Understanding the physical and social environmental determinants of road traffic injury in South Africa

Abstract Road traffic injuries (RTIs) are a major public health challenge, accounting for significant injury, economic and psycho-social burden to societies across the world. While decreases are projected for many high-income countries (HICs) over the next decade or so, staggering increases in the burden of mortality and morbidity are forecast for low- and middle-income countries (LMICs). The unique contextual influences on RTIs in LMICs are, however, not well understood. Conceptual frameworks applied mostly to HICs also do not provide adequate recognition of the unique contextual influences of LMICs. Accordingly, the research in this thesis adopts a predominantly geographical approach to incorporate a large range of physical and social environmental effects, and which are aggregated at different spatial and spatial-temporal scales to understand the contextual influences to road traffic injuries (RTIs) in the South African (S.A) setting. In this regard, four studies are presented; these include: a geographical epidemiology and risk analysis at the district council level and for time, space and population aggregations; an integrated spatialtemporal analysis at the province-week level; a fine-scale geographical analysis at the police area level; and a small area analysis at the suburb level for the city of Durban. In addition to important effects relating to alcohol and travel exposure, findings have shown most environmental influences on RTIs in S.A to be development-related, including effects relating to social and area deprivation, violence and crime, and rurality. With the exception of rurality, the above effects showed a positive association with the occurrence of RTIs in S.A. The findings have implications for alignment and possible integration of road safety policies and practices with other developmental policies in the country. In addition, this research has shown that geographical approaches may provide a useful analytical framework for understanding the complexity and interacting influences within broader systems-based approaches; and especially those of the contextual environment that are particularly relevant for LMIC settings.

Name dc:type.qualificationname

phd

Level dc:type.qualificationlevel

doctoral

Grantor dc:publisher.institution

University of East Anglia

Year dc:date.issued

2013

Author dc:creator

• Sukhai, Anesh

Language dc:language

en