Describe the inequitable distribution of the burden of road
traffic injuries globally
> 90% of the burden of RTI is in LMIc.
- The rate of harm to people outside the car has risen while it has fallen slightly for people inside the car - Breadwinners who die increase poverty
What is the trend of RTIs in HIc vs LIMIc
Globally rate of RTIS has been increasing even though in HIc it is decreasing, bc LIMIc it is increasing.
However in both LIMIcs and HICs disadvantaged socioeconomic groups are at greatest risk- living in hazardous environments.
Men and women Children and adults Pedestrians and in car Fatal and non fatal Pedestrian car crashes or car car crashes - what are the main inequities
Men>women Children> adults Pedestrian> car Fatal> non fatal Ped car> carcar
What is the distribution of RTIs in NZ
Road deaths are greatest for
15-29 age group, younger age= more DALYs with largest contributor to Males in this age group
Auckland fatalities >NZ.
Explain the distal/ upstream drivers of this inequitable distribution
Deficiencies in the legal and policy frameworks related to education and income. Disproportionally affect the poor
- influencing the choice of transport for vulnerable road users: poor more likely to use public transport that is poorly funded and regulated- more likely to be vulnerable road user
- limiting the choice of where they can live-> so more hazardous environments
- compelling children to be unaccompanied when walking
- limiting access to health services consequent to accidents
What is a more hazardous environment
along highways conflicts between space use between road users and locals, poor road design in poor areas- no crossings, less speed restrictions, no safe and accessible playgrounds
what is a vulnerable road user
Pedestrian, pedal cyclist and motorised 2 wheel riders
What are the 5 pillars of road safety strategy
- Road safety management: following full UN legal instruments
- Safer roads and mobility: protective and quality infrastructure
- Safe vehicles : improving vehicle safety
- Safer road users” road user behaviour: seat belts, drink driver etc
- Post crash response: increase response, improve long term and acute rehab
What are the WHO commission on Social determinants of health
- improve daily living conditions
- tackle the inequitable distribution of power money and resources
- Measure and understand the problem and asses impact of action
What are the 5 key risk factors to target for road safety efforts in LIMC
Speed, Alcohol, Seatbelts and child restraints, Helmets, visibility. Legislation need but also monitoring.
What are the main points of all these things trying to address RTIs
An environmental approach targetting the social determinants, rather than proximal causal factors is more effective because it finds the relationship between risks and social status and the context for this
