2. Socio economic factors in road safety Duncan Vernon Road Safety Manager RoSPA

3. Social Factors in Road Safety Presented by: Duncan Vernon Road Safety Manager (England)

4. RoSPA’s mission is to save lives and reduce injuries Social Factors? nUsed interchangeably with “social determinants” nDefined by WHO as “the conditions in which people are born, grow, live, work and age, including the health system” nSome examples: education, housing, employment, wealth, local community nOf importance because they are responsible for much of the inequality in health seen between and within different countries

5. RoSPA’s mission is to save lives and reduce injuries Social Factors? A model published by WHO in 1991 showing the main determinants of health

6. RoSPA’s mission is to save lives and reduce injuries What Does the Evidence Say? nRoSPA performed a literature review to inform a policy position nWe found three main strands of evidence àThe size and scale of injury inequality between the most and least affluent àThe reasons behind this difference àWhat interventions have been tried and evaluated in order to address the influence that these social factors have on injury rates nWill be published as “Social Factors in Road Safety” on the RoSPA website

7. RoSPA’s mission is to save lives and reduce injuries What Does the Evidence Say? nThe literature showed an association between deprivation and injury. nFound strong consistency between studies over time and between different areas in the UK nDifferent measures of deprivation gave similar patterns – whether area based measures (e.g. The Index of Multiple Deprivation) or individual measures (e.g. social class or occupational group) nThe strength of the association was different between road user groups – there was very strong evidence for child pedestrian and cyclists, much weaker evidence for drivers

8. RoSPA’s mission is to save lives and reduce injuries Why is there a Difference in Injury Rates? nThree main areas were identified àExposure to risk àThe road environment, habitation and local area àSocial environment and deprivation nSadly, much of the evidence was becoming dated

9. RoSPA’s mission is to save lives and reduce injuries Why is there a Difference in Injury Rates? nExposure to risk àChildren in the quarter of families with the lowest income crossed 50% more roads than those in the highest àFamilies were much less likely to own cars àChildren more likely to walk to school and less likely to be accompanied

10. RoSPA’s mission is to save lives and reduce injuries Why is there a Difference in Injury Rates? nThe Road Environment, Habitation and The Local Area àHigh population density àLong straight roads with terraced housing, which can encourage higher vehicle speeds àStudies of on-street parking have come to different conclusions nLeisure Facilities àChildren end up playing on the street because there is nowhere else to play – there is little garden space and local parks are seen as dangerous. Parents report that at least they can keep an eye on their children outside the house àLimited number, awareness and take up of formal leisure activities àWorries about changing land use and parks being turned into car parks

11. RoSPA’s mission is to save lives and reduce injuries Why is there a Difference in Injury Rates? nSocial Environment and Deprivation nFamily size àSingle parent families – social isolation or a lack of social support, and being caught in a poverty trap due to lack of affordable child care àLarge families – overcrowded accommodation with more than one child per bedroom, and supervision is more difficult nDo ETP initiatives connect? àUn-equitable distribution of road safety efforts – how do we assess need? àHow do we take account of the barriers to people adopting the safer behaviours that we want them to – are they intrinsic or extrinsic?

12. RoSPA’s mission is to save lives and reduce injuries How can Road Safety Practice have an Influence? nFar fewer studies which look at how to address this problem than there are defining it! nWithin health, the idea of community participation and empowerment has been suggested as a method of reducing inequalities nMuch enthusiasm for it from communities but there are barriers to engaging communities àPersonnel issues – to do with the time that time people have to be involved and the skills that people can bring àPlanning issues – to do with a lack of funds or resources and an inappropriate focus for the programme àLack of empowerment as true within communities as between them

13. RoSPA’s mission is to save lives and reduce injuries Finding new Partners within Public Health? nMany of the ways that people define and refer to health and wellbeing in their own lives are also related to aspects of safety nMany of these social determinants of injury are similarly social determinants of illness nThese social factors can have a long term effects over the course of their lives, and so injury prevention can look at more than addressing immediate factors to an injury nSome potential examples of interventions with a long term influence: àAddressing fundamental concepts such as wellbeing àEarly intervention and parental support

14. RoSPA’s mission is to save lives and reduce injuries Conclusions nSocial factors can have a large influence on the number of injuries on the road nAddressing social factors within interventions is hard but taking them into account when assessing need and measuring effectiveness will help to build an evidence base nSome Public Health activities may already be having an (unmeasured) influence on road injuries – making more links between public health and road safety departments should help us to understand where there is common ground

15. Thank you www.rospa.com Duncan Vernon dvernon@rospa.com 0121 248 2078