What makes children learn how to swim? - health, lifestyle and environmental factors associated with swimming ability among children in the city of Malmö, Sweden.

BACKGROUND: Swimming ability among children in the city of Malmö, Sweden is strongly affected by socioeconomic differences. We investigated to what extent mediating health and lifestyle factors, such as children's eating, sleeping and physical activity habits, as well as the characteristics of the social and working environment at both school and home, could explain the socioeconomic gradient in swimming ability. METHODS: Our study population included children who started their first-grade school-year in 2012 or 2013 at any of the public primary schools of Malmö, Sweden. Cross-sectional, self-reported questionnaire-based data about health status and swimming ability in the fourth grade (age 10) were included from the Pupil Health Database (ELSA) for 3468 children. RESULTS: Children's self-reported swimming ability was strongly associated with both individual- and school-based sociodemographic variables. Nine health, lifestyle and environmental variables were identified as potential mediators and included in the final model. Four of these variables, "Activity", "Outdoor time", "Social relationships at home and on the free time", and "Positivity about future", were significantly and positively associated with children's ability to swim. CONCLUSIONS: Social support, optimism for the future and an active lifestyle were positively associated with children's swimming skills; however, compared to the socioeconomic factors, these health- and lifestyle factors contributed very little. It is possible, that interventions concerning children's swimming ability in lower socioeconomic neighbourhoods, should in addition to children's swimming lessons, target the whole families with the goal of increasing their possibilities for socialising and engaging in different kinds of recreational activities.

Socioeconomic differences in swimming ability among children in Malmö, southern Sweden: Initial results from a community-level intervention.

Aims: To investigate to what extent socioeconomic differences in swimming abilities persist among children in the city of Malmö, Sweden, after a community-level swimming intervention programme in public primary schools. Methods: A compulsory swimming education programme was launched in 2014 in second grade (at age 8) in all public primary schools in Malmö, Sweden. Data for the present study on sociodemographic conditions and self-reported swimming ability in fourth grade (age 10) were used for the last birth cohort unexposed (n = 1695) and the first birth cohort exposed (n = 1773) to the intervention. Results: The swimming ability was 78 and 77%, respectively, in the pre- and post-intervention cohorts. Significantly lower self-reported swimming ability was found both pre- and post-intervention among children with support activities in school, with parents born outside Europe, North America and Australia, with manual working, unemployed or studying parents and in children enrolled in schools with socioeconomic index below median. Conclusions: The findings do not suggest that sociodemographic differences in swimming ability have decreased in the first birth cohort exposed to the community-level intervention in Malmö. Striking differences in self-reported swimming ability were noted when the children reached the fourth grade both pre- and post-intervention with marked lower abilities in socially disadvantaged groups. Monitoring of swimming abilities should continue for the present, and similar interventions aimed at reducing inequalities among children. Efforts to increase water comfort at preschool age ought to be considered.