Probability of dying from road injury has dropped worldwide in all but 5 nations

Road injuries have become more frequent but less fatal over the past three decades, according to a new scientific study.

The probability of dying from a road accident increased in only five nations since 1990—Central African Republic, Jamaica, Somalia, Swaziland, and United Arab Emirates.

Disability from road injuries is multifactorial, and largely driven by injuries such as lower limb fracture, traumatic brain injury, open wounds, digit amputations, and muscle and tendon injuries. These conditions often require medical treatment to prevent long-term disability, which is not always available in areas with high rates of road injuries.

"Many factors affect the risk of road injuries, including vehicle and road safety and engineering; enforcement of speeding, seatbelt, and alcohol laws; and access to medical care," said Dr. Spencer James, senior author on the study and Lead Research Scientist at the Institute for Health Metrics and Evaluation (IHME) at the University of Washington School of Medicine. "It's encouraging to find improvements globally in road injury mortality over the past three decades, though there is still considerable progress to be made since road injuries should be considered preventable."

In 2017, 54 million people worldwide were injured in road accidents, leading to 1.2 million deaths. Regions with the highest incidence rates in 2017 were Central Europe, Australasia, and Eastern Europe.

Road injuries become more burdensome as countries transition to more stable economies, according to James. He and the study's coauthors found middle-income nations experienced the greatest increases in incidence between 1990 and 2017.

Men ages 25-29 are most likely to be injured, with a global incidence rate that is more than double the rate for women in the same age group.

Published today in the international medical journal BMJ Injury Prevention, the study is part of the annual Global Burden of Disease (GBD). The analysis provides comparable estimates of road-injury-related mortality and morbidity across 195 countries and territories. Road injuries were defined as involving motor vehicles, pedestrians, motorcyclists, and cyclists.

"While individuals injured in road accidents today are less likely to die, their injuries can still result in short- and long-term disability," said James. "This places a substantially higher burden on both individuals and health systems, with especially dramatic increases in costs related to care."

Additional findings include:

• Globally, the incidence rate for road injuries for all ages combined increased by 15.7% from 1990 to 2017.
  • The greatest increases in the all-ages incidence rate during the time period were observed in Sri Lanka (143.3%), China (130.3%), and Marshall Islands (121.5%).
  • By comparison, Portugal, Ethiopia, and South Korea saw the largest declines in the all ages incidence rate, at -40.9%, -38.3%, and -35.9%, respectively.
• In 2017, the probability of dying from a road injury was highest in Haiti (15.6% of those injured, or about one in seven), Central African Republic (10.4%), El Salvador (7.3%), Afghanistan (7.2%), and Guatemala (7.0%).
• For males aged 20-24 and 25-29, global incidence rates were double those for females.
  • Among females ages 20-24, the rate was 585.8 new cases of road injury per 100,000, versus 1,229.2 for males. Among 25-29 year-olds, the female rate was 660.5, versus 1,354.0 for males.
• At 261,802 deaths in 2017, China ranked highest globally in number of total deaths, but 48th out of 195 countries in terms of death rate for all ages combined.

ROAD INJURY DEATH RATES, 195 COUNTRIES AND TERRITORIES, 2017

Highest death rates:

1. Central African Republic: 75.6 deaths per 100,000 people (all ages combined)

2. Oman: 43.0

3. Lesotho: 41.2

4. Haiti: 37.9

5. United Arab Emirates: 37.5

6. Saudi Arabia: 35.0

7. Swaziland: 33.0

8. Tunisia: 32.1

9. Yemen: 31.4

10. Papua New Guinea: 30.7

Lowest death rates:

1. Singapore: 3.53 deaths per 100,000 people (all ages combined)

2. Ireland: 3.86

3. Sweden: 3.88

4. Switzerland: 3.89

5. Malta: 3.97

6. United Kingdom: 4.02

7. Norway: 4.09

8. Iceland: 4.24

9. Greenland: 4.28

10. Andorra: 4.67

RISK OF DEATH GIVEN A ROAD INJURY, 2017

Highest risk of death given a road injury:

1. Haiti: 15.6% of road injuries resulted in death

2. Central African Republic: 10.4%

3. El Salvador: 7.3%

4. Afghanistan: 7.2%

5. Guatemala: 7.0%

6. Bolivia: 6.8%

7. Ecuador: 6.7%

8. Burkina Faso: 6.5%

9. Guyana: 6.4%

10. Dominican Republic: 6.1%

Lowest risk of death given a road injury:

1. Slovenia: 0.44% of road injuries resulted in death

2. New Zealand: 0.45%

3. Switzerland: 0.49%

4. Czech Republic: 0.51%

5. Ireland: 0.52%

6. Singapore: 0.52%

7. Iceland: 0.55%

8. Andorra: 0.56%

9. Croatia: 0.57%