Queensland Department of Transport and Main Roads, Queensland University of Technology, Rockhampton, QLD 4700, Australia.
Centre for Accident Research & Road Safety-Queensland, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia.
Int J Environ Res Public Health. 2020 Feb 25;17(5):1467. doi: 10.3390/ijerph17051467.
Road trauma is a significant health problem in rural and remote regions of Australia, particularly for Indigenous communities. This study aims to identify and compare the circumstances leading to (proximal causation) and social determinants of (distal causation) crashes of Indigenous and non-Indigenous people in these regions and their relation to remoteness. This is a topic seriously under-researched in Australia. Modelled on an earlier study, 229 persons injured in crashes were recruited from local health facilities in rural and remote North Queensland and interviewed, mainly by telephone, according to a fixed protocol which included a detailed narrative of the circumstances of the crash. A qualitative analysis of these narratives identified several core themes, further explored statistically in this sample, supplemented by participants in the earlier study with compatible questionnaire data, designed to determine which factors were more closely associated with Indigenous status and which with remoteness. Indigenous participants were less often vehicle controllers, more likely to have recently been a drink driver or passenger thereof; to be unemployed, unlicensed, distracted or fatigued before the crash, alcohol dependent and have lower perceived social, but not personal, locus of control in a traffic crash than non-Indigenous persons. Differences between Indigenous and non-Indigenous participants are largely ascribable to hardship and transport disadvantage due to lack of access to licensing and associated limitations on employment opportunities. Based on these findings, a number of policy recommendations relating to educational, enforcement and engineering issues have been made.
道路创伤是澳大利亚农村和偏远地区的一个重大健康问题，尤其是对原住民社区而言。本研究旨在确定和比较导致这些地区原住民和非原住民车祸（近因）的情况以及车祸的社会决定因素（远因），并探讨它们与偏远程度的关系。这是澳大利亚一个研究严重不足的课题。本研究以早期的一项研究为蓝本，从北昆士兰农村和偏远地区的当地医疗机构招募了 229 名在车祸中受伤的人，并根据一个固定的协议对他们进行了采访，主要通过电话进行，协议包括对车祸情况的详细叙述。对这些叙述的定性分析确定了几个核心主题，在本样本中进一步进行了统计探讨，并辅以早期研究中具有兼容问卷数据的参与者，旨在确定哪些因素更密切地与原住民身份相关，哪些因素更密切地与偏远程度相关。与非原住民参与者相比，原住民参与者较少是车辆驾驶者，更有可能是最近的酒驾者或乘客；在车祸前失业、无驾照、分心或疲劳、酒精依赖，并且在交通车祸中感知到的社会控制，但不是个人控制，低于非原住民参与者。原住民和非原住民参与者之间的差异主要归因于缺乏获得驾照的机会以及由此对就业机会的限制而导致的贫困和交通劣势。基于这些发现，提出了一些与教育、执法和工程问题相关的政策建议。
