mead, E., & Macniven, R. (2026). The views of swim school providers on impacts of a population-level swimming lesson voucher program. Health Promotion Journal of Australia. https://doi.org/10.1002/hpja.70177

Playter, K., Hurley, E., Lavin-Parsons, K., Parida, K., Ballinger, Z., Wong, K., & Valente, A. (2024). Water safe Worcester: Student-led drowning prevention in an adolescent underserved population. Frontiers in Public Health. https://doi.org/10.3389/fpubh.2024.1387094

Safi, S. A., & Bachynski, K. (2026). Improving accessibility of swimming lessons to reduce childhood drowning rates. Discover Public Health. https://doi.org/10.1186/s12982-026-02339-6

Santibañez-Gutierrez, A., Fernández-Landa, J., Calleja-González, J., Todorović, N., Ranisavljev, M., Štajer, V., Anđelić, B., Zenić, N., Bianco, A., & Drid, P. (2022). Epidemiology of children's swimming competence and water safety. Frontiers in Public Health, 10. https://doi.org/10.3389/fpubh.2022.961342

Spittle, S., Spittle, M., & Itoh, S. (2022). Outsourcing physical education in schools: What and why do schools outsource to external providers? Frontiers in Sports and Active Living, 4. https://doi.org/10.3389/fspor.2022.854617

Stahlmann, K., Mena, E., Kuhnert, R., Conrad, A., & Bolte, G. (2022). Social inequalities in the association between social infrastructure and mental health: An observational cross-sectional analysis of children and adolescents in Germany. International Journal of Environmental Research and Public Health, 19(11). https://doi.org/10.3390/ijerph19116760

Tanaka, C., Lee, E.-Y., & Tanaka, S. (2025). Relationship between socioeconomic status and organized sports among primary school children: A gender-based analysis of sports participation. Sports. https://doi.org/10.3390/sports13060165

Thibaut, E., Van Poppel, M., & Scheerder, J. (2022). Just keep on swimming: The policy effectiveness of building swimming pools. European Journal for Sport and Society. https://doi.org/10.1080/16138171.2021.1878434

Thomas, J., & Harden, A. (2008). Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Medical Research Methodology, 8, 45. https://doi.org/10.1186/1471-2288-8-45

Tranfield, D., Denyer, D., & Smart, P. (2003). Towards a methodology for developing evidence-informed management knowledge by means of systematic review. British Journal of Management, 14(3), 207–222. https://doi.org/10.1111/1467-8551.00375

Wang, S., Macniven, R., Peden, A., & Angell, B. (2026). Evaluating the economic impact of learn-to-swim programmes: A cost–benefit analysis of the First Lap voucher programme in Australia. Health Promotion Journal of Australia. https://doi.org/10.1002/hpja.70162

Wareham, D. M., Fuller, J. T., Pocovi, N. C., Jenkins, H., Ayre, J., Mace, K., Tambree, K., & Hancock, M. J. (2026). Motivators, barriers, and facilitators for starting and continuing a swimming program for chronic back pain: A qualitative study. Musculoskeletal Science and Practice, 82. https://doi.org/10.1016/j.msksp.2026.103518

Willcox-Pidgeon, S. M., Peden, A. E., & Scarr, J. (2021). Exploring children's participation in commercial swimming lessons through the social determinants of health. Health Promotion Journal of Australia. https://doi.org/10.1002/hpja.335

Willcox-Pidgeon, S., Franklin, R. C., & Devine, S. (2025). Drowning prevention strategies for migrant adults in Australia: A qualitative multiple case study. BMC Public Health. https://doi.org/10.1186/s12889-025-23104-5

Windle, N., Peden, A. E., Angell, B., & Macniven, R. (2026). Parent/carer experiences and challenges in redeeming the First Lap swimming lesson voucher in New South Wales, Australia. Managing Sport and Leisure. https://doi.org/10.1080/23750472.2024.2373141

World Health Organization. (2014). Global report on drowning: Preventing a leading killer. World Health Organization.