Azetsop Jacquineau
Faculté de Sciences Médicales de L'Université de N'djaména, Chad.
Public Health Ethics. 2010 Jul;3(2):115-127. doi: 10.1093/phe/phq013. Epub 2010 Jun 4.
Road traffic injury and deaths (RTID) are an important public health problem in Kenya, primarily affecting uneducated and disenfranchised people from lower socioeconomic groups. Studies conducted by Kenyan experts from police reports and surveys have shown that pedestrian and driver behaviors are the most important proximal causes of crashes, signifying that the occurrence of crashes results directly from human action. However, behaviors and risk factors do not fully explain the magnitude of RTID neither does it account for socioeconomic gradient in RTID. Instead, a social justice approach to RTID highlights the need for emphasizing distal causal factors. They allow us to understand how social inequities determine risk for RTID. Hence, designing policies that focus on behaviors will simply mask the underlying systemic causes of this growing phenomenon. To eradicate the RTID and address the gradient, a broader policy framework that includes the social dimension of injury, a strong political will to address the underlying causes of RTID and an effective partnership with stakeholders needs to be developed.
道路交通伤害与死亡(RTID)是肯尼亚一个重要的公共卫生问题,主要影响来自社会经济地位较低群体、未受过教育且被剥夺权利的人群。肯尼亚专家根据警方报告和调查进行的研究表明,行人和驾驶员的行为是撞车事故最重要的直接原因,这意味着撞车事故的发生直接源于人类行为。然而,行为和风险因素并不能完全解释道路交通伤害与死亡的严重程度,也无法说明道路交通伤害与死亡中的社会经济梯度问题。相反,一种针对道路交通伤害与死亡的社会正义方法强调了关注远端因果因素的必要性。这些因素使我们能够理解社会不平等如何决定道路交通伤害与死亡的风险。因此,制定侧重于行为的政策只会掩盖这一日益严重现象的潜在系统性原因。为了根除道路交通伤害与死亡并解决这种梯度问题,需要制定一个更广泛的政策框架,其中包括伤害的社会层面、解决道路交通伤害与死亡根本原因的坚定政治意愿以及与利益相关者建立有效的伙伴关系。