Road Safety as a Public Health Problem: Case of Ecuador in the Period 2000–2019

Trends in traffic accident mortality and social inequalities in Ecuador from 2011 to 2022

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.

Identification of the Mechanical Failure Factors with Potential Influencing Road Accidents in Ecuador

Road traffic accidents result in injury or even death of passengers. One potential cause of these accidents is mechanical failures due to a lack of vehicle maintenance. In the quest to identify these mechanical failures, this paper aims to set up the procedure to identify the mechanical failures that contribute to traffic accidents in cities located in developing countries, including the city of Cuenca-Ecuador. For present research, a database provided by the entity responsible for the Vehicle Technical Inspection, the Empresa Pública Municipal de Movilidad, Tránsito y Transporte and for the ones responsible of managing traffic accident data, Oficina de Investigación de Accidentes de Tránsito and Sección de Investigación de Accidentes de Tránsito was used. The vehicle subcategories M1 and M3 (bus type) and N1, so named according to Ecuadorian technical standards, were considered the most relevant regarding accident rates. The database was analysed with descriptive statistics, a Pareto chart and time series with the quadratic trend. From this analysis, the most significant failures found in the VTI in all three subcategories were the alignment of the driver headlight, both horizontal and vertical, braking imbalance on the 2nd axle, insufficient tire tread and parking brake effectiveness. All these failures showed a decreasing trend over time and in the forecast at a maximum of two to three years. The most relevant causes of road accidents recorded during the period 2009–2018 related to mechanical failures were the braking system (65.5%) and the steering system (17.2%) for subcategory M1.