WALLER J A, CURRAN R, NOYES F
Calif Med. 1964 Oct;101(4):272-6.
An analysis by the California Department of Public Health of California Highway Patrol reports for 1961 showed that traffic accidents injured one and one-half times as many people per 1,000 population in rural California counties (under 50,000 people) as in urban counties (over 500,000 people), also persons injured in rural counties were almost four times as likely to die of their injuries as those injured in urban counties.A death certificate study was undertaken of 782 traffic deaths (excluding pedestrians) occurring in rural and urban California counties during 1961. Accidents occurring in rural counties tended to be single vehicle accidents which resulted in less severe injuries, while those in urban counties tended to be two vehicle and multiple vehicle accidents resulting in more serious injuries. The anatomic distribution of injuries was the same for both urban and rural accidents. However, people dying in rural accidents more frequently died at the scene of the accident, died sooner after injury, and died of less serious injuries than did those injured in urban accidents. For injuries where theoretically few lives should be salvaged by prompt emergency care, the time between injury and death was about the same in urban as in rural counties. Where such care should delay or prevent death because the injury was possibly or probably salvageable, those injured in rural counties died more quickly.Thirty-two per cent of fatalities in rural counties happened to urban and out-of-state residents, while only 12 per cent of fatalities in urban counties were to rural or out-of-state residents, suggesting that traffic accidents to non-residents may place an excessive load upon medical care resources in rural areas.
加利福尼亚州公共卫生部对1961年加利福尼亚州公路巡逻队报告进行的一项分析表明，在加利福尼亚州农村县（人口低于5万），每1000人口中因交通事故受伤的人数是城市县（人口超过50万）的1.5倍，而且农村县受伤人员因伤死亡的可能性几乎是城市县受伤人员的四倍。对1961年发生在加利福尼亚州农村和城市县的782起交通死亡事故（不包括行人）进行了死亡证明研究。农村县发生的事故往往是单车事故，造成的伤害较轻，而城市县的事故往往是双车和多车事故，造成的伤害更严重。城市和农村事故中受伤的解剖分布是相同的。然而，在农村事故中死亡的人比在城市事故中受伤的人更频繁地在事故现场死亡，受伤后死亡更快，而且死于不太严重的伤害。对于理论上通过及时的紧急护理挽救生命的可能性很小的伤害，城市和农村县受伤与死亡之间的时间大致相同。在这种护理应该延迟或预防死亡的情况下，因为伤害可能或很可能可以挽救，农村县受伤的人死亡更快。农村县32%的死亡事故发生在城市和州外居民身上，而城市县只有12%的死亡事故是农村或州外居民，这表明非居民的交通事故可能给农村地区的医疗资源带来过大负担。
