Road traffic crash fatalities: An examination of national fatality rates and factors associated with the variation in fatality rates between nations with reference to the World Health Organisation Decade of Action for Road Safety 2011 - 2020
The decade 2011 – 2020 has been declared the Decade of Action for Road safety by the World Health Organisation (WHO). The WHO has published baseline road traffic crash (RTC) fatality data for all member nations. The WHO has also suggested five Pillars of Action, mechanisms that may be instigated at the national level within the decade to halt or reduce the national RTC fatality toll. This thesis demonstrates that the some of the baseline data published by the WHO and derived from RTC reports compiled by national police forces may not best reflect the number of RTC deaths within each nation. Moreover, this data may not be directly comparable between nations due to definitional and other issues identified. Vital registration (death certificate) data which is directly collated by the WHO may be a better measure for international comparative work. Contrary to some previous studies, no significant association was found between the level of national economic development (in terms of per capita Gross National Income (GNI)) and health-derived RTC fatality rates for the year 2002. In multiple regression analysis of factors associated with GNI and presumed causal in the international variation in RTC fatality rates, exposure to risk of crash, percent of the vehicle population which are 2- or 3-wheeled, percent of the population aged 15 – 24 years, per capita alcohol consumption and health spend as a percent of GDP were all significantly associated with RTC fatality rate. No evidence was found to support WHO Pillar 4 in that road user behaviour modification via enactment and enforcement of road safety legislation was not significantly associated with the variation in RTC fatality rate. The demographic and cultural factors identified may not be amenable to modification. This has implications for the globalisation of remedial actions as proposed by the WHO.
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