© WHO, U n i t 1 Magnitude and impact of road traffic injuries

© WHO, Objectives By the end of this unit, the trainee should be able to: describe the global magnitude and trends of road traffic fatalities; discuss the global socioeconomic and health burden of road traffic injuries; describe the magnitude and trends of road traffic injuries in his or her own country, region or city; discuss the socioeconomic and health burden of road traffic injuries in his or her own country, region or city. Objectives

© WHO, million deaths a year million are injured or disabled 11th leading cause of death account for 2.1% of all deaths globally Copyright Etienne Creux, Pretoria News Road traffic injuries are a huge public health and development problem

© WHO, Distribution of global injury mortality by cause Road traffic injuries account for 23% of all injury deaths worldwide Source: WHO Global Burden of Disease project, 2002, Version 1

© WHO, WHO region Low- and middle- income countries High-income countries African Region Region of the Americas South-East Asia Region European Region Eastern Mediterranean Region Western Pacific Region – 14.8 – Road traffic injury mortality rate (per population) in WHO regions, 2002 The African Region has the highest mortality rate.

© WHO, Road traffic injury mortality rates (per population) in WHO regions, 2002 The majority of road traffic deaths occur in low- and middle-income countries.

© WHO, Disease or injury 2002 Disease or injury 10. Perinatal conditions10. Road traffic injuries 9. Tuberculosis 9. Trachea, bronchus, lung cancers 8. Road traffic injuries8. Tuberculosis 7. Trachea, bronchus, lung cancers7. Diarrhoeal diseases 6. Diabetes mellitus6. Perinatal conditions 5. Chronic obstructive pulmonary disease 4. Chronic obstructive pulmonary disease 4. HIV/AIDS 3. HIV/AIDS 3. Lower respiratory infections 2. Cerebrovascular disease 1. Ischaemic heart disease 5. Lower respiratory infections WHO predicts that road traffic injuries will rise to eighth place by 2030 as a cause of death

© WHO, Source: Kopits E, Cropper M., The World Bank predicts that road traffic deaths will increase by 67% worldwide between 2000 and 2020

© WHO, Downward trends in road traffic fatalities in high-income countries

© WHO, Upward trends in road traffic fatalities in low-and middle- income countries Brazil

© WHO, Upward trends in road traffic fatalities in low-and middle- income countries India

© WHO, Upward trends in road traffic fatalities in low-and middle- income countries Trinidad and Tobago

© WHO, Most of those killed are vulnerable road users Source: Various WHO collaborators in countries

© WHO, Half of all global road traffic deaths occur among young adults between 15 and 44 years of age. 73% of all global road traffic fatalities are males. In Africa, a third of all road traffic deaths occur among those aged 5-14 years. Males takes more risks as drivers or pedestrians. In high-income countries young drivers are disproportionately represented. In low- and middle-income countries, most young victims are vulnerable road users. Young adults and males are at greatest risk

© WHO, Costs (US $ billion) The costs of road traffic injuries are enormous Region Estimated annual crash GNP 1997 (US $ billion) GNP (%) Africa Asia Latin America and Caribbean Middle East Central and Eastern Europe Subtotal Highly motorized countries Total Source: Jacobs G, et al

© WHO, Economic costs of road traffic injuries to households Loss of main breadwinner Loss of earnings Medical bills, funeral costs, legal bills Rehabilitation costs

© WHO, Worldwide, about 1.2 million persons are killed in road traffic crashes every year. 20 million to 50 million more are injured or disabled in these crashes. Road traffic injuries account for 2.1% of global mortality and 23% of all injury deaths worldwide. Road traffic injuries are predicted to rise from tenth place in 2002 to eighth place in 2030 as a cause of death. Key points (1)

© WHO, There are downward trends in road traffic deaths in high-income countries and increases in most low- and middle-income countries. The global economic cost of road traffic injuries is about US $ 518 billion per year. Key points (2)

© WHO, Task Look at the table on the next slide which presents data on estimated road traffic fatalities per population in the WHO African Region for Carefully study the table and write down key features related to the distribution of road traffic fatalities per by sex and age.

© WHO, Estimated mortality a caused by road traffic injuries b in WHO African region Age c in yearsMalesFemales 0– – – – – and above Total a Mortality is measured by number of road traffic fatalities per population. b Road traffic injury = ICD10 V01–V89, V99, Y850 (ICD9 E810–E819, E826–E829, E929). C Age-standardized.

© WHO, Expected results The purpose of this exercise is to assist trainees to identify and summarize key elements in the distribution of road traffic fatalities per population for the WHO African Region. They are to describe variations noted in this indicator by different age groups for males and females.

© WHO, Questions to think about a)What challenges does your country face as a result of road traffic crashes? b)In most countries, road traffic injury costs exceed 1% of gross national product. This figure is generally considered to be an underestimate of national road traffic collision costs. What is the estimated cost of road traffic injuries in your country? How is this estimate derived? How often is this estimate updated?

© WHO, Questions to think about c)Conduct a review of literature to establish how much research has been done on costs of road traffic injuries in your country. Look for published research on this issue in both local and international journals. This activity is meant to equip you with library research skills and capacity to examine existing literature. You can work on your own, or with two or three colleagues. Try to summarize the results and indicate gaps in knowledge that need to be filled. Consider preparing a manuscript based on your review to submit to a journal.

© WHO, Questions to think about d)Identify a family you know where someone has been involved in a non-fatal road traffic collision recently. Seek permission to gather information on the economic costs of that crash for that family. Prepare a summary of the economic costs to the family and immediate society. Think of ways of using this information to enhance prevention of road traffic injuries in your local setting.