Tackling the global burden of road traffic injuries

Traffic jam

According to the Department for Transport, between June 2017-18, 1,770 people lost their lives due to a road traffic collision in Great Britain.

But this isn’t an issue that only affects developed countries. It’s a global problem with many low-and-middle-income countries having even higher numbers of victims. Road traffic incidents can result in the loss of loved ones for families and friends, and for those who do survive, they can mean sustaining life-changing injuries and trauma. These impacts stretch beyond the individual, affecting economies and put pressure on health systems.

This August, we’re marking National Road Victim Month. We spoke to IGHI clinical research fellow, Miss Seema Yalamanchili to discuss how road traffic injury is impacting societies across the world and her PhD project in using crowdsourced data to map collisions. 

What are the rates of road traffic injury globally?

According to World Health Organization estimations,1.35 million die from road traffic collisions every year, with a further 20 to 50 million suffering injuries that often result in disability.

How does this impact societies and health systems?

Wherever you are in the world, those injured on the roads are frequently young, poor and male. Victims are often breadwinners for the household. The further cost of providing healthcare for the injured is an additional burden for these families and society.

The World Bank has highlighted road traffic injuries as the single largest cause of mortality and long-term disability among those aged 15-29; prime working age. Currently road traffic collisions cost most countries about 3% of GDP.

The United Nations declared 2011-2020 the Decade for Action on Road Safety, with the aim of halving road traffic injury. The World Bank believes such an achievement could significantly increase long-term growth by 7-22% in GDP per capita.

Why is it a particular problem for low-and-middle income countries (LMICs)?

Over 90% of global road fatalities are in LMICs, despite these countries having only 60% of the world’s vehicles. Compared to developed countries, LMICs have weaker preventative measures. Many high- income countries developed policies on road safety, such as reduced speeds and bans on drink-driving, some decades ago. But such laws are yet to be introduced or effectively enforced in many LMICs.

LMICs often have fragile, poorly equipped health systems which struggle to rapidly deliver injury care, particularly in the prehospital and emergency settings. This results in lower quality post-crash care. Rehabilitation services are also scarce in LMICs, so those who survive rarely recover fully.

Is it a problem that appears to be getting worse or better?

Overall the picture is mixed. Injury rates in many high-income countries remain static, if not improving. Globally rates of road injuries have increased, but road mortality appears to have decreased to some degree.

With research in this area, high-income countries and regions tend to be grouped together. Particularly in the European Union (EU), road safety policies were collectively implemented earlier as per EU rules, but despite this, there is variation. Progress in reducing fatalities has slowed since 2013 and it’s unlikely that we will meet the UN target of halving road deaths by 2020.

In LMICs, the picture is also varied but bleaker overall, with higher rates of injury and death but a slower decline.

Tell us about your work in road traffic injury.

My work explores how various forms of novel crowdsourced data, such as those from news sources, social media and mobile apps, might be used to map road traffic injury. Such data – pooled by large groups of people – and methods have previously successfully tracked infectious disease outbreaks like Ebola, Zika and influenza.

We hope to validate this approach against ‘gold-standard’ transport and health data in London. If effective, we could use this technique to create crowdsourced mapping tools for road traffic collisions and injury in countries struggling to collect adequate data. This could supplement any traditional data collected by government authorities, which is labour intensive and frequently incomplete.

We’re also linking transport and health data to more clearly describe the patient journey, from road collision characteristics to outcomes. We hope this will highlight how all countries would benefit from such datasets, offering greater insight into underappreciated risk factors and patient outcomes.

How might collecting data be a valuable way of easing the burden?

The data that the WHO collects and uses to monitor road traffic collisions, injury and deaths are submitted by individual countries. But in many LMICs, the data is incomplete so estimates are used instead.

Data is housed and gathered in different places, such as transport or police organisations for collision information. Sometimes data isn’t collected at all. If it is collected, it may or may not make it into government records. Without an accurate and informative picture of the burden of road injury, countries cannot realise the cost of this problem. This obstructs efforts to advocate for greater investment and awareness for road safety.

What impact is your research going to have on people’s lives and health systems?

I hope the work will serve as an exemplar of how novel methods can be used to benefit global public health, trauma systems and urban planners, regardless of context. There has been exponential growth in data and data sources. With the right expertise, this can be harnessed for public benefit to extract the most useful information.

In particular we want to understand how these methods can identify trends in road collisions and injury linked to geography and time. If effective we plan to use this to map high risk patterns, particularly where traditional data is incomplete or absent. This could be both in acute crises where there is a breakdown in data collection services, or in settings where lack of data is a long-term issue.

What are the next steps in your research?

We have been looking at multiple sources of crowdsourced traffic incident data but since the COVID-19 lockdown, there have been differences in road user behaviour. Road use has reduced but unfortunately this has also been accompanied by some riskier behaviour on the roads, increasing injuries. We are looking to see whether our crowdsourced data can detect these changes and to what extent.

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