Safe mobility, socioeconomic inequalities, and aging: A 12-year multilevel interrupted time-series analysis of road traffic death rates in a Latin American country

Abstract

As the resources for road safety in developing countries are scarce and unevenly distributed, vulnerable road users-such as the elderly-may be particularly at risk of road traffic deaths. To date, the impact of road safety measures over the rate of road traffic deaths in older adults (60 years or older), considering the within-country socioeconomic inequalities, has not been explored in developing nations. This study takes the Chilean case as an example-with its 2005 traffic law reform as one of the road safety measures investigated-, in which open data available from official national sources for all its 13 regions over the 2002-2013 period were used for a multilevel interrupted time-series analysis. A statistically significant secular reduction of the rates of road traffic deaths in the elderly population was found (incidence rate ratio [IRR] 0.95, 95% confidence interval [CI] 0.91 to 0.99), but no evidence for a significant intercept or slope change after the traffic law reform was observed. Regions with the highest number of traffic offenses prosecuted in local police courts had lower rates of road traffic deaths in older adults (IRR 0.95, 95% CI 0.90 to 1.00), and those regions in the third (IRR 1.61, 95% CI 1.16 to 2.25) and the fifth (IRR 1.66, 95% CI 1.08 to 2.54) quintiles of socioeconomic deprivation had higher rates of road traffic deaths in the elderly. Such findings strongly support the conceptualization of the road safety of seniors in developing countries as a social equity issue, with implications for the design of traffic regulations and road environments.

Promoting Sustainable Mobility: A Perspective from Car and Public Transport Users

“…Therefore, safer pedestrian crossings would encourage more older adults to walk. As implied by previous studies, elderly people are more concerned about the issues of safe mobility [ 56 , 57 , 58 ]. As expected, crime prevention as a factor encouraging walking was more important for women than for men.…”

Mortality due to road traffic injuries in older adults in the Republic of Ecuador between 1990 and 2018: a descriptive study

“…Tales hallazgos pueden atribuirse a una mayor exposición, vulnerabilidad y al crecimiento demográfico de las personas de edad avanzada. A medida que la población envejece, la mortalidad por esta causa comienza a ser más visible [7].…”

“…Estas pueden indagar con mayor profundidad la casuística de la problemática tratada en este estudio [5]. Estos resultados pueden ser punto de partida para elaborar estrategias orientadas a las nuevas realidades demográficas que reduzcan la alta carga de mortalidad por lesiones de tránsito en la población adulta ecuatoriana [7] [19], que comienza a presentar evidencias de envejecimiento. En este sentido, es necesario elaborar estrategias en seguridad vial orientadas a proteger la población adulta, que está en progresivo crecimiento.…”

“…El evidente envejecimiento de la población y los problemas relacionados con el tránsito exigen un abordaje global para los sistemas de salud pública orientados a las personas mayores [7] y hace que sea urgente una exploración sobre la situación actual en el país orientada a facilitar información precisa y confiable para la toma de decisiones en seguridad vial [8]. Por lo tanto, este estudio tuvo como objetivo estimar la tendencia de mortalidad por lesiones de tránsito en adultos mayores de 60 años y más y la comparación con los menores de 60 años durante el período 1990-2018 en Ecuador.…”

Spatial analysis of road traffic accident deaths in the state of Paraná, 2007-2016

“…The road traffic injury control is a public health problem (Mohan, 2008), since the road traffic violence is in eighth place among the leading causes of death worldwide and leaves some 50 million people injured, according to the Global Status Report on Road Safety 2018 (WHO, 2018). Also, the number of occurrences is disproportionate in developing countries (Nantulya & Reich, 2002), revealing inequalities (Nantulya & Reich, 2003), with worse conditions for populations from India (India State-Level Disease Burden Initiative Road Injury Collaborators, 2020), and Latin America (Martínez, Contreras, & Moreno, 2020), and Africa (Adeloye, Thompson, Akanbi, Azuh, Samuel, & Omoregbe, 2016) -v10i11.19942 annum for highway accidents and BRL 10 billion per annum for urban roads and street accidents (IPEA, 2015). The greatest cost relates to lost productivity, due to time off work or death, with impacts on Social Security and families, followed by health expenditure, overburdening emergency, hospital and rehabilitation services (Andrade & Mello-Jorge, 2016).…”