Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, 410078, China.
Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, 35294, USA.
Chin J Traumatol. 2021 Mar;24(2):88-93. doi: 10.1016/j.cjtee.2021.01.007. Epub 2021 Jan 19.
This research examined road traffic injury mortality and morbidity disparities across of country development status, and discussed the possibility of reducing country disparities by various actions to accelerate the pace of achieving Sustainable Development Goals target 3.6 - to halve the number of global deaths and injuries from road traffic accidents by 2020.
Data for road traffic mortality, morbidity, and socio-demographic index (SDI) were extracted by country from the estimates of the Global Burden of Disease study, and the implementation of the three types of national actions (legislation, prioritized vehicle safety standards, and trauma-related post-crash care service) were extracted from the Global Status Report on Road Safety by World Health Organization. We fitted joinpoint regression analysis to identify and quantify the significant rate changes from 2011 to 2017.
Age-adjusted road traffic mortality decreased substantially for all the five SDI categories from 2011 to 2017 (by 7.52%-16.08%). Age-adjusted road traffic mortality decreased significantly as SDI increased in the study time period, while age-adjusted morbidity generally increased as SDI increased. Subgroup analysis by road user yielded similar results, but with two major differences during the study period of 2011 to 2017: (1) pedestrians in the high SDI countries experienced the lowest mortality (1.68-1.90 per 100,000 population) and morbidity (110.45-112.72 per 100,000 population for incidence and 487.48-491.24 per 100,000 population for prevalence), and (2) motor vehicle occupants in the high SDI countries had the lowest mortality (4.07-4.50 per 100,000 population) but the highest morbidity (428.74-467.78 per 100,000 population for incidence and 1025.70-1116.60 per 100,000 population for prevalence). Implementation of the three types of national actions remained nearly unchanged in all five SDI categories from 2011 to 2017 and was consistently stronger in the higher SDI countries than in the lower SDI countries. Lower income nations comprise the heaviest burden of global road traffic injuries and deaths.
Global road traffic deaths would decrease substantially if the large mortality disparities across country development status were reduced through full implementation of proven national actions including legislation and law enforcement, prioritized vehicle safety standards and trauma-related post-crash care services.
本研究考察了不同国家发展阶段的道路交通伤害死亡率和发病率的差异，并探讨了通过各种行动减少国家间差异的可能性，以加快实现可持续发展目标 3.6 的步伐，即到 2020 年将全球道路交通事故死亡和受伤人数减少一半。
从全球疾病负担研究中按国家提取道路交通死亡率、发病率和社会人口指数（SDI）的数据，并从世界卫生组织全球道路安全状况报告中提取三种国家行动（立法、优先车辆安全标准和创伤后碰撞后护理服务）的实施情况。我们拟合了 joinpoint 回归分析，以确定和量化 2011 年至 2017 年的显著变化率。
从 2011 年到 2017 年，所有五个 SDI 类别的年龄调整后的道路交通死亡率都大幅下降（7.52%-16.08%）。在研究期间，随着 SDI 的增加，年龄调整后的道路交通死亡率显著下降，而年龄调整后的发病率通常随着 SDI 的增加而增加。按道路使用者进行的亚组分析得出了类似的结果，但在 2011 年至 2017 年的研究期间有两个主要差异：（1）高 SDI 国家的行人死亡率最低（每 10 万人 1.68-1.90 人），发病率最低（每 10 万人 110.45-112.72 人），患病率最低（每 10 万人 487.48-491.24 人），（2）高 SDI 国家的汽车乘客死亡率最低（每 10 万人 4.07-4.50 人），但发病率最高（每 10 万人 428.74-467.78 人）发病率和每 10 万人 1025.70-1116.60 人患病率）。从 2011 年到 2017 年，所有五个 SDI 类别中这三种国家行动的实施情况几乎没有变化，在较高 SDI 国家的实施力度始终强于较低 SDI 国家。低收入国家承担着全球道路交通伤害和死亡的最大负担。
如果通过全面实施包括立法和执法、优先车辆安全标准和创伤后碰撞后护理服务在内的经证实的国家行动，减少国家发展阶段之间的巨大死亡率差异，全球道路交通死亡人数将大幅减少。
