Road Injury: A Big Problem for Global Health
Embargoed Until 11am, Friday, May 5, 2006
Road Traffic Injury: A Big Problem for Global Health
A major review published today in The Lancet has revealed the enormous burden of road traffic injuries in countries that can least afford to meet the health and economic costs.
The authors of the review, from the University of Auckland, the George Institute for International Health in Sydney and the National Institute of Public Health in Mexico, believe that while motorisation has enhanced the lives of many individuals and societies, the benefits have come with a high price, highlighting a critical need to address road traffic injuries as a public health priority.
Associate Professor Shanthi Ameratunga, of the University of Auckland, reported that: “Although the number of lives lost in road crashes in high-income countries has decreased in recent decades, for the majority of the world’s population the burden of road traffic injury is increasing dramatically in terms of societal and economic costs.”
In 2002, 1.2 million people were killed and 50 million injured in road traffic crashes worldwide, costing an estimated US$518 billion. The economic costs of road crashes are estimated to exceed the total amount of development assistance low and middle income countries receive annually. “Without appropriate action, road traffic injuries are predicted to escalate from being the ninth leading contributor to the global burden of disease in 1990 to the third leading contributor by 2020,” Dr Ameratunga added.
“The World Bank reports that in 20 years the global road death toll will increase by 66%, with an even greater divergence between rich and poor nations projected in the future. While a 28% reduction in fatalities is expected in high-income countries, increases in fatalities of 92% and 147% are anticipated in China and India, respectively.”
The Lancet paper identifies the vulnerability of some road user groups, particularly pedestrians and two-wheeler users, who are vastly over-represented among crash victims at a global level. Studies in Asia show that motorcyclists have particularly high rates of injury whereas in Africa pedestrians are the most frequently injured road users. In most countries, rich and poor, road injury rates are also reported to be higher among those of lower socioeconomic groups, indicating a steep social class gradient.
“Recognition of road crashes as a major public health problem that is predictable and preventable is essential in addressing this emerging epidemic,” said Ameratunga. “Many high income countries have had dramatic success in reducing the incidence of road traffic injuries in recent decades despite increases in motorization. The extent of the growing problem can be minimised if intervention strategies that are known to be effective are implemented.”
Many strategies to produce safer people, safer roads and safer vehicles had shown success in reducing fatalities and casualties, Ameratunga said. For example, introducing graduated driver licensing systems reduced road crash injury rates among 16-year-olds by 28% in wealthier regions; the introduction of speed humps in Ghana showed a 55% reduction in all road traffic deaths; use of daytime running lights for motorised two-wheelers led to a 15 % reduction in fatal daytime crashes in Singapore; and use of seatbelts has been shown to reduce the risk of serious injury by 40% and fatal injury by 65%, although vehicles in many low and middle income countries often lack functioning seatbelts.
The authors also emphasise the importance of establishing surveillance systems that will monitor patterns of injuries and impacts of preventive strategies. Such surveillance systems must capture not only deaths but also non-fatal outcomes, given the potentially catastrophic impacts of non-fatal injuries on families and communities who must care for these individuals.
“A continuing global commitment to address the growing problem of road traffic injuries is required,” said Ameratunga. “This must recognise the disparities in the experience of road injury based on income and social context, between and within countries.”
Notes for Editors:
Researchers reviewed the best available evidence in conjunction with acknowledgement from the World health Organisation (WHO), the World Bank, United Nations (UN) who have also recognised road safety as a matter of urgency.
Associate Professor Shanthi Ameratunga
Shanthi Ameratunga is a paediatrician and public health physician with joint appointments as the Director of the Injury Prevention Research Centre and a senior epidemiologist at the School of Population Health, University of Auckland. Shanthi’s research interests include injury, trauma outcomes and youth health and she serves on several Australasian and global networks focusing on injury prevention. Sri Lankan by birth and ethnicity, Shanthi is particularly is committed to helping develop the local capacity and capability to implement effective evidence-based public health policy in low- and middle-income countries. She is the Project Director of the TRIP Project addressing injuries in the Pacific, funded by an International Collaborative Research Grant awarded by the Wellcome Trust (UK) and the Health Research Council of NZ.
Professor Robyn Norton
Robyn Norton is a Principal Director of The George Institute for International Health and Professor of Public Health at The University of Sydney. She holds an Honorary Professorship at the Peking University Health Science Center in Beijing, China, and is an Honorary Consultant Epidemiologist at the Royal Prince Alfred Hospital in Sydney. Robyn is currently Chair of the Road Traffic Injuries Research Network, an initiative supported by the Global Forum for Health Research, and a member of the Interim Steering Committee for the International Society for Injuries and Violence Prevention. She is also a Board member of the International Society for Child and Adolescent Injury Prevention and a Board member of the journal Injury Prevention.
Professor Martha Hijar
Doctor Martha Híjar is a senior research currently responsible of the Research Line on Injuries and Violence at the National Institute of Public Health of Mexico. She is also professor at the School of Public Health and at the Universidad Nacional Autonoma de México. She is the Director of the México PAHO/WHO Collaborating Centre for research on Injuries and Violence. She is author and Co-author of many papers and books chapters on Injury and Violence research, most of them on Road Traffic Injuries. She is board member of the Road Traffic Injuries Research Network and of the Salud Publica de Mexico Journal.