Ecological study of road traffic injuries in the eastern Mediterranean region: country economic level, road user category and gender perspectives

Abstract

BackgroundThe Eastern Mediterranean region has the second highest number of road traffic injury mortality rates after the African region based on 2013 data, with road traffic injuries accounting for 27% of the total injury mortality in the region. Globally the number of road traffic deaths has plateaued despite an increase in motorization, but it is uncertain whether this applies to the Region. This study investigated the regional trends in both road traffic injury mortality and morbidity and examined country-based differences considering on income level, categories of road users, and gender distribution.MethodsRegister-based ecological study linking data from Global Burden of Disease Study with the United Nations Statistics Division for population and World Bank definition for country income level. Road traffic injury mortality rates and disability-adjusted life years were compiled for all ages at country level in 1995, 2005, 2015 and combined for a regional average (n = 22) and a global average (n = 122). The data were stratified by country economic level, road user category and gender.ResultsRoad traffic injury mortality rates in the Region were higher than the global average for all three reference years but suggest a downward trend. In 2015 mortality rates were more than twice as high in low and high income countries compared to global income averages and motor vehicle occupants had a 3-fold greater mortality than the global average. Severe injuries decreased by more than half for high/middle income countries but remained high for low income countries; three times higher for males than females.ConclusionDespite a potential downward trend, inequalities in road traffic injury mortality and morbidity burden remain high in the Eastern Mediterranean region. Action needs to be intensified and targeted to implement and enforce safety measures that prevent and mitigate severe motor vehicle crashes in high income countries especially and invest in efforts to promote public, active transport for vulnerable road users in the resource poor countries of the Region.

Gender equality and gender norms: framing the opportunities for health

“…127 Pedestrian injuries may reflect gender norms of who occupies public spacesin some settings a large proportion of pedestrian injuries are found among poorer men walking to work, but this may vary in other contexts. 128…”

Are There Changes in Inequalities in Injuries? A Review of Evidence in the WHO European Region

“…People from low socioeconomic status and from less affluent areas tend to die by injury to a greater extent than others [12]. Other reviews were target specific, by age group [13,14,15,16,17,18], injury cause, such as road traffic [19,20], falls [21], burns [22,23,24], or housing and neighbourhood conditions [25,26]. From among those reviews, only a few are specific to the European context, which is the focus of the present review, and to the best of our knowledge only one study [27] reviewed the literature on trends in social inequalities in injuries.…”

Low-Quality Domestic Automobiles Continue to Threaten Lives in Iran: Economic Instability as the Potential Contributor

“…On the other hand, the exit of European car manufacturers over US sanctions and continued inflation may result in further reduction of production quality and purchasing power and consequently, increase the demand for cheaper domestic vehicles. This is of special significance for younger individuals and families, who on average have lower income and a higher risk of exposure to traffic injuries, 6 seeking to own their first vehicle. We are thus likely to see increased mortality and morbidity from road accidents in Iran as an indirect consequence of the continuation of economic instability.…”