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Zhai G, Xie K, Yang D, Yang H. Developing equity-aware safety performance functions for identifying hotspots of pedestrian-involved crashes. ACCIDENT; ANALYSIS AND PREVENTION 2024; 207:107759. [PMID: 39214036 DOI: 10.1016/j.aap.2024.107759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 08/20/2024] [Accepted: 08/23/2024] [Indexed: 09/04/2024]
Abstract
Crashes are frequently disproportionally observed in disadvantaged areas. Despite the evident disparities in transportation safety, there has been limited exploration of quantitative approaches to incorporating equity considerations into road safety management. This study proposes a novel concept of equity-aware safety performance functions (SPFs), enabling a distinct treatment of equity-related variables such as race and income. Equity-aware SPFs introduce a fairness distance and integrate it into the log-likelihood function of the negative binomial regression as a form of partial lasso regularization. A parameter λ is used to control the importance of the regularization term. Equity-aware SPFs are developed for pedestrian-involved crashes at the census tract level in Virginia, USA, and then employed to compute the potential for safety improvement (PSI), a prevalent metric used in hotspot identification. Results show that equity-aware SPFs can diminish the effects of equity-related variables, including poverty ratio, black ratio, Asian ratio, and the ratio of households without vehicles, on the expected crash frequencies, generating higher PSIs for disadvantaged areas. Based on the results of Wilcoxon signed-rank tests, it is evident that there are significant differences in the rankings of PSIs when equity awareness is considered, especially for disadvantaged areas. This study adds to the literature a new quantitative approach to harmonize equity and effectiveness considerations, empowering more equitable decision-making in safety management, such as allocating resources for safety enhancement.
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Affiliation(s)
- Guocong Zhai
- Department of Civil & Environmental Engineering, Old Dominion University, Norfolk, VA 23529, USA
| | - Kun Xie
- Department of Civil & Environmental Engineering, Old Dominion University, Norfolk, VA 23529, USA.
| | - Di Yang
- Department of Transportation & Urban Infrastructure Studies, Morgan State University, Baltimore, MD 21251, USA
| | - Hong Yang
- Department of Electrical & Computer Engineering, Old Dominion University, Norfolk, VA 23529, USA
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Holguín-Carvajal JP, Otzen T, Sanhueza A, Castillo Á, Manterola C, Muñoz G, García-Aguilera F, Salgado-Castillo F. Trends in traffic accident mortality and social inequalities in Ecuador from 2011 to 2022. BMC Public Health 2024; 24:1951. [PMID: 39034408 PMCID: PMC11264957 DOI: 10.1186/s12889-024-19494-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Accepted: 07/16/2024] [Indexed: 07/23/2024] Open
Abstract
BACKGROUND Traffic accidents (TA) remain a significant global public health concern, impacting low-and middle-income countries. This study aimed to describe the trend in TA mortality and inequalities in Ecuador for 2011-2022, distributed by year, gender, age group, geographical location, type of accident, and social inequalities. METHODS An ecological study was conducted using INEC national-level data on TA fatalities in Ecuador. Mortality rates were calculated per 100,000 population and analyzed by year, gender, age group, geographic region, and accident type. Annual percentage variation (APV) was determined using linear regression models. Inequality analyses examined associations between TA mortality and socioeconomic factors like per capita income and literacy rates. Complex measures such as the Slope Inequality Index (SII) were calculated to assess the magnitude of inequalities. RESULTS There were 38,355 TA fatalities in Ecuador from 2011 to 2022, with an overall mortality rate of 19.4 per 100,000 inhabitants. The rate showed a non-significant decreasing trend (APV - 0.4%, p = 0.280). Males had significantly higher mortality rates than females (31.99 vs. 7.19 per 100,000), with the gender gap widening over time (APV 0.85%, p = 0.003). The Amazon region had the highest rate (24.4 per 100,000), followed by the Coast (20.4 per 100,000). Adults aged ≥ 60 years had the highest mortality (31.0 per 100,000), followed by those aged 25-40 years (28.6 per 100,000). The ≥ 60 age group showed the most significant rate decrease over time (APV - 2.25%, p < 0.001). Pedestrians were the most affected group after excluding unspecified accidents, with a notable decreasing trend (APV - 5.68%, p < 0.001). Motorcyclist fatalities showed an increasing trend, ranking third in TA-related deaths. Lower literacy rates and per capita income were associated with higher TA mortality risks. Inequality in TA mortality between provinces with the highest and lowest per capita income increased by 247.7% from 2011 to 2019, as measured by the SII. CONCLUSION While overall TA mortality slightly decreased in Ecuador, significant disparities persist across demographic groups and geographic regions. Older adults, males, pedestrians, and economically disadvantaged populations face disproportionately higher risks. The increasing trend in motorcycle-related fatalities and widening socioeconomic inequalities are particularly concerning.
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Affiliation(s)
- Juan Pablo Holguín-Carvajal
- Programa de Doctorado en Ciencias Médicas, Universidad de La Frontera, Temuco, Chile
- Facultad de Medicina, Universidad del Azuay, Cuenca, Ecuador
- Núcleo Milenio de Sociomedicina, Santiago, Chile
| | - Tamara Otzen
- Programa de Doctorado en Ciencias Médicas, Universidad de La Frontera, Temuco, Chile.
- Núcleo Milenio de Sociomedicina, Santiago, Chile.
- Departamento de Especialidades Médicas, Universidad de La Frontera, Temuco, Chile.
| | | | - Álvaro Castillo
- Núcleo Milenio de Sociomedicina, Santiago, Chile
- Department of Public Health, Facultad de Medicina y Ciencia, Universidad San Sebastián, Concepción, Chile
- Millennium Nucleus for the Evaluation and Analysis of Drug Policies (nDP), Santiago, Chile
| | - Carlos Manterola
- Programa de Doctorado en Ciencias Médicas, Universidad de La Frontera, Temuco, Chile
- Núcleo Milenio de Sociomedicina, Santiago, Chile
| | - Georgina Muñoz
- Programa de Doctorado en Ciencias Médicas, Universidad de La Frontera, Temuco, Chile
- Facultad de Medicina, Universidad del Azuay, Cuenca, Ecuador
- Núcleo Milenio de Sociomedicina, Santiago, Chile
| | - Fernanda García-Aguilera
- Programa de Doctorado en Ciencias Médicas, Universidad de La Frontera, Temuco, Chile
- Núcleo Milenio de Sociomedicina, Santiago, Chile
- Universidad Central del Ecuador, Quito, Ecuador
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Branion-Calles M, Winters M, Rothman L, Harris MA. Risk Factors and Inequities in Transportation Injury and Mortality in the Canadian Census Health and Environment Cohorts (CanCHECs). Epidemiology 2024; 35:252-262. [PMID: 38290144 PMCID: PMC10836781 DOI: 10.1097/ede.0000000000001696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 11/21/2023] [Indexed: 02/01/2024]
Abstract
BACKGROUND Road traffic injury contributes substantially to morbidity and mortality. Canada stands out among developed countries in not conducting a national household travel survey, leading to a dearth of national transportation mode data and risk calculations that have appropriate denominators. Since traffic injuries are specific to the mode of travel used, these risk calculations should consider travel mode. METHODS Census data on mode of commute is one of the few sources of these data for persons aged 15 and over. This study leveraged a national data linkage cohort, the Canadian Census Health and Environment Cohorts, that connects census sociodemographic and commute mode data with records of deaths and hospitalizations, enabling assessment of road traffic injury associations by indicators of mode of travel (commuter mode). We examined longitudinal (1996-2019) bicyclist, pedestrian, and motor vehicle occupant injury and fatality risk in the Canadian Census Health and Environment Cohorts by commuter mode and sociodemographic characteristics using Cox proportional hazards models within the working adult population. RESULTS We estimated positive associations between commute mode and same mode injury and fatality, particularly for bicycle commuters (hazard ratios for bicycling injury was 9.1 and for bicycling fatality was 11). Low-income populations and Indigenous people had increased injury risk across all modes. CONCLUSIONS This study shows inequities in transportation injury risk in Canada and underscores the importance of adjusting for mode of travel when examining differences between population groups.
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Affiliation(s)
- Michael Branion-Calles
- From the School of Occupational and Public Health, Faculty of Community Services, Toronto Metropolitan University, Toronto, Ontario, Canada
- Department of Emergency Medicine, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Meghan Winters
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Linda Rothman
- From the School of Occupational and Public Health, Faculty of Community Services, Toronto Metropolitan University, Toronto, Ontario, Canada
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - M. Anne Harris
- From the School of Occupational and Public Health, Faculty of Community Services, Toronto Metropolitan University, Toronto, Ontario, Canada
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Verma S, Wilson F, Wang H, Smith L, Tak HJ. Impact of Community Socioeconomic Characteristics on Emergency Medical Service Delays in Responding to Fatal Vehicle Crashes. AJPM FOCUS 2023; 2:100129. [PMID: 37790947 PMCID: PMC10546577 DOI: 10.1016/j.focus.2023.100129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Introduction This study aimed to determine the impact of community socioeconomic status on emergency medical services' response time for fatal vehicle crashes. Methods Authors used the 2019 National Highway Traffic Safety Administration Fatality Analysis Reporting System and 2019-2020 Area Health Resource Files to obtain emergency medical services' time intervals and county socioeconomic characteristics (e.g., median household income, availability of trauma centers, and rurality), generating a study sample of 18,540 individuals involved in fatal vehicle crashes between January and December 2019. Generalized linear models with log-link and Gamma-family were used to obtain estimates, and other variables were adjusted in the model. Results Both the mean time of the emergency medical service arrival to the site of the crash and the mean transport time from the crash site to hospital varied by county SES. Counties with a higher mean household income had 12% shorter emergency medical services' arrival times and up to 7% shorter emergency medical services' hospital transport times than counties with lower SES. The emergency medical services' hospital transport times by emergency medical services also varied by proximity to trauma centers and were 15% shorter in counties that had ≥2 trauma centers than in counties without trauma centers. Conclusions This study shows socioeconomic disparities in emergency medical service rescue time for fatal vehicle crashes. Community characteristics play a major role in emergency medical services' arrival time intervals. Prior research demonstrated a strong link between the timeliness of emergency medical service response and the likelihood of survival in fatal motor vehicle accidents. These findings showing that socioeconomically disadvantaged areas and those lacking trauma facilities had slower emergency medical service rescue times, suggest that socioeconomic status may be a predictor of mortality in fatal motor vehicle accidents. Effective emergency medical services are essential to reduce the morbidity and mortality among motor vehicle crash victims; however, disparities exist in the timeliness of these services by geographic and socioeconomic county characteristics. Further research is urgently needed to inform policy interventions.
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Affiliation(s)
- Sachi Verma
- College of Public Health, Department of Health Services Research & Administration, University of Nebraska Medical Center, Omaha, Nebraska
| | - Fernando Wilson
- Matheson Center for Health Care Studies, University of Utah, Salt Lake City, Utah
- Department of Population Health Sciences, University of Utah, Salt Lake City, Utah
| | - Hongmei Wang
- College of Public Health, Department of Health Services Research & Administration, University of Nebraska Medical Center, Omaha, Nebraska
| | - Lynette Smith
- College of Public Health, Department of Biostatistics, University of Nebraska Medical Center, Omaha, Nebraska
| | - Hyo Jung Tak
- College of Public Health, Department of Health Services Research & Administration, University of Nebraska Medical Center, Omaha, Nebraska
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Pratt S, Hagan-Haynes K. Applying a Health Equity Lens to Work-Related Motor Vehicle Safety in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6909. [PMID: 37887647 PMCID: PMC10606728 DOI: 10.3390/ijerph20206909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 09/30/2023] [Accepted: 10/06/2023] [Indexed: 10/28/2023]
Abstract
Motor vehicle crashes (MVCs) are the leading cause of fatal work-related injuries in the United States. Research assessing sociodemographic risk disparities for work-related MVCs is limited, yet structural and systemic inequities at work and during commutes likely contribute to disproportionate MVC risk. This paper summarizes the literature on risk disparities for work-related MVCs by sociodemographic and employment characteristics and identifies worker populations that have been largely excluded from previous research. The social-ecological model is used as a framework to identify potential causes of disparities at five levels-individual, interpersonal, organizational, community, and public policy. Expanded data collection and analyses of work-related MVCs are needed to understand and reduce disparities for pedestrian workers, workers from historically marginalized communities, workers with overlapping vulnerabilities, and workers not adequately covered by employer policies and safety regulations. In addition, there is a need for more data on commuting-related MVCs in the United States. Inadequate access to transportation, which disproportionately affects marginalized populations, may make travel to and from work less safe and limit individuals' access to employment. Identifying and remedying inequities in work-related MVCs, whether during the day or while commuting, will require the efforts of industry and multiple public sectors, including public health, transportation, and labor.
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Affiliation(s)
- Stephanie Pratt
- National Institute for Occupational Safety and Health, Division of Safety Research, Morgantown, WV 26505, USA;
- Strategic Innovative Solutions, LLC, Clearwater, FL 33760, USA
| | - Kyla Hagan-Haynes
- Injury and Violence Prevention Center, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
- National Institute for Occupational Safety and Health, Western States Division, Denver, CO 80225, USA
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Nishtala MV, Reed M, Schumacher J, Hanlon B, Venkatesh M, Collins M, Zarzaur BL. Catastrophic health expenditure in nonneurological injury due to motor vehicle crash. J Trauma Acute Care Surg 2023; 95:172-180. [PMID: 37125834 PMCID: PMC10524788 DOI: 10.1097/ta.0000000000003993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
BACKGROUND Motor vehicle crashes (MVCs) are a leading cause of nonfatal injury in the United States and impose a high financial cost to the patient and the economy. For many patients, this cost may be financially devastating and contribute to worsening health outcomes after injury. We aimed to describe the population level risk of catastrophic health expenditure (CHE) and determine factors associated with risk of CHE. METHODS We performed a retrospective review using the 2014-2017 Nationwide Inpatient Sample. The study population consisted of uninsured and privately insured adults aged 26 to 64 years who were hospitalized for nonneurologic traumatic injury due to MVCs. Our measure of financial hardship was CHE, which was defined as hospital charges ≥40% of postsubsistence income. Income estimates were derived from zip-code level data using Γ distribution modeling. RESULTS Our sample included 189,000 patients, of which 149,705 had private insurance and 39,375 were uninsured. The median estimated income for the study cohort was $66,118 (interquartile range, $65,353-$66,884). The median cost of hospitalization was $53,467 (interquartile range, $29,854-$99,914). In addition, 91.5% of uninsured patients suffering from MVC are at risk for CHE, and 10.1% of privately insured patients are at risk for CHE. Among the insured, Black, Hispanic, and low income were associated with CHE. CONCLUSION Nine of 10 uninsured patients are at risk for CHE after hospitalization for MVC. Despite having insurance, 10% of patients are still at risk of CHE. Black, Hispanic, and low-income communities are at highest risk of having private insurance and still experiencing CHE. This is the first population level analysis after the implementation of the Affordable Care Act that assesses the financial burden of no insurance and underinsurance. These data are important to understand the effectiveness of insurance coverage and guide hospital and policy level interventions to prevent CHE. LEVEL OF EVIDENCE Prognostic and Epidemiological; Level III.
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Affiliation(s)
- Madhuri V Nishtala
- From the Department of Surgery (M.V.N., J.S., M.V., B.L.Z.), University of Wisconsin School of Medicine and Public Health; Department of Consumer Behavior and Family Economics (M.R.), University of Wisconsin-Madison; Department of Biostatistics and Medical Informatics (B.H.), University of Wisconsin School of Medicine and Public Health; and Department of Surgery (M.C.), Robert M. La Follette School of Public Affairs, University of Wisconsin-Madison, Madison, Wisconsin
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Montenegro Martínez G, Arias-Castro CE, Silva Sánchez DC, Cardona-Arango D, Segura-Cardona Á, Muñoz-Rodríguez DI, Gutiérrez Ossa J, Henao Villegas S. [Social inequalities related to road traffic mortality]. GACETA SANITARIA 2023; 37:102313. [PMID: 37352821 DOI: 10.1016/j.gaceta.2023.102313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 04/25/2023] [Accepted: 04/28/2023] [Indexed: 06/25/2023]
Abstract
OBJECTIVE To synthesize the social inequalities related to mortality from traffic accidents reported in scientific publications. METHOD A scoping review following the PRISMA-ScR guide was carried out. Using the MesH vocabulary, we systematically searched for articles in English, Portuguese and Spanish published in the EBSCO, Scielo, Scopus, Ovid, and PubMed databases. RESULTS We identified 47,790 records in the initial search, of which 35 articles met the selection criteria. Nine out ten publications are in high-income countries; there is a greater interest in analyzing mortality in occupants and drivers of vehicles and motorcyclists. Half of the publications use race-ethnicity and geolocation as socioeconomic position variables. The articles included in this review indicate that groups of people with low socioeconomic positions have higher mortality due to traffic accidents. CONCLUSIONS The highest mortality from traffic accidents occurs in people with low socioeconomic positions which suggests the development of road safety actions from a comprehensive, integrative perspective and linked to other political agendas to reduce their incidence by 2030. Although road traffic fatalities are higher in low and middle-income countries, few publications are available in these countries. It is necessary to strengthen the research capacities in these countries.
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Affiliation(s)
| | | | | | | | | | | | - Jahir Gutiérrez Ossa
- Facultad de Ciencias Administrativas y Económicas, Universidad CES, Medellín, Colombia
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EHSANI JOHNATHONP, MICHAEL JEFFREYP, MacKENZIE ELLENJ. The Future of Road Safety: Challenges and Opportunities. Milbank Q 2023; 101:613-636. [PMID: 37096617 PMCID: PMC10126980 DOI: 10.1111/1468-0009.12644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 10/03/2022] [Accepted: 01/06/2023] [Indexed: 04/26/2023] Open
Abstract
Policy Points Traditional approaches to addressing motor vehicle crashes are yielding diminishing returns. A comprehensive strategy known as the Safe Systems approach shows promise in both advancing safety and equity and reducing motor vehicle crashes. In addition, a range of emerging technologies, enabled by artificial intelligence, such as automated vehicles, impairment detection and telematics hold promise to advance road safety. Ultimately, the transportation system will need to evolve to provide the safe, efficient, and equitable movement of people and goods without reliance on private vehicle ownership, towards encouraging walking, bicycling and the use of public transportation.
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Mujica OJ, Zhang D, Hu Y, Espinosa IC, Araneda N, Dragomir A, Luta G, Sanhueza A. Inequalities in Violent Death across Income Levels among Young Males and Females in Countries of the Americas. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5256. [PMID: 37047871 PMCID: PMC10094469 DOI: 10.3390/ijerph20075256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 03/12/2023] [Accepted: 03/17/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Violent deaths (i.e., those due to road traffic injury, homicide, and suicide) are among the most important causes of premature and preventable mortality in young people. This study aimed at exploring inequalities in violent death across income levels between males and females aged 10 to 24 years from the Americas in 2015, the SDG baseline year. METHODS In a cross-sectional ecological study design, eleven standard summary measures of health inequality were calculated separately for males and females and for each cause of violent death, using age-adjusted mortality rates and average income per capita for 17 countries, which accounted for 87.9% of the target population. RESULTS Premature mortality due to road traffic injury and homicide showed a pro-poor inequality pattern, whereas premature mortality due to suicide showed a pro-rich inequality pattern. These inequalities were statistically significant (p < 0.001), particularly concentrated among young males, and dominated by homicide. The ample array of summary measures of health inequality tended to generate convergent results. CONCLUSIONS Significant inequalities in violent death among young people seems to be in place across countries of the Americas, and they seem to be socially determined by both income and gender. These findings shed light on the epidemiology of violent death in young people and can inform priorities for regional public health action. However, further investigation is needed to confirm inequality patterns and to explore underlying mechanisms, age- and sex-specific vulnerabilities, and gender-based drivers of such inequalities.
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Affiliation(s)
| | - Dihui Zhang
- Department of Biostatistics, Bioinformatics and Biomathematics, Georgetown University, Washington, DC 20057, USA
| | - Yi Hu
- Department of Biostatistics, Bioinformatics and Biomathematics, Georgetown University, Washington, DC 20057, USA
| | - Isabel C. Espinosa
- T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA
| | - Nelson Araneda
- Department of Education, University of La Frontera, Temuco 4811230, Chile
| | - Anca Dragomir
- Department of Oncology, Georgetown University, Washington, DC 20057, USA
| | - George Luta
- Department of Biostatistics, Bioinformatics and Biomathematics, Georgetown University, Washington, DC 20057, USA
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Jahanjoo F, Sadeghi-Bazargani H, Asghari-Jafarabadi M. Modeling road traffic fatalities in Iran's six most populous provinces, 2015-2016. BMC Public Health 2022; 22:2234. [PMID: 36451170 PMCID: PMC9710022 DOI: 10.1186/s12889-022-14678-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 11/21/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Prevention of road traffic injuries (RTIs) as a critical public health issue requires coordinated efforts. We aimed to model influential factors related to traffic safety. METHODS In this cross-sectional study, the information from 384,614 observations recorded in Integrated Road Traffic Injury Registry System (IRTIRS) in a one-year period (March 2015-March 2016) was analyzed. All registered crashes from Tehran, Isfan, Fras, Razavi Khorasan, Khuzestan, and East Azerbaijan provinces, the six most populated provinces in Iran, were included in this study. The variables significantly associated with road traffic fatality in the uni-variate analysis were included in the multiple logistic regression. RESULTS According to the multiple logistic regression, thirty-two out of seventy-one different variables were identified to be significantly associated with road traffic fatality. The results showed that the crash scene significantly related factors were passenger presence(OR = 4.95, 95%CI = (4.54-5.40)), pedestrians presence(OR = 2.60, 95%CI = (1.75-3.86)), night-time crashes (OR = 1.64, 95%CI = (1.52-1.76)), rainy weather (OR = 1.32, 95%CI = (1.06-1.64)), no intersection control (OR = 1.40, 95%CI = (1.29-1.51)), double solid line(OR = 2.21, 95%CI = (1.31-3.74)), asphalt roads(OR = 1.95, 95%CI = (1.39-2.73)), nonresidential areas(OR = 2.15, 95%CI = (1.93-2.40)), vulnerable-user presence(OR = 1.70, 95%CI = (1.50-1.92)), human factor (OR = 1.13, 95%CI = (1.03-1.23)), multiple first causes (OR = 2.81, 95%CI = (2.04-3.87)), fatigue as prior cause(OR = 1.48, 95%CI = (1.27-1.72)), irregulation as direct cause(OR = 1.35, 95%CI = (1.20-1.51)), head-on collision(OR = 3.35, 95%CI = (2.85-3.93)), tourist destination(OR = 1.95, 95%CI = (1.69-2.24)), suburban areas(OR = 3.26, 95%CI = (2.65-4.01)), expressway(OR = 1.84, 95%CI = (1.59-2.13)), unpaved shoulders(OR = 1.84, 95%CI = (1.63-2.07)), unseparated roads (OR = 1.40, 95%CI = (1.26-1.56)), multiple road defects(OR = 2.00, 95%CI = (1.67-2.39)). In addition, the vehicle-connected factors were heavy vehicle (OR = 1.40, 95%CI = (1.26-1.56)), dark color (OR = 1.26, 95%CI = (1.17-1.35)), old vehicle(OR = 1.46, 95%CI = (1.27-1.67)), not personal-regional plaques(OR = 2.73, 95%CI = (2.42-3.08)), illegal maneuver(OR = 3.84, 95%CI = (2.72-5.43)). And, driver related factors were non-academic education (OR = 1.58, 95%CI = (1.33-1.88)), low income(OR = 2.48, 95%CI = (1.95-3.15)), old age (OR = 1.67, 95%CI = (1.44-1.94)), unlicensed driving(OR = 3.93, 95%CI = (2.51-6.15)), not-wearing seat belt (OR = 1.55, 95%CI = (1.44-1.67)), unconsciousness (OR = 1.67, 95%CI = (1.44-1.94)), driver misconduct(OR = 2.51, 95%CI = (2.29-2.76)). CONCLUSION This study reveals that driving behavior, infrastructure design, and geometric road factors must be considered to avoid fatal crashes. Our results found that the above-mentioned factors had higher odds of a deadly outcome than their counterparts. Generally, addressing risk factors and considering the odds ratios would be beneficial for policy makers and road safety stakeholders to provide support for compulsory interventions to reduce the severity of RTIs.
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Affiliation(s)
- Fatemeh Jahanjoo
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, 5167846311, East Azerbaijan, Islamic Republic of Iran
- Injury Epidemiology and Prevention Research Group, Turku Brain Injury Center, Turku University Hospital and the University of Turku, Turku, Finland
| | - Homayoun Sadeghi-Bazargani
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, 5167846311, East Azerbaijan, Islamic Republic of Iran.
| | - Mohammad Asghari-Jafarabadi
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, 5167846311, East Azerbaijan, Islamic Republic of Iran.
- Cabrini Research, Cabrini Health, Melbourne, VIC, 3144, Australia.
- School of Public Health and Preventative Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, 3800, Australia.
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Qi M, Hu X, Li X, Wang X, Shi X. Analysis of road traffic injuries and casualties in China: a ten-year nationwide longitudinal study. PeerJ 2022; 10:e14046. [PMID: 36128192 PMCID: PMC9482767 DOI: 10.7717/peerj.14046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 08/21/2022] [Indexed: 01/19/2023] Open
Abstract
Background Road traffic injuries (RTIs) are a serious global problem, and a huge challenge for both economic development and public health. Methods This longitudinal study was based on the national data from Chinese authorities. Descriptive analysis was utilized to analyze the prevalence and trend of RTIs among different types, groups and regions. In addition, ridge regression or/and curve regression were also used to explore the relationship between those possible influencing factors and RTIs. Results From 2010 to 2019, the death toll from motor vehicle accidents (MVAs) decreased firstly and then increased, while the death toll from non-MVAs continued to rise since 2012, and the death toll from pedestrian and occupant accidents fluctuated only a little. The mortality rate of MVA was relatively stable from 2010 to 2012, and declined from 2013. The mortality rate of motor vehicle accidents was higher in rural than urban, the same to male compared with female. The results of ridge regression showed that gross domestic product (GDP)-per-capita, total population, number of health personnel and car ownership were positively correlated with the death toll of non-MVAs (P < 0.05). Additionally, the results of curve regression suggested that the quadratic or cubic relationship between each factor and the number of MVAs was well fitted, while only partially fitted in fatalities. Conclusions In recent years, RTIs in China show different trends, and the problem of non-motor vehicle traffic injuries has been neglected which should be paid more attention. Moreover, according to the new trends and traffic conditions in RTIs revealed in this study, it is necessary to formulate targeted intervention measures establish a multi-faceted comprehensive safety system to reduce the disease burden of RTIs as well as the total injuries.
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Affiliation(s)
- Miao Qi
- Department of Epidemiology and Health Statistics, School of Public Health, Zunyi Medical University, Zunyi, Guizhou, China
| | - Xiuli Hu
- Department of Epidemiology and Health Statistics, School of Public Health, Zunyi Medical University, Zunyi, Guizhou, China
| | - Xiahong Li
- Department of Epidemiology and Health Statistics, School of Public Health, Zunyi Medical University, Zunyi, Guizhou, China
| | - Xue Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Zunyi Medical University, Zunyi, Guizhou, China
| | - Xiuquan Shi
- Department of Epidemiology and Health Statistics, School of Public Health, Zunyi Medical University, Zunyi, Guizhou, China,Center for Injury Research and Policy & Center for Pediatric Trauma Research, The Research Institute at Nationwide Children’s Hospital, The Ohio State University College of Medicine, Columbus, OH, USA
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12
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Coburn SB, Manabe YC, Laeyendecker O, Sherman SG, Baker OR, Quinn TC, Graham LA, Dennis Thomas F, Southall P, Weedn VW, Ehsani J, Klock E, Li R, Shields WC, Michael JP, Li L, Althoff K. Severe Acute Respiratory Syndrome Coronavirus 2 Antibody Seroprevalence in Decedents Undergoing Forensic Postmortem Examination: Feasibility for
Real-Time Pandemic Surveillance. Open Forum Infect Dis 2022; 9:ofac142. [PMID: 35415200 PMCID: PMC8995069 DOI: 10.1093/ofid/ofac142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 03/22/2022] [Indexed: 11/16/2022] Open
Abstract
Background Population-based seroprevalence studies offer comprehensive characterization of coronavirus disease 2019 (COVID-19) spread, but barriers exist and marginalized populations may not be captured. We assessed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody seroprevalence among decedents in Maryland over 6 months in 2020. Methods Data were collected on decedents undergoing forensic postmortem examination in Maryland from 24 May through 30 November 2020 from whom a blood specimen could be collected. Those with available blood specimens were tested with the CoronaCHEK lateral flow antibody assay. We assessed monthly seroprevalence compared to the statewide estimated number of cases and proportion of positive test results (testing positivity). We used Poisson regression with robust variance to estimate adjusted prevalence ratios (aPRs) with 95% confidence intervals (CIs) for associations of demographic characteristics, homelessness, and manner of death with SARS-CoV-2 antibodies. Results Among 1906 decedents, 305 (16%) were positive for SARS-CoV-2 antibodies. Monthly seroprevalence increased from 11% to 22% over time and was consistently higher than state-level estimates of testing positivity. Hispanic ethnicity was associated with 2- to 3.2-fold higher seropositivity (P < .05) irrespective of sex. Deaths due to motor vehicle crash were associated with 62% increased seropositivity (aPR, 1.62 [95% CI, 1.15-2.28]) vs natural manner of death. Though seroprevalence was lower in decedents of illicit drug overdose vs nonoverdose in early months, this shifted, and seroprevalence was comparable by November 2020. Conclusions Decedents undergoing forensic postmortem examination, especially those dying due to motor vehicle trauma, may be a sentinel population for COVID-19 spread in the general population and merits exploration in other states/regions.
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Affiliation(s)
- Sally B Coburn
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Yukari C Manabe
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Oliver Laeyendecker
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Susan G Sherman
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Owen R Baker
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Thomas C Quinn
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | | | | | - Pamela Southall
- Office of the Chief Medical Examiner, Maryland Department of Health, Baltimore, Maryland, USA
| | - Victor W Weedn
- University of Maryland Baltimore Graduate School, Baltimore, Maryland, USA
| | - Johnathon Ehsani
- Center for Injury Research and Policy, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Ethan Klock
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Rong Li
- Office of the Chief Medical Examiner, Maryland Department of Health, Baltimore, Maryland, USA
| | - Wendy C Shields
- Center for Injury Research and Policy, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Jeffrey Paul Michael
- Center for Injury Research and Policy, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Ling Li
- Office of the Chief Medical Examiner, Maryland Department of Health, Baltimore, Maryland, USA
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Keri N Althoff
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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13
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Walshe EA, Romer D, Wyner AJ, Cheng S, Elliott MR, Zhang R, Gonzalez AK, Oppenheimer N, Winston FK. Licensing Examination and Crash Outcomes Postlicensure in Young Drivers. JAMA Netw Open 2022; 5:e228780. [PMID: 35467733 PMCID: PMC9039772 DOI: 10.1001/jamanetworkopen.2022.8780] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
IMPORTANCE Despite US graduated driver licensing laws, young novice driver crash rates remain high. Study findings suggest comprehensive license policy that mandates driver education including behind-the-wheel (BTW) training may reduce crashes postlicensure. However, only 15 states mandate BTW training. OBJECTIVE To identify differences in licensing and crash outcomes for drivers younger than 18 years who are subject to comprehensive licensing requirements (graduated driver licensing, driver education, and BTW training) vs those aged 18 to 24 years who are exempt from these requirements. DESIGN, SETTING, AND PARTICIPANTS This prospective, population-based cohort study used Ohio licensing data to define a cohort of 2018 license applicants (age 16-24 years, n = 136 643) and tracked licensed driver (n = 129 897) crash outcomes up to 12 months postlicensure. The study was conducted from January 1, 2018, to December 31, 2019, and data analysis was performed from October 7, 2019, to February 11, 2022. MAIN OUTCOMES AND MEASURES Licensing examination performance and population-based, police-reported crash rates in the first 2 months and 12 months postlicensure across age groups, sex, and census tract-level sociodemographic variables were measured. Poisson regression models compared newly licensed driver crash rates, with reference to individuals licensed at 18 years, while controlling for census tract-level sociodemographic factors, time spent in the learner permit period, and licensing examination performance measures. RESULTS Of 136 643 novice drivers, 69 488 (50.9%) were male and 67 152 (49.1%) were female. Mean (SD) age at enrollment (age at first on-road examination) was 17.7 (2.1) years. License applicants aged 16 and 17 years performed best on license examinations (15 466 [21.6%] and 5112 [30.9%] failing vs 7981 [37.5%] of applicants aged 18 years). Drivers licensed at 18 years had the highest crash rates of all those younger than 25 years. Compared with drivers licensed at 18 years, crash rates were 27% lower in individuals aged 16 years and 14% lower in those aged 17 years during the first 2 months postlicensure when controlling for socioeconomic status, time spent in learner permit status, and license examination performance measures (adjusted relative risk [aRR] at age 16 years: 0.73; 95% CI, 0.67-0.80; age 17 years: aRR, 0.86; 95% CI, 0.77-0.96). At 12 months postlicensure, crash rates were 19% lower for individuals licensed at age 16 years (aRR, 0.81; 95%, CI, 0.77-0.85) and 6% lower at age 17 years (aRR, 0.94; 95% CI, 0.89-0.99) compared with individuals aged 18 years. CONCLUSIONS AND RELEVANCE In Ohio, drivers younger than 18 years who are subject to graduated driver licensing and driver education, including BTW training requirements, had lower crash rates in the first year postlicensure compared with those aged 18 years, with controls applied. These findings suggest that it may be fruitful for future work to reconsider the value of mandated driver license policies, including BTW training, and to examine reasons for delayed licensure and barriers to accessing training.
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Affiliation(s)
- Elizabeth A. Walshe
- Center for Injury Research and Prevention, Children's Hospital of Philadelphia Research Institute, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Daniel Romer
- Annenberg Public Policy Center, University of Pennsylvania, Philadelphia
| | | | - Shukai Cheng
- Center for Injury Research and Prevention, Children's Hospital of Philadelphia Research Institute, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Michael R. Elliott
- School of Public Health, University of Michigan, Ann Arbor
- Institute for Social Research, University of Michigan, Ann Arbor
| | - Robert Zhang
- Wharton School, University of Pennsylvania, Philadelphia
| | - Alexander K. Gonzalez
- Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia Research Institute, Philadelphia
| | - Natalie Oppenheimer
- Center for Injury Research and Prevention, Children's Hospital of Philadelphia Research Institute, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Flaura K. Winston
- Center for Injury Research and Prevention, Children's Hospital of Philadelphia Research Institute, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- Division of General Pediatrics, University of Pennsylvania Perelman School of Medicine; Philadelphia
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14
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Benson AJ, Tefft BC, Arnold LS, Horrey WJ. Fatal hit-and-run crashes: Factors associated with leaving the scene. JOURNAL OF SAFETY RESEARCH 2021; 79:76-82. [PMID: 34848022 DOI: 10.1016/j.jsr.2021.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 04/08/2021] [Accepted: 08/12/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Hit-and-run crashes are a criminal offense that leave the victim without prompt medical care or the ability to receive financial compensation. METHOD The purpose of the current study was to quantify the factors associated with the probability that a driver leaves the scene of a fatal crash, using multiple imputation to incorporate information from drivers who were never apprehended and thus whose characteristics were unknown. RESULTS The results of this study show that in addition to driver, vehicle, and environmental factors having significant impacts on the likelihood of a driver fleeing the scene, economic and demographic factors are important as well. Practical Applications: This analysis allows for a more holistic understanding of hit-and-run crashes and informs potential countermeasures and future research.
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15
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Okui T, Park J. Analysis of the regional distribution of road traffic mortality and associated factors in Japan. Inj Epidemiol 2021; 8:60. [PMID: 34711289 PMCID: PMC8555252 DOI: 10.1186/s40621-021-00356-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 10/14/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Regional differences in road traffic (RT) mortality among municipalities have not been revealed in Japan. Further, the association between RT mortality and regional socioeconomic characteristics has not been investigated. We analyzed geographic differences in RT mortality and its associated factors using the Vital Statistics in Japan. METHODS We used data on RT mortality by sex and municipality in Japan from 2013 to 2017. We calculated the standardized mortality ratio (SMR) of RT for each municipality by sex using an Empirical Bayes method. The SMRs were mapped onto a map of Japan to show the geographic differences. In addition, an ecological study investigated the municipal characteristics associated with the SMR using demographic socioeconomic, medical, weather, and vehicular characteristics as explanatory variables. The ecological study used a spatial statistical model. RESULTS The mapping revealed that the number of municipalities with a high SMR of RT (SMR > 2) was larger in men than in women. In addition, SMRs of capital areas (Kanagawa and Tokyo prefectures) tended to be low in men and women. The regression analysis revealed that population density was negatively associated with the SMR in men and women, and the degree of the association was the largest among explanatory variables. In contrast, there was a positive association between the proportion of non-Japanese persons and SMR. The proportions of lower educational level (elementary school or junior high school graduates), agriculture, forestry, and fisheries workers, service workers, and blue-collar workers were positively associated with the SMR in men. The proportion of unemployed persons was negatively associated with the SMR in men. CONCLUSIONS Socioeconomic characteristics are associated with geographic differences in RT mortality particularly in men. The results suggested preventive measures targeted at men of low socioeconomic status and non-Japanese persons are needed to decrease RT mortality further.
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Affiliation(s)
- Tasuku Okui
- Medical Information Center, Kyushu University Hospital, Maidashi 3-1-1, Higashi-ku, Fukuoka City, Fukuoka Prefecture, 812-8582, Japan.
| | - Jinsang Park
- Department of Pharmaceutical Sciences, International University of Health and Welfare, Fukuoka, Japan
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16
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Budziszewski R, Thompson R, Lucido T, Walker J, Meyer LK, Arthur LG, Grewal H. Measuring the effectiveness of a car seat program in an urban, level one pediatric trauma center. Inj Epidemiol 2021; 8:19. [PMID: 34517909 PMCID: PMC8436462 DOI: 10.1186/s40621-021-00313-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 03/09/2021] [Indexed: 11/10/2022] Open
Abstract
Background Motor vehicle collisions (MVCs) are a significant safety issue in the United States. Young children are disproportionally impacted by car accidents and suffer high rates of injuries and mortality. When used properly, car seats have been found to reduce the severity of injuries. However, individuals from low-income areas often do not have access to education or car seats compared to those in suburban or higher income areas. Therefore, the goal of the present study was to measure the effectiveness of a car seat program in an urban, Level I Pediatric Trauma Center on caregiver car seat knowledge. Methods Caregivers (N = 200) attended a single, one-hour car seat educational program with a Child Passenger Safety Technician (CPST). The sessions included educational and hands-on components, where caregivers were asked to complete a seven-item pre-post knowledge assessment. For completion of the course, caregivers received a car seat for their child. Results A paired t-test revealed that the workshop significantly increased caregiver knowledge from pre-post: t (199) = − 12.56, p < .001; d = 1.27. McNemar’s Chi-Square analyses displayed that caregivers increased in all knowledge categories (p < .001). Conclusions While caregivers in urban areas or in low-income areas may have less access to resources, hospital-led car seat courses can increase knowledge of proper car seat usage in these communities. These findings should be used to establish programs in hospitals in areas where these resources are not readily available to caregivers.
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Affiliation(s)
| | | | - Thomas Lucido
- Drexel University College of Medicine, Philadelphia, PA, USA
| | - Janelle Walker
- St. Christopher's Hospital for Children, Philadelphia, PA, USA
| | - Loreen K Meyer
- St. Christopher's Hospital for Children, Philadelphia, PA, USA
| | - L Grier Arthur
- St. Christopher's Hospital for Children, Philadelphia, PA, USA.,Drexel University College of Medicine, Philadelphia, PA, USA
| | - Harsh Grewal
- St. Christopher's Hospital for Children, Philadelphia, PA, USA.,Drexel University College of Medicine, Philadelphia, PA, USA
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17
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Sartin EB, Metzger KB, Pfeiffer MR, Myers RK, Curry AE. Facilitating research on racial and ethnic disparities and inequities in transportation: Application and evaluation of the Bayesian Improved Surname Geocoding (BISG) algorithm. TRAFFIC INJURY PREVENTION 2021; 22:S32-S37. [PMID: 34402327 PMCID: PMC8792156 DOI: 10.1080/15389588.2021.1955109] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 07/07/2021] [Accepted: 07/08/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Racial and ethnic disparities and/or inequities have been documented in traffic safety research. However, race/ethnicity data are often not captured in population-level traffic safety databases, limiting the field's ability to comprehensively study racial/ethnic differences in transportation outcomes, as well as our ability to mitigate them. To overcome this limitation, we explored the utility of estimating race and ethnicity for drivers in the New Jersey Safety and Health Outcomes (NJ-SHO) data warehouse using the Bayesian Improved Surname Geocoding (BISG) algorithm. In addition, we summarize important recommendations established to guide researchers developing and implementing racial and ethnic disparity research. METHODS We applied BISG to estimate population-level race/ethnicity for New Jersey drivers in 2017 and evaluated the concordance between reported values available in integrated administrative sources (e.g., hospital records) and BISG probability distributions using an area under the receiver operator curve (AUC) within each race/ethnicity category. Overall AUC was calculated by weighting each AUC value by the population count in each reported category. In an exemplar analysis using 2017 crash data, we conducted an analysis of average monthly police-reported crash rates in 2017 by race/ethnicity using the NJ-SHO and BISG sets of race/ethnicity values to compare their outputs. RESULTS We found excellent or outstanding concordance (AUC ≥0.86) between reported race/ethnicity and BISG probabilities for White, Hispanic, Black, and Asian/Pacific Islander drivers. We found poor concordance for American Indian/Alaskan Native drivers (AUC= 0.65), and concordance was no better than random assignment for Multiracial drivers (AUC = 0.52). Among White, Hispanic, Asian/Pacific Islander, and American Indian/Alaskan native drivers, monthly crash rates calculated using both NJ-SHO reported race/ethnicity values and BISG probabilities were similar. Monthly crash rates differed by 11% for Black drivers, and by more than 200% for Multiracial drivers. CONCLUSION Findings of excellent or outstanding concordance between and mostly similar crash rates derived from reported race/ethnicity and BISG probabilities for White, Hispanic, Black, and Asian/Pacific Islander drivers (98.9% of all drivers in this sample) demonstrate the potential utility of BISG in enabling research on transportation disparities and inequities. Concordance between race/ethnicity values were not acceptable for American Indian/Alaskan Native and Multiracial drivers, which is similar to previous applications and evaluations of BISG. Future work is needed to determine the extent to which BISG may be applied to traffic safety contexts.
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Affiliation(s)
- Emma B. Sartin
- Center for Injury Research and Prevention, Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Kristina B. Metzger
- Center for Injury Research and Prevention, Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Melissa R. Pfeiffer
- Center for Injury Research and Prevention, Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Rachel K. Myers
- Center for Injury Research and Prevention, Children’s Hospital of Philadelphia, Philadelphia, PA
- Division of Emergency Medicine, Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Allison E. Curry
- Center for Injury Research and Prevention, Children’s Hospital of Philadelphia, Philadelphia, PA
- Division of Emergency Medicine, Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
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18
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Nunes A, Axhausen KW. Road safety, health inequity and the imminence of autonomous vehicles. NAT MACH INTELL 2021. [DOI: 10.1038/s42256-021-00382-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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19
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Roberts SC, Zhang F, Fisher D, Vaca FE. The effect of hazard awareness training on teen drivers of varying socioeconomic status. TRAFFIC INJURY PREVENTION 2021; 22:455-459. [PMID: 34251927 DOI: 10.1080/15389588.2021.1940984] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 06/03/2021] [Accepted: 06/04/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To compare the effectiveness of the Risk Awareness and Perception Training (RAPT) program among teens of various socioeconomic status (SES). METHODS A secondary analysis was undertaken of data collected from 5036 teen participants for a study in 2011. They were randomly assigned to either receive RAPT or a placebo training. The total number of crashes (property damage only and injury) within the first 12 months after licensure was recorded. A Poisson regression model was employed to investigate the effectiveness of RAPT in terms of crash frequency among teens in different levels of SES, as measured by SES level (high or low) or poverty rate. RESULTS Poverty rate was significantly associated with participants' crash frequency within the first 12 months after licensure such that when poverty rate increased, the crash frequency increased. The interacting effect of poverty rate and training was also significant. When compared to participants who did not receive RAPT, participants who received RAPT had fewer crashes when poverty rate increased. CONCLUSION The RAPT program attenuated the negative effect of teen drivers' SES on crashes. No significant effect of sex or age was found, indicating that in terms of crashes, regardless of age or sex, RAPT is equally effective at reducing crashes for lower SES teens.
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Affiliation(s)
- Shannon C Roberts
- Mechanical and Industrial Engineering Department, University of Massachusetts Amherst, Amherst, Massachusetts
| | - Fangda Zhang
- Mechanical and Industrial Engineering Department, University of Massachusetts Amherst, Amherst, Massachusetts
| | - Donald Fisher
- Transportation Human Factors Division, Volpe National Transportation Systems Center, Cambridge, Massachusetts
| | - Federico E Vaca
- Department of Emergency Medicine, Yale Neurocognitive Driving Simulation Research Center (DrivSim Lab), Yale School of Medicine, New Haven, Connecticut
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20
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Pulido J, Molist G, Vallejo F, Jiménez-Mejías E, Hoyos J, Regidor E, Barrio G. No effect of the Penalty Point System on road traffic accident mortality among men with a high socioeconomic status in Spain. ACCIDENT; ANALYSIS AND PREVENTION 2021; 156:106154. [PMID: 33933718 DOI: 10.1016/j.aap.2021.106154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 04/15/2021] [Accepted: 04/17/2021] [Indexed: 06/12/2023]
Abstract
The purpose of this study was to assess the effect of the Penalty Point System (PPS) on road traffic accident mortality by gender and socioeconomic status. We conducted a nationwide prospective study covering adult people living in Spain on November 2001. They were followed up until 30 Nov 2007 to determine vital status and cause of death. An interrupted time-series analysis was used to assess whether PPS (explanatory variable) had both immediate and long-term effect on the rates of road traffic accident mortality (RTAMs) separately by gender. Subjects were classified by socioeconomic status (low and high) using two indicators: educational attainment (up to lower secondary education; upper secondary education or more) and occupation (manual and non-manual workers). We performed several segmented Poisson regression models, controlling for trend, seasonality, 2004 road safety measures and fuel consumption as proxy for traffic exposure. Among men, we found a decrease on the RTAMs immediately after PPS in those with low educational level (16.2 %, IC95 %: 6.1 %-25.2 %) and manual workers (16.3 %, IC95 %: 2.8 %-27.8 %), and a non-significant increase among those with high education level and non-manual workers (6.2 % and 1.8 %). Among women, there were no significant differences in the immediate effect of PPS by socioeconomic status. We did not identify significant trend changes between pre-PPS and post-PPS periods in any socioeconomic group. In a context of downward trend of traffic mortality, the PPS implementation led to an immediate reduction on death rates only among men with a low socioeconomic status.
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Affiliation(s)
- J Pulido
- Department of Public Health and Maternal and Child Health, Complutense University of Madrid, Madrid, Spain; National School of Public Health, Institute of Health Carlos III, Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - G Molist
- Granollers General Hospital, Research and Innovation Area, Granollers, Barcelona, Spain
| | - F Vallejo
- National School of Public Health, Institute of Health Carlos III, Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - E Jiménez-Mejías
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain; Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain; Biosanitary Research Institute (Ibs Granada), Granada, Spain
| | - J Hoyos
- Department of Public Health and Maternal and Child Health, Complutense University of Madrid, Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.
| | - E Regidor
- Department of Public Health and Maternal and Child Health, Complutense University of Madrid, Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain; Health Research Institute of the Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - G Barrio
- National School of Public Health, Institute of Health Carlos III, Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
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21
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Mőller H, Rogers K, Cullen P, Senserrick T, Boufous S, Ivers R. Socioeconomic status during youth and risk of car crash during adulthood. Findings from the DRIVE cohort study. J Epidemiol Community Health 2021; 75:755-763. [PMID: 33687994 DOI: 10.1136/jech-2020-214083] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 11/16/2020] [Accepted: 12/20/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND Young drivers of low socioeconomic status (SES) have a disproportionally high risk of crashing compared with their more affluent counterparts. Little is known if this risk persists into adulthood and if it differs between men and women. METHODS We used data from a 2003/2004 Australian survey of young drivers (n=20 806), which included measures of drivers' demographics and established crash risk factors. These data were linked to police-reported crash, hospital and death data up to 2016. We used negative binomial regression models to estimate the association between participants' SES, with car crash. RESULTS After adjusting for confounding, drivers of lowest SES had 1.30 (95% CI 1.20 to 1.42), 1.90 (95% CI 1.25 to 2.88), 3.09 (95% CI 2.41 to 3.95) and 2.28 (95% CI 1.85 to 2.82) times higher rate of crash, crash-related hospitalisation, crash in country areas and crash on streets with a speed limit of 80 km/hour or above compared with drivers of highest SES, respectively. For single-vehicle crashes, women in the lowest SES groups had 2.88 (95% CI 1.83 to 4.54) times higher rate of crash compared with those in the highest SES group, but no differences were observed for men from different SES groups. CONCLUSION Young drivers who lived in areas of low SES at the time of the survey had a sustained increased risk of crash over the following 13 years compared with drivers from the most affluent areas. Our findings suggest that in addition to traditional measures, road transport injury prevention needs to consider the wider social determinants of health.
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Affiliation(s)
- Holger Mőller
- Injury Division, The George Institute for Global Health, Newtown, New South Wales, Australia .,School of Population Health, UNSW, Sydney, New South Wales, Australia
| | - Kris Rogers
- Injury Division, The George Institute for Global Health, Newtown, New South Wales, Australia.,Graduate School of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Patricia Cullen
- School of Population Health, UNSW, Sydney, New South Wales, Australia.,Ngarruwan Ngadju, First Peoples Health and Wellbeing Research Centre, Australian Health Services Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - Teresa Senserrick
- Queensland University of Technology (QUT), Centre for Accident Research and Road Safety - Queensland (CARRS-Q), Kelvin Grove, Brisbane, Queensland, Australia
| | - Soufiane Boufous
- School of Aviation, Transport and Road Safety (TARS) Research,Faculty of Science, UNSW, Sydney, New South Wales, Australia
| | - Rebecca Ivers
- School of Population Health, UNSW, Sydney, New South Wales, Australia
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22
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Stickley A, Baburin A, Jasilionis D, Krumins J, Martikainen P, Kondo N, Leinsalu M. Macroeconomic changes and educational inequalities in traffic fatalities in the Baltic countries and Finland in 2000-2015: a register-based study. Sci Rep 2021; 11:2397. [PMID: 33504848 PMCID: PMC7840907 DOI: 10.1038/s41598-021-81135-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 12/31/2020] [Indexed: 11/10/2022] Open
Abstract
This study examined trends and inequalities in road traffic accident (RTA) mortality in the Baltic countries (Estonia, Latvia, Lithuania) and Finland in relation to large-scale macroeconomic changes in the 2000s. Educational inequalities in RTA mortality in 2000-2003, 2004-2007, 2008-2011 and 2012-2015 among 30-74 year olds were examined using census-linked longitudinal mortality data and by estimating the relative and slope index of inequality. Overall RTA mortality decreased substantially between 2000-2003 and 2012-2015. From 2004-2007 to 2008-2011, the RTA mortality decline accelerated but was larger in the Baltic countries. Among men the RTA mortality decline was mostly driven by a larger fall among the high and middle educated. Among women, the changes in RTA mortality by educational level had no clear pattern. From 2000-2003 to 2012-2015 relative educational inequalities in RTA mortality increased among men, although more in the Baltic countries. Among women the pattern was mixed across countries. Absolute inequalities fell in all countries among both sexes. Educational inequalities in male RTA mortality may be growing because of increasingly less access to safer cars and a more hazardous driving culture among the lower educated.
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Affiliation(s)
- Andrew Stickley
- Stockholm Centre for Health and Social Change (SCOHOST), Södertörn University, 141 89, Huddinge, Sweden. .,Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan.
| | - Aleksei Baburin
- Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia
| | - Domantas Jasilionis
- Max Planck Institute for Demographic Research, Rostock, Germany.,Demographic Research Centre, Vytautas Magnus University, Kaunas, Lithuania
| | - Juris Krumins
- Demography Unit, Faculty of Business, Management and Economics, University of Latvia, Riga, Latvia
| | - Pekka Martikainen
- Max Planck Institute for Demographic Research, Rostock, Germany.,Population Research Unit, University of Helsinki, Helsinki, Finland.,Centre for Health Equity Studies (CHESS), Stockholm University and Karolinska Institutet, Stockholm, Sweden
| | - Naoki Kondo
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan.,Institute for Future Initiatives, The University of Tokyo, Tokyo, Japan
| | - Mall Leinsalu
- Stockholm Centre for Health and Social Change (SCOHOST), Södertörn University, 141 89, Huddinge, Sweden. .,Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia.
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23
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Althoff KN, Laeyendecker O, Li R, Coburn SB, Klock E, Baker OR, Quinn TC, Michael J, Shields WC, Ehsani J, Thomas FD, Graham LA, Ali Z, Manabe YC, Li L. Severe Acute Respiratory Syndrome Coronavirus 2 Antibody Status in Decedents Undergoing Forensic Postmortem Examination in Maryland, May 24 to June 30, 2020. Open Forum Infect Dis 2020; 8:ofaa611. [PMID: 33506069 PMCID: PMC7798730 DOI: 10.1093/ofid/ofaa611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 12/12/2020] [Indexed: 12/05/2022] Open
Abstract
Seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies was 10% among the subset of decedents undergoing forensic postmortem examination in June in Maryland. Decedents of motor vehicle crashes had similar seroprevalence compared with those with a natural death (including decedents with SARS-CoV-2 infection). Decedents of motor vehicle crashes may be a sentinel surveillance population.
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Affiliation(s)
- Keri N Althoff
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Oliver Laeyendecker
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.,Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Rong Li
- Office of the Chief Medical Examiner, Maryland Department of Health, Baltimore, Maryland, USA
| | - Sally B Coburn
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Ethan Klock
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Owen R Baker
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Thomas C Quinn
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.,Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Jeffrey Michael
- Center for Injury Research and Policy, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Wendy C Shields
- Center for Injury Research and Policy, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Johnathon Ehsani
- Center for Injury Research and Policy, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | | | | | - Zabiullah Ali
- Office of the Chief Medical Examiner, Maryland Department of Health, Baltimore, Maryland, USA
| | - Yukari C Manabe
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Ling Li
- Office of the Chief Medical Examiner, Maryland Department of Health, Baltimore, Maryland, USA.,Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA
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24
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Metzger KB, Sartin E, Foss RD, Joyce N, Curry AE. Vehicle safety characteristics in vulnerable driver populations. TRAFFIC INJURY PREVENTION 2020; 21:S54-S59. [PMID: 32851883 PMCID: PMC7910315 DOI: 10.1080/15389588.2020.1805445] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 07/30/2020] [Accepted: 07/31/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE National data suggest drivers who are younger, older, and have lower socioeconomic status (SES) have heightened crash-related injury rates. Ensuring vulnerable drivers are in the safest vehicles they can afford is a promising approach to reducing crash injuries in these groups. However, we do not know the extent to which these drivers are disproportionately driving less safe vehicles. Our objective was to obtain population-based estimates of the prevalence of important vehicle safety criteria among a statewide population of drivers. METHODS We analyzed data from the NJ Safety and Health Outcomes warehouse, which includes all licensing and crash data from 2010-2017. We borrowed the quasi-induced exposure method's fundamental assumption-that non-responsible drivers in clean (i.e., only one responsible driver) multi-vehicle crashes are reasonably representative of drivers on the road-to estimate statewide prevalence of drivers' vehicle characteristics across four driver age groups (17-20; 21-24; 25-64, and ≥65) and quintiles of census tract median household income (n = 983,372). We used NHTSA's Product Information Catalog and Vehicle Listing platform (vPIC) to decode the VIN of each crash-involved vehicle to obtain model year, presence of electronic stability control (ESC), vehicle type, engine horsepower, and presence of front, side, and curtain air bags. RESULTS The youngest and oldest drivers were more likely than middle-aged drivers to drive vehicles that were older, did not have ESC, and were not equipped with side airbags. Additionally, across all age groups drivers of higher SES were in newer and safer vehicles compared with those of lower SES. For example, young drivers living in lowest-income census tracts drove vehicles that were on average almost twice as old as young drivers living in highest-income tracts (median [IQR]: 11 years [6-14] vs. 6 years [3-11]). CONCLUSIONS Vehicle safety is an important component of seminal road safety philosophies that aim to reduce crash fatalities. However, driver groups that are overrepresented in fatal crashes-young drivers, older drivers, and those of lower SES-are also driving the less safe vehicles. Ensuring drivers are in the safest car they can afford should be further explored as an approach to reduce crash-related injuries among vulnerable populations.
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Affiliation(s)
- Kristina B Metzger
- Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Emma Sartin
- Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Robert D Foss
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Nina Joyce
- Brown University, Providence, Rhode Island
| | - Allison E Curry
- Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
- University of Pennsylvania, Philadelphia, Pennsylvania
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25
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Saeednejad M, Sadeghian F, Fayaz M, Rafael D, Atlasi R, Kazemzadeh Houjaghan A, Abedi kichi R, Asgardoon MH, Zabihi Mahmoudabadi H, Salamati Z, Naji Z, Rahimi-Movaghar V, Salamati P. Association of Social Determinants of Health and Road Traffic Deaths: A Systematic Review. Bull Emerg Trauma 2020; 8:211-217. [PMID: 33426135 PMCID: PMC7783304 DOI: 10.30476/beat.2020.86574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 06/28/2020] [Accepted: 09/14/2020] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE This study aims to review systematically the association of social determinants of health (SDH) and road traffic deaths (RTD) within scientific literature. METHODS A search strategy was designed and run in EMBASE, PubMed via MEDLINE, Scopus, Web of Science, and Cochrane library. Through title, abstract, and full-text screening, all English original papers (except ecological studies) which studied social determinants of health and fatal injuries were included. Papers which studied association between RTD and the education, income, rural settlement, and marital status were evaluated and the related data was extracted from the full-texts. RESULTS Eleven articles out of 7,897 primary results were selected to be included in the study. Among eight papers studied education, seven confirmed a negative association between years of schooling and RTD. Two out of three articles reported no association between income leveland RTD. Among three papers studied rural settlement, two approved a positive relationship between this determinant and RTD. Both articles studied marital status, confirmed an association between this determinant and RTD. CONCLUSION A few papers studied association of social determinants of health (SDH) and RTD. There was an inverse relationship between education and RTD. The evidence for such an association between income, rural settlement, and marital state was scarce. Further investigations are recommended through original research.
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Affiliation(s)
- Mina Saeednejad
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Farideh Sadeghian
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Mahsa Fayaz
- Department of Epidemiology and Biostatistics, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Dennis Rafael
- Faculty of Health - School of Health Policy & Management, University of Toronto, Toronto, Canada
| | - Rasha Atlasi
- Department of Medical Library and Information Science, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Raziyeh Abedi kichi
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Hossein Zabihi Mahmoudabadi
- Sina hospital, Department of surgery, school of medicine, Tehran University of medical sciences, Tehran, Iran
| | - Zahra Salamati
- School of Architecture, College of Fine Arts, University of Tehran,Tehran, Iran
| | - Zohrehsadat Naji
- Young Researchers and Elites Club, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Vafa Rahimi-Movaghar
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Payman Salamati
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
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26
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Roy A, Garner AA, Epstein JN, Hoza B, Nichols JQ, Molina BSG, Swanson JM, Arnold LE, Hechtman L. Effects of Childhood and Adult Persistent Attention-Deficit/Hyperactivity Disorder on Risk of Motor Vehicle Crashes: Results From the Multimodal Treatment Study of Children With Attention-Deficit/Hyperactivity Disorder. J Am Acad Child Adolesc Psychiatry 2020; 59:952-963. [PMID: 31445873 PMCID: PMC9747063 DOI: 10.1016/j.jaac.2019.08.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 07/22/2019] [Accepted: 08/15/2019] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To determine motor vehicle crash (MVC) risk in adults with a history of childhood attention-deficit/hyperactivity disorder (ADHD) and persistent ADHD symptoms. METHOD Participants with (n = 441) and without (n = 239; local normative comparison group) childhood ADHD from the Multimodal Treatment of Attention-Deficit/Hyperactivity Disorder (MTA) Study were included. Participants provided self-reports on total number of MVCs they had been involved in and the time of licensure. Driving experience was estimated as the number of months since licensure. Total number of MVCs by adulthood was regressed on baseline ADHD status adjusting for sex, age at follow-up, driving experience, baseline oppositional defiant disorder/conduct disorder comorbidity, baseline household income level, adult oppositional defiant disorder/conduct disorder symptoms, adolescent and adult substance use, and adult antisocial personality disorder symptoms. We repeated the analysis using adult ADHD status (persistent versus desistant versus local normative comparison group) and symptom level as the predictor variables. Results are presented as incidence rate ratio (IRR) and CI. RESULTS Childhood ADHD was associated with a higher number of MVCs (IRR = 1.45, CI = 1.15-1.82), and adult ADHD symptom persistence was associated with more MVCs than desistance (IRR = 1.46, CI = 1.14-1.86). ADHD desistance was not associated with a significantly increased risk for MVCs compared with the local normative comparison group (IRR = 1.24, CI = 0.96-1.61). Concurrent symptoms of inattention and hyperactivity/impulsivity predicted MVC risk. CONCLUSION Persistence of ADHD into adulthood is a stronger predictor of MVC risk than childhood-limited ADHD. CLINICAL TRIAL REGISTRATION INFORMATION Multimodal Treatment of Attention Deficit Hyperactivity Disorder (MTA) Study; https://clinicaltrials.gov; NCT00000388.
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Affiliation(s)
- Arunima Roy
- The Royal's Institute of Mental Health Research, University of Ottawa, Ontario, Canada
| | | | - Jeffery N Epstein
- University of Cincinnati College of Medicine and the Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Ohio
| | | | | | | | - James M Swanson
- Child Development Center, School of Medicine, University of California, Irvine
| | | | - Lily Hechtman
- Division of Child Psychiatry, Montreal Children's Hospital, McGill University, Quebec, Canada.
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27
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Lomia N, Berdzuli N, Sharashidze N, Sturua L, Pestvenidze E, Kereselidze M, Topuridze M, Stray-Pedersen B, Stray-Pedersen A. Socio-Demographic Determinants of Road Traffic Fatalities in Women of Reproductive Age in the Republic of Georgia: Evidence from the National Reproductive Age Mortality Study (2014). Int J Womens Health 2020; 12:527-537. [PMID: 32765119 PMCID: PMC7367745 DOI: 10.2147/ijwh.s244437] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Accepted: 06/09/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose Globally and in the European region, the road traffic injuries (RTI) have emerged as a major public health and development problem, killing the most productive adult members of a population, including women. This study aimed to identify the key socio-demographic determinants of premature and avoidable RTI mortality in reproductive-aged women (15–49 years) in Georgia. Materials and Methods The study employed verbal autopsy data from the second national reproductive age mortality survey (RAMOS 2014). Univariate and multivariate logistic regression models were fitted using the Firth method to assess the crude and adjusted effects of each individual level socio-demographic factor on the odds of RTI-attributed death, with corresponding 95% confidence intervals (COR and AOR, 95% CI). Results Of 843 women aged 15–49 years, 78 (9.3%) were the victims of fatal traffic crashes. After multivariate adjustment, the odds of dying from RTI were significantly higher in women aged 15–29 years (AOR=7.73, 95% CI= 4.20 to 14.20), those being employed (AOR=2.11, 95% CI= 1.22 to 3.64) and the wealthiest (AOR=2.88, 95% CI= 1.44 to 5.77) compared, respectively, to their oldest (40–49 years), unemployed and poorest counterparts. Conversely, there were no statistically significant ethnic, marital, rural/urban, and educational disparities in women’s RTI fatalities. Overall, motorized four-wheeler occupants (78.2%), particularly passengers (71.8%), appeared to be the most common victims of fatal road injuries than pedestrians (20.5%). Alarmingly, the vast majority (85.9%) of any type of road users died instantly at the scene of collision, as compared to deaths en route to hospital (1.3%) or in hospital (11.5%). Conclusion Age, employment, and wealth status appeared to be the strong independent predictors of young women’s RTI mortality in Georgia. Future comprehensive research would be advantageous for further deciphering the differential impact of social determinants on traffic-induced fatalities, as a vital platform for evidence-based remedial actions on this predictable and preventable safety hazard.
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Affiliation(s)
- Nino Lomia
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Nino Berdzuli
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Nino Sharashidze
- Department of Clinical and Research Skills, Faculty of Medicine, Iv. Javakhishvili Tbilisi State University, Tbilisi, Georgia
| | - Lela Sturua
- Department of Noncommunicable Diseases, National Center for Disease Control and Public Health, Tbilisi, Georgia
| | - Ekaterine Pestvenidze
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Maia Kereselidze
- Department of Medical Statistics, National Center for Disease Control and Public Health, Tbilisi, Georgia
| | - Marina Topuridze
- Health Promotion Division, Department of Noncommunicable Diseases, National Center for Disease Control and Public Health, Tbilisi, Georgia
| | - Babill Stray-Pedersen
- Department of Obstetrics and Gynecology, Rikshospitalet, Oslo University Hospital, and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Arne Stray-Pedersen
- Department of Forensic Sciences, Oslo University Hospital, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
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28
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Paglione L, Angelici L, Davoli M, Agabiti N, Cesaroni G. Mortality inequalities by occupational status and type of job in men and women: results from the Rome Longitudinal Study. BMJ Open 2020; 10:e033776. [PMID: 32499259 PMCID: PMC7282329 DOI: 10.1136/bmjopen-2019-033776] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Socioeconomic inequalities have a strong impact on population health all over the world. Occupational status is a powerful determinant of health in rich societies. We aimed at investigating the association between occupation and mortality in a large metropolitan study. DESIGN Cohort study. SETTING Rome, capital of Italy. PARTICIPANTS We used the Rome Longitudinal Study, the administrative cohort of residents in Rome at the 2001 general census, followed until 2015. We selected residents aged 15-65 years at baseline. For each subject, we had information on sex, age and occupation (occupational status and type of job) according to the Italian General Census recognition. MAIN OUTCOME MEASURES We investigated all-cause, cancer, cardiovascular and accidental mortality, major causes of death in the working-age population. We used Cox proportional hazards models to investigate the association between occupation and all-cause and cause-specific mortality in men and women. RESULTS We selected 1 466 726 subjects (52.1% women). 42 715 men and 29 915 women died during the follow-up. In men, 47.8% of deaths were due to cancer, 26.7% to cardiovascular causes and 6.4% to accidents, whereas in women 57.8% of deaths were due to cancer, 19.3% to cardiovascular causes and 3.5% to accidents. We found an association between occupational variables and mortality, more evident in men than in women. Compared with employed, unemployed had a higher risk of mortality for all causes with an HR=1.99 (95% CI 1.92 to 2.06) in men and an HR=1.49 (95% CI 1.39 to 1.60) in women. Compared with high-qualified non-manual workers, non-specialised manual workers had a higher mortality risk (HR=1.68, 95% CI 1.59 to 1.77 and HR=1.30, 95% CI 1.20 to 1.40, for men and women, respectively). CONCLUSIONS This study shows the importance of occupational variables as social health determinants and provides evidence for policy-makers on the necessity of integrated and preventive policies aimed at improving the safety of the living and the working environment.
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Affiliation(s)
- Lorenzo Paglione
- Department of Civil, Constructional and Environmental Engineering, Sapienza University of Rome, Roma, Italy
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Roma, Italy
| | - Laura Angelici
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Roma, Italy
| | - Marina Davoli
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Roma, Italy
| | - Nera Agabiti
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Roma, Italy
| | - Giulia Cesaroni
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Roma, Italy
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29
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Nunes A, Harper S, Hernandez KD. The Price Isn't Right: Autonomous Vehicles, Public Health, and Social Justice. Am J Public Health 2020; 110:796-797. [PMID: 32374683 DOI: 10.2105/ajph.2020.305608] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Ashley Nunes
- Ashley Nunes is with the Labor and Worklife Program, Harvard Law School, Cambridge, MA. Sam Harper is with the Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada. At the time of the study, Kristen D. Hernandez was with the Center for Transportation & Logistics, Massachusetts Institute of Technology, Cambridge
| | - Sam Harper
- Ashley Nunes is with the Labor and Worklife Program, Harvard Law School, Cambridge, MA. Sam Harper is with the Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada. At the time of the study, Kristen D. Hernandez was with the Center for Transportation & Logistics, Massachusetts Institute of Technology, Cambridge
| | - Kristen D Hernandez
- Ashley Nunes is with the Labor and Worklife Program, Harvard Law School, Cambridge, MA. Sam Harper is with the Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada. At the time of the study, Kristen D. Hernandez was with the Center for Transportation & Logistics, Massachusetts Institute of Technology, Cambridge
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30
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Leveau CM, Tapia Granados JA. Educational inequalities in traffic deaths during fluctuations of the economy in four Argentinian provinces, 1999-2013. Public Health 2019; 175:28-35. [PMID: 31377690 DOI: 10.1016/j.puhe.2019.06.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 06/17/2019] [Accepted: 06/24/2019] [Indexed: 12/31/2022]
Abstract
OBJECTIVES The objective of this study is to analyse how educational differentials in traffic mortality changed during economic fluctuations in four Argentinian provinces. STUDY DESIGN Retrospective quantitative analysis of secondary data. METHODS Data on fatalities due to traffic injuries (all traffic injuries, pedestrians/cyclists, motorcyclists, car users and unspecified road users) in four Argentinian provinces between 1999 and 2013 were linked to population data and information on the educational level of the deceased to compute mortality rates by educational level. Negative binomial models were estimated using age, sex, year, province of residence, year of economic expansion or recession and educational level as explanatory variables. RESULTS Annual traffic mortality differentials by educational level were lower during the period of economic crisis. An absolute increase in traffic mortality was observed in individuals of low educational level during economic expansions, but here, there were no traffic mortality differences for individuals of medium to high educational level. The educational gap in motorcyclist mortality widened during the period of quick economic expansion between 2005 and 2013. CONCLUSIONS We found less educational inequality in traffic mortality during an economic crisis in a developing country. However, the educational inequalities for different subtypes of traffic mortality show different patterns of evolution during the cycle of economic expansion and recession. Considering deaths due to traffic injuries, economic growth seems to be riskier for individuals of lower educational level compared with those of medium-high educational level.
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Affiliation(s)
- C M Leveau
- Instituto de Salud Colectiva, Universidad Nacional de Lanús, Buenos Aires, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina.
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31
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Efficacy of intervention at traffic schools reducing impulsive action, and association with candidate gene variants. Acta Neuropsychiatr 2019; 31:159-166. [PMID: 31182183 DOI: 10.1017/neu.2019.2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Road traffic injuries are the leading cause of death among young people. Recognition of the contribution of impulsive behaviour may help novice drivers to behave more safely. Previously a brief intervention focusing on impulsive traffic behaviour conducted by psychologists in driving schools had been effective. The aim of this study was an independent re-evaluation of the effect of the intervention, as conducted by driving school teachers, and assessment of the potential associations with candidate genotypes. METHODS Driving school students (mean age 22.5, SD=7.9) were divided into intervention (n=704) and control (n=737) groups. Driving school teachers were trained to administer the intervention which consisted of a lecture and group work (1.5 h in total) on impulsivity. Traffic offences and crashes were monitored during 3 years, using police and traffic insurance fund databases. Functional polymorphisms of the dopamine transporter (DAT) and serotonin transporter genes (DAT1 VNTR and 5-HTTLPR) were assessed. RESULTS The intervention significantly lowered general traffic risk and prevalence of traffic accidents. DAT1 VNTR 9R carriers, particularly males, had higher general traffic risk in the whole sample. Female 5-HTTLPR s' allele carriers of the intervention group had the lowest general traffic risk. Intervention was most effective in female DAT1 VNTR 10R/10R homozygotes. CONCLUSIONS Brief impulsivity-centred intervention appears as a promising strategy for preventing risk-taking behaviour in novice drivers and can be fully integrated to driving school curriculum.
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32
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Soori H, Razzaghi A, Kavousi A, Abadi A, Khosravi A, Alipour A. Risk factors of deaths related to road traffic crashes in World Health Organization regions: A systematic review. ARCHIVES OF TRAUMA RESEARCH 2019. [DOI: 10.4103/atr.atr_59_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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33
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Alphonsus KB, Waldner C, Fuller D. Examining the association between area level deprivation and vehicle collisions that result in injury. Canadian Journal of Public Health 2018; 109:43-51. [PMID: 29981062 DOI: 10.17269/s41997-018-0036-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2017] [Accepted: 12/01/2017] [Indexed: 12/30/2022]
Abstract
OBJECTIVE The objective of this study was to examine the association between area level deprivation and vehicle collisions resulting in either property damage or injury. METHODS A multilevel observational study was conducted using the 2000 to 2010 Saskatchewan Traffic Accident Information System (TAIS) (n = 72,234) and 2006 Census data at the Dissemination Area level (n = 337) for the city of Saskatoon. RESULTS Total area level deprivation was associated with severity of traffic collisions, but the association varied based on time of day and road repair status. Collisions were more likely to result in injury from the most deprived (Q5) versus the least deprived quintile (Q1) at all times of day; the difference was greatest in the evening (OR 1.7, 95% CI 1.3 to 2.3). However, there was no other evidence of a monotonic increase in risk associated with area level deprivation. When there were faded markings or potholes, the odds of a collision involving injury were 2.6 (95% CI 1.5 to 4.4) times greater for the most deprived quintile compared to the least deprived quintile. There were no significant differences in the risk of injury between area level deprivation quintiles when road conditions were good. CONCLUSION While the association between area level deprivation and whether vehicle collisions result in injury in Saskatoon varies based on time of day and road repairs, under many circumstances the most deprived areas report more injuries from collisions compared to the least deprived.
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Affiliation(s)
| | - Cheryl Waldner
- School of Public Health, University of Saskatchewan, Saskatoon, SK, Canada.,Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Daniel Fuller
- Canada Research Chair in Population Physical Activity, School of Human Kinetics and Recreation, Memorial University of Newfoundland, Physical Education Building, Room 2023, St. John's, NL, A1C 5S7, Canada.
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Rehm J, Probst C. Decreases of Life Expectancy Despite Decreases in Non-Communicable Disease Mortality: The Role of Substance Use and Socioeconomic Status. Eur Addict Res 2018; 24:53-59. [PMID: 29627831 DOI: 10.1159/000488328] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 03/09/2018] [Indexed: 01/05/2023]
Abstract
With the epidemiological transition, causes of death shifted from communicable to non-communicable diseases (NCDs) and life expectancy increased, as these NCD deaths occurred later in life. However, in the United States, over the past years, life expectancy has been stagnating or decreasing despite decreasing NCD mortality rates. Analyses of the most important underlying causes of death with increasing premature mortality reveal that psychoactive substance use played a crucial role for these increases. Furthermore, it can be shown, that a high proportion of the increased premature mortality and decreased life expectancies happened in lower socio-economic strata. Substance use policies should thus focus on lowering the gap between substance-attributable mortality in higher versus lower socioeconomic strata.
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Affiliation(s)
- Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Addiction Policy, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Institute of Medical Science, University of Toronto, Faculty of Medicine, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Institute of Clinical Psychology and Psychotherapy and Center of Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany
| | - Charlotte Probst
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Institute of Clinical Psychology and Psychotherapy and Center of Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany
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Adanu EK, Smith R, Powell L, Jones S. Multilevel analysis of the role of human factors in regional disparities in crash outcomes. ACCIDENT; ANALYSIS AND PREVENTION 2017; 109:10-17. [PMID: 28992450 DOI: 10.1016/j.aap.2017.09.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 08/02/2017] [Accepted: 09/26/2017] [Indexed: 06/07/2023]
Abstract
A growing body of research has examined the disparities in road traffic safety among population groups and geographic regions. These studies reveal disparities in crash outcomes between people and regions with different socioeconomic characteristics. A critical aspect of the road traffic crash epidemic that has received limited attention is the influence of local characteristics on human elements that increase the risk of getting into a crash. This paper applies multilevel logistic regression modeling techniques to investigate the influence of driver residential factors on driver behaviors in an attempt to explain the area-based differences in the severity of road crashes across the State of Alabama. Specifically, the paper reports the effects of characteristics attributable to drivers and the geographic regions they reside on the likelihood of a crash resulting in serious injuries. Model estimation revealed that driver residence (postal code or region) accounted for about 7.3% of the variability in the probability of a driver getting into a serious injury crash, regardless of driver characteristics. The results also reveal disparities in serious injury crash rate as well as significant proportions of serious injury crashes involving no seatbelt usage, driving under influence (DUI), unemployed drivers, young drivers, distracted driving, and African American drivers among some regions. The average credit scores, average commute times, and populations of driver postal codes are shown to be significant predictors for risk of severe injury crashes. This approach to traffic crash analysis presented can serve as the foundation for evidence-based policies and also guide the implementation of targeted countermeasures.
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Affiliation(s)
- Emmanuel Kofi Adanu
- Department of Civil, Construction and Environmental Engineering, The University of Alabama Tuscaloosa, AL, United States.
| | - Randy Smith
- Department of Computer Science, The University of Alabama Tuscaloosa, AL, United States.
| | - Lars Powell
- Alabama Center for Insurance Information and Research, The University of Alabama Tuscaloosa, AL, United States.
| | - Steven Jones
- Department of Civil, Construction and Environmental Engineering, The University of Alabama Tuscaloosa, AL, United States.
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Curry AE, Metzger KB, Williams AF, Tefft BC. Comparison of older and younger novice driver crash rates: Informing the need for extended Graduated Driver Licensing restrictions. ACCIDENT; ANALYSIS AND PREVENTION 2017; 108:66-73. [PMID: 28858774 DOI: 10.1016/j.aap.2017.08.015] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Revised: 07/07/2017] [Accepted: 08/10/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Few previous studies have directly compared crash rates of older and younger novice drivers. To inform discussion about whether Graduated Driver Licensing (GDL) policies that are applied in the US for younger novice drivers should be applied to older novice drivers, we conducted a longitudinal study to examine overall, nighttime, and multiple passenger crash rates over the initial four years of licensure differ for novice drivers licensed at different ages. METHODS Using data from the New Jersey Traffic Safety Outcomes (NJ-TSO) data warehouse, we selected all NJ drivers who obtained their initial intermediate driver's license from 2006 through 2014 and had at least one month of follow-up from the date of licensure to study end or death (n=1,034,835). Novice drivers were grouped based on age at licensure: age 17; 18-20; 21-24; and 25 or older. We estimated monthly rates for overall crashes (per 10,000 licensed drivers) as well as: late night crashes (11:01 p.m.-4:59 a.m.); early night crashes (9:00 p.m.-11:00 p.m.); and multiple passenger crashes (two or more passengers). Average monthly rates were calculated for specific relevant time periods and Poisson regression models were used to compare rates: (1) between novice driver groups with the same time since licensure; (2) over the first 48 months of licensure within each novice driver group; and (3) between same-aged 21-year-old drivers with varying lengths of licensure. RESULTS Although initial (three months post-licensure) overall crash rates of novice NJ drivers age 21 and older were higher than rates of same-aged experienced drivers, they were substantially lower than initial rates for 17- to 20-year-old novice drivers, who are licensed under GDL policies. Moreover, older novice drivers experience much less steep crash reductions over the first year of licensure than younger novice drivers. Nighttime crash rates among the 21- to 24-year old and aged 25 and older novice driver groups were stable over the first year of licensure. For novice drivers under age 21, early night crash rates declined rapidly over the course of licensure, while changes in late night crashes were much smaller. First-year multiple passenger crash rates were highest for drivers licensed at age 18-20, and novice driver groups experienced varying amounts of reduction in multiple passenger crashes over time. CONCLUSIONS Study findings support NJ's current GDL policies for 17- to 20-year-old novice drivers and the potential for added benefits from beginning the nighttime restriction at 9:00 p.m. Conversely, there was a lack of compelling evidence for additional policies for drivers licensed at age 21-24 and no evidence to indicate a need for additional GDL policies for NJ novices aged 25 years and older.
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Affiliation(s)
- Allison E Curry
- Center for Injury Research and Prevention, Children's Hospital of Philadelphia, 2716 South Street, 13th Floor Philadelphia, PA 19146, USA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, 34th Street & Civic Center Boulevard, Philadelphia, PA 19104, USA.
| | - Kristina B Metzger
- Center for Injury Research and Prevention, Children's Hospital of Philadelphia, 2716 South Street, 13th Floor Philadelphia, PA 19146, USA.
| | | | - Brian C Tefft
- AAA Foundation for Traffic Safety, 607 14th Street, NW, Suite 201, Washington, DC 20005, USA.
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Harper S, Bruckner TA. Did the Great Recession increase suicides in the USA? Evidence from an interrupted time-series analysis. Ann Epidemiol 2017. [DOI: 10.1016/j.annepidem.2017.05.017] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Shults RA, Banerjee T, Perry T. Who's not driving among U.S. high school seniors: A closer look at race/ethnicity, socioeconomic factors, and driving status. TRAFFIC INJURY PREVENTION 2016; 17:803-809. [PMID: 27064697 PMCID: PMC5712435 DOI: 10.1080/15389588.2016.1161761] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 03/01/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVES We examined associations among race/ethnicity, socioeconomic factors, and driving status in a nationally representative sample of >26,000 U.S. high school seniors. METHODS Weighted data from the 2012 and 2013 Monitoring the Future surveys were combined and analyzed. We imputed missing values using fully conditional specification multiple imputation methods. Multivariate logistic regression modeling was conducted to explore associations among race/ethnicity, socioeconomic factors, and driving status, while accounting for selected student behaviors and location. Lastly, odds ratios were converted to prevalence ratios. RESULTS 23% of high school seniors did not drive during an average week; 14% of white students were nondrivers compared to 40% of black students. Multivariate analysis revealed that minority students were 1.8 to 2.5 times more likely to be nondrivers than their white counterparts, and students who had no earned income were 2.8 times more likely to be nondrivers than those earning an average of ≥$36 a week. Driving status also varied considerably by student academic performance, number of parents in the household, parental education, census region, and urbanicity. CONCLUSIONS Our findings suggest that resources-both financial and time-influence when or whether a teen will learn to drive. Many young people from minority or lower socioeconomic families who learn to drive may be doing so after their 18th birthday and therefore would not take advantage of the safety benefits provided by graduated driver licensing. Innovative approaches may be needed to improve safety for these young novice drivers.
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Affiliation(s)
- Ruth A. Shults
- Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, Atlanta, Georgia
| | - Tanima Banerjee
- Office of Research and Global Affairs, University of Michigan School of Nursing, Ann Arbor, Michigan
| | - Timothy Perry
- University of Michigan Institute for Social Research, Ann Arbor, Michigan
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