Elsevier

The Lancet

Volume 367, Issue 9521, 6–12 May 2006, Pages 1533-1540
The Lancet

Review
Road-traffic injuries: confronting disparities to address a global-health problem

https://doi.org/10.1016/S0140-6736(06)68654-6Get rights and content

Summary

Evidence suggests that the present and projected global burden of road-traffic injuries is disproportionately borne by countries that can least afford to meet the health service, economic, and societal challenges posed. Although the evidence base on which these estimates are made remains somewhat precarious in view of the limited data systems in most low-income and middle-income countries (as per the classification on the World Bank website), these projections highlight the essential need to address road-traffic injuries as a public-health priority. Most well-evaluated effective interventions do not directly focus on efforts to protect vulnerable road users, such as motorcyclists and pedestrians. Yet, these groups comprise the majority of road-traffic victims in low-income and middle-income countries, and consequently, the majority of the road-traffic victims globally. Appropriately responding to these disparities in available evidence and prevention efforts is necessary if we are to comprehensively address this global-health dilemma.

Section snippets

Current estimates of the global burden

The 2004 world report1 used information from a range of sources, including the WHO mortality database and global burden of disease estimates, the World Bank,3 the transport research laboratory,11 and specific studies identified through electronic databases, websites, organisations, and individuals.

In 2002, road-traffic injuries ranked as the 11th leading cause of death in the world. The aggregate rates of road-traffic fatality per 100 000 population were lowest in high-income countries in the

Prevention of road-traffic injuries: a global evidence-based perspective

As highlighted in the previous section, despite the absence of reliable and valid information about the incidence of road-traffic injuries, there can be no doubt that the health burden will grow in the next few years, mostly in low-income and middle-income countries. Although the continued rise in motorisation in these countries suggests a degree of inevitability, many high-income countries have had great successes in reducing the incidence of road-traffic injuries in past decades despite

Conclusions

Motorisation has enhanced the lives of many individuals and societies. However, the benefits have come with a price. Although the numbers of lives lost in road crashes in high-income countries indicate a downward trend in recent decades, for most of the world's population, the burden of road-traffic injury—in terms of societal and economic costs—is rising substantially.

The best available evidence suggests the burden is greatest and growing in low-income and middle-income countries—but estimates

Search strategy and selection criteria

For this review we identified studies from electronic databases (Cochrane databases, MEDLINE, EMBASE, and CINAHL), and by hand-searching peer-reviewed journals in the injury field (in particular, Injury Prevention, Injury, Journal of Trauma, Accident Analysis and Prevention, Injury Control and Safety Promotion, and Traffic Injury Prevention). We also found relevant studies in the 2004 world report on road-traffic injury prevention, in bibliographies of content-specific articles and

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