– Accidental drowning is the second leading cause of death for U.S. children under age 5, after birth defects. For youngsters under 15, only traffic accidents are responsible for more deaths by injury. And while drowning rates have declined slightly since the turn of the century, blacks die from drowning at much higher rates than whites.

Faced with such stubborn figures, public health advocates and researchers complain that state and local governments aren’t doing enough to prevent drowning deaths. Critics say most states don’t have sufficient laws or don’t enforce laws that could lessen the chances of drowning, such as requirements for fencing around private pools and the presence of trained lifeguards. And, they say, too little is being done to make sure that children have water safety skills.

“There is so much that can and should be done,” said Andrea Gielen of the Johns Hopkins University Center for Injury Research and Policy.

According to the Centers for Disease Control and Prevention, 3,391 people died by accidental drowning in the United States in 2013, about the norm in the years since 2000. Of the 2013 drownings, 625 were children under 15.

Injury and swimming experts say the best way to reduce the risk of drowning is by making sure that people know how to swim. “It’s just common sense,” said Jeffrey Weiss, a Phoenix pediatrician.

The Minnesota Legislature is studying a proposal that would require that all public school students be given access to free swim lessons. But no other states appear to be taking that approach.

The state of Washington may be a model for others. It requires that all children under 13 wear a Coast Guard-approved life preserver in any boat that isn’t anchored and is less than 19 feet in length.

Thomas Gill, a spokesman with the United States Lifesaving Association, said that some areas of the country have a shortage of lifeguards — a result of poor pay. Public pools usually curtail hours or limit areas where swimming is permitted when shortages of lifeguards occur, Gill said.

Tom Griffiths, president of the Aquatic Safety Research Group, said there have been a few drownings at public schools, but they were a result of school systems thinking that a swim instructor could simultaneously serve as a lifeguard. “It’s impossible for them to do both at the same time,” he said.

Griffiths promotes the idea that children and weak swimmers should wear life jackets in any body of water.

In many states, initiatives have been undertaken not by government, but by activists in partnership with hospitals, fire departments and emergency responders.

The Red Cross offers funding, training and technical assistance to help the cities implement anti-drowning measures, many of them aimed at improving swimming skills and increasing CPR training.

While many advocates, such as the Red Cross and YMCA, say swim lessons are the most effective way to prevent drowning, that approach has been controversial.

The American Academy of Pediatrics used to recommend against swimming lessons for children under 4. Weiss said the policy stemmed from concerns that parents and other adults would relax their supervision of young children if they had learned to swim.

But the thinking changed after a 2009 study showing that swimming competency was one of the best ways of reducing drowning. The group changed its policies to remove objections to lessons for children as young as 1.

The drowning rate among black children is 5.5 times that of whites, according to the CDC. The reason is both cultural and economic, swimming experts say.