TRAFFIC-RELATED MORTALITY IN INDUSTRIALIZED AND LESS-DEVELOPED-COUNTRIES

Road traffic-related mortality has traditionally been regarded as a pr oblem primarily of industrialized countries. There is, however, growin g evidence of a strong negative relationship between economic developm ent and exposure-adjusted traffic-related death rates. Cross-sectional data on road traffic-related deaths in 1990 were obtained from 83 cou ntries. The relationship between such mortality and a number of indepe ndent variables was examined at the individual country level by means of multiple regression techniques. These were also used to elucidate f actors associated with variations in age, sex, and case-fatality patte rns of road traffic mortality. Countries were grouped according to reg ion and socioeconomic features, and the mortality data were summarized by these groups. The gross national product per capita was positively correlated with traffic-related mortality/100 000 population/year (P= 0.01), but negatively correlated with traffic deaths/1000 registered v ehicles (P<0.0001). Increasing population density was associated with a proportionately greater number of traffic-related deaths in the youn g and the elderly (P=0.036). Increasing GNP per capita and increased p roportional spending on health care were associated with decreasing ca se-fatality rates among traffic-accident victims (P=0.02 and 0.017, re spectively). Middle-income countries appear to have, on average, the l argest road-traffic mortality burden. After adjusting for motor vehicl e numbers, however, the poorest countries show the highest road traffi c-related mortality rates. Many industrialized countries would appear to have introduced interventions that reduce the incidence of road tra ffic injury, and improve the survival of those injured. A major public health challenge is to utilize this experience to avoid the predicted increase in traffic-related mortality in less developed countries.