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墨西哥在联合国行动十年框架下实施的道路安全战略的影响。

Impact of Mexican Road Safety Strategies implemented in the context of the UN's Decade of Action.

机构信息

Health Systems Research Center, National Institute of Public Health, Cuernavaca, Mexico.

Health Systems Research Center, National Institute of Public Health, Cuernavaca, Mexico.

出版信息

Accid Anal Prev. 2021 Sep;159:106227. doi: 10.1016/j.aap.2021.106227. Epub 2021 Jun 18.

Abstract

OBJECTIVE

To evaluate advancements in the prevention of road traffic injuries (RTI) in Mexico in the context of the United Nation's Decade of Action for Road Safety.

METHODS

An analysis of the trend and age-period-cohort effects of RTI mortality from 1999 to 2018 was conducted. Mortality figures were age-standardized using the direct method and population estimates of 2018 as the standard. To evaluate whether advancements might be attributed to higher levels of death misclassification, we conducted sensitive analysis using multiple imputation to redistributed deaths allocated to non-specific ICD-10 codes. Non-fatal RTI from four nationally representative health surveys (2000, 2006, 2012 and 2018) were analyzed.

FINDINGS

Implementation of Mexico's National Road Safety Strategy 2011-2020 was associated with an average annual percentage change reduction in the age-standardized RTI mortality rate of 1.3% (95%-CI: -1.8,-0.9). Reductions are more evident in pedestrians and four + wheelers (-6.7% and -5.3%, respectively, from 2011 to 2018); mortality trend in motorcyclists increased from 1999 to 2018 an average of 12.8% annually (95%-CI: 9.9, 15.9). Potential underestimation of mortality due to death misclassification decreased from 22.7% in 1999 to 16.4% in 2018; sensitive analysis showed that reductions might not be attributed to death misclassification. Non-fatal injuries decreased in four + wheelers but increased in motorcyclists. The number of individuals suffering permanent consequences from RTI increased.

CONCLUSIONS

Results showed some potential gains of Mexico's road safety strategies: RTI in four + wheelers decreased. Efforts should be put in place urgently to prevent the growing number of RTI in motorcyclists.

摘要

目的

在联合国道路安全行动十年的背景下,评估墨西哥在道路交通事故(RTI)预防方面的进展。

方法

分析了 1999 年至 2018 年 RTI 死亡率的趋势和年龄-时期-队列效应。使用直接法对死亡率进行年龄标准化,并以 2018 年的人口估计数作为标准。为了评估进展是否可能归因于更高的死亡分类错误率,我们使用多重插补进行了敏感性分析,将分配给非特异性 ICD-10 代码的死亡重新分配。使用四个具有全国代表性的健康调查(2000 年、2006 年、2012 年和 2018 年)分析非致命性 RTI。

结果

实施 2011-2020 年墨西哥国家道路安全战略与年龄标准化 RTI 死亡率的平均年百分比变化减少 1.3%(95%-CI:-1.8,-0.9)相关。在行人(行人从 2011 年到 2018 年减少了-6.7%;从 2011 年到 2018 年,四轮车减少了-5.3%)和四轮车(从 2011 年到 2018 年减少了-6.7%);从 1999 年到 2018 年,摩托车手的死亡率趋势平均每年增加 12.8%(95%-CI:9.9,15.9)。由于死亡分类错误导致的死亡率潜在低估从 1999 年的 22.7%下降到 2018 年的 16.4%;敏感性分析表明,这种减少可能不是由于死亡分类错误。四轮车的非致命性伤害减少了,但摩托车手的伤害增加了。因 RTI 而遭受永久性后果的人数增加了。

结论

结果表明,墨西哥道路安全战略取得了一些潜在进展:四轮车的 RTI 减少了。应紧急采取措施,防止摩托车手不断增加的 RTI 数量。

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