Road traffic deaths in Brazil: rising trends in pedestrian and motorcycle occupant deaths

Objective: According to the World Health Organization, the global burden of road traffic mortality exceeds 1.27 million people annually; over 90 percent occur in low- and middle-income countries. Brazil's road traffic mortality rate of ～20 per 100,000 is significantly higher than nearby Chile or Argentina. To date, there has been very little information published on road traffic fatalities among vulnerable road users (VRUs) in Brazil. Methods: Road traffic fatality data from 2000 to 2008 were extracted from Brazil's Mortality Information System (SIM). Road traffic deaths were extracted using the International Classification of Diseases (ICD-10) V-codes (V01-V89) and then subcategorized by VRU categories. Information was then disaggregated by gender, age, and region. Results: In 2008, 39,211 deaths due to road traffic injuries were recorded in Brazil, resulting in a crude mortality rate of 20.7 per 100,000 inhabitants. Pedestrian mortality averaged 5.46 deaths per 100,000 between 2000 and 2008. The mortality rate for elderly pedestrians (80+ years) is 20.1 per 100,000, over 10 times that of 0- to 9-year-olds. In the past decade, motorcycle occupant mortality has dramatically increased by over 300 percent from 1.5 per 100,000 in 2000 to 4.7 per 100,000 in 2008. The 20- to 29-year age group remains most affected by motorcycle deaths, with a peak fatality rate of 10.76 per 100,000 in 2008. The north and northeast regions, with the lower per capita gross domestic product (GDP), have higher proportions of VRU deaths compared with other regions. Conclusions: Vulnerable road users are contributing an increasing proportion of the road traffic fatalities in Brazil. Nationally, elderly pedestrians are at particularly high risk and motorcycle fatalities are increasing at a rapid rate. Less prosperous regions have higher proportions of VRU deaths. Understanding the epidemiology of road traffic mortality in vulnerable road user categories will better allow for targeted interventions to reduce these preventable deaths.     

Mortality from road traffic accidents in a rapidly urbanizing Chinese city: A 20-year analysis in Shenzhen, 1994–2013

Objective: This study aimed to describe the trends of motorization and mortality rates from road traffic accidents and examine their associations in a rapidly urbanizing city in China, Shenzhen.

Methods: Using data from the Shenzhen Deaths Registry between 1994 and 2013, we calculated the annual mortality rates of road traffic accidents, in addition to the age- and sex-specific mortality rates and their annual percentage changes (APCs) for the period of 2000–2013. We also examined the associations between mortality rate of road traffic accidents and traffic growth with Spearman's rank correlation analysis and a log-linear model derived from Smeed's law.

Results: A total of 20,196 deaths due to road traffic accidents, including 14,391 (71.3%) male deaths and 5,805 (28.7%) female deaths, were recorded in Shenzhen from 1994 to 2013. The annual mortality rates in terms of deaths per population and deaths per vehicle changed in similar patterns, demonstrating an increase since 1994 and peaking in 1997, followed by a steady decrease thereafter. The decrease in mortality was faster in individuals aged 20 year or older compared to those younger than 20 years. The mortality rates in term of deaths per population were positively correlated with the total number of vehicles per kilometer of road but negatively correlated with the motorization rate in term of vehicles per population. The estimated model for deaths due to road traffic accidents in relation to the total population and the number of registered vehicles was ln (deaths/10,000 vehicles) = ?1.902 × ln (vehicles/population) ? 1.961. The coefficient was statistically significant (P < .001) and the coefficient of determination was 0.966, indicating a good model fit.

Conclusions: We described a generally decreasing trend in the mortality rates of road traffic accidents in a rapidly urbanizing Chinese city based observations in the 20-year period from 1994 to 2013. The decreased mortality rate may be explained by the expansion of road network construction, improved road safety regulations and management, as well as more accessible ambulance services in recent years. Nevertheless, road traffic accidents remain a universal problem of great public health concern in the whole population.     

Effect of the zero-tolerance drinking and driving law on mortality due to road traffic accidents according to the type of victim,sex, and age in Rio de Janeiro,Brazil: An interrupted time series study

Objective: The objective of this study was to estimate the effect of the Brazilian zero-tolerance drinking and driving law on mortality rates due to road traffic accidents according to the type of victim, sex, and age.

Methods: An interrupted time series design was used to compare yearly mortality rates due to road traffic accidents in Rio de Janeiro, Brazil, before and after the zero-tolerance drinking and driving law came into effect on June 19, 2008. Yearly mortality rates were compared according to the type of victim: pedestrian, cyclist, motorcyclist, and vehicle occupant. We used the Prais-Winsten procedure of autoregression in the analysis of time series; the outcome of this analysis was the annual percentage change in the rates. Overall and stratified analyses were conducted to investigate whether the zero-tolerance drinking and driving law may have had a distributional effect on mortality rates due to road traffic accidents depending on sex and age group; a significance level of P < .01 was accepted.

Results: From 1999 to 2016, there were 15,629 deaths due to road traffic accidents in Rio de Janeiro. The effect of the zero-tolerance drinking and driving law on overall mortality rates due to road traffic accidents in Rio de Janeiro was not statistically significant. However, among cyclists and motorcyclists aged ≥60 years and among pedestrians of both sexes and aged ≥20 years, the effect of the zero-tolerance drinking and driving law was to decrease mortality due to road traffic accidents at a yearly rate.

Conclusion: There is evidence of reduced mortality rates due to road traffic accidents among cyclists and motorcyclists aged ≥60 years and among pedestrians of both sexes aged ≥20 years in the second major Brazilian capital 9 years after the zero-tolerance drinking and driving law was adopted.     

我国公路交通事故的现状及特征分析

根据2000—2006年全国公路交通事故统计数据,以2006年为重点,分析当前我国公路交通事故的发展形势、地区差异和事故特征。研究表明:我国的公路交通事故自2003年开始总体由快速上升转为持续下降,但高速公路和西部地区的公路交通事故仍有增长可能;与经济欠发达地区相比,经济发达地区的事故总量较大,但事故死亡率较低;国道、省道和高等级公路的事故死亡率均大幅高于其他公路;约80%的死亡事故是发生在平直、一般弯和一般坡等良好路段上的车辆互碰、碰撞行人和翻车,76%的特大事故属于坠车和正面碰撞;雾、雪等恶劣天气更易在高等级公路上引发交通事故。     

我国道路交通安全教育培训思考

统计数据显示,我国2007-2009年道路运输事故呈下降趋势。但道路运输事故造成的死亡人数远远高于煤炭事故造成的死亡人数,道路交通安全形势依然很严峻。交通安全形势严峻的主要原因之一就是人为因素,加强对交通参与者的相关教育培训,提高安全意识,规范安全行为,是改善交通安全形势的根本途径。本文系统分析了我国的安全教育环境、交通文化、交通安全法律法规及交通安全教育培训存在问题,提出了改善我国交通安全教育的措施及建议。     

Progress towards zero,an international comparison: Improvements in traffic fatality from 1990 to 2010 for different age groups in the USA and 15 of its peers

IntroductionIn January 2015, the United States Department of Transportation (USDOT) announced that the official target of the federal government transportation safety policy was zero deaths. Having a better understanding of traffic fatality trends of various age cohorts—and to what extent the US is lagging other countries—is a crucial first step to identifying policies that may help the USDOT achieve its goal.MethodIn this paper we analyze fatality rates for different age cohorts in developed countries to better understand how road traffic fatality patterns vary across countries by age cohort. Using benchmarking analysis and comparative index analysis based on panel data modelling and data for selected years between 1990 and 2010, we compare changes in the rate of road traffic fatality over time, as well as the absolute level of road traffic fatality for six age groups in the US, with 15 other developed countries.Results-ConclusionsOur findings illustrate tremendous variations in road fatality rates (both in terms of the absolute values and the rates of improvement over time) among different age cohorts in all of the 16 countries. Looking specifically at the US, our analysis shows that safety improvements for Youngsters (15-17 years old) was much better than for other age groups, and closely tracked peer countries. In sharp contrast, Children (0-14 years old) and Seniors (+65 years old) in the US, fare very poorly when compared to peer countries. For example, in 2010, Children in the US were a stunning five times more likely to experience a road traffic fatality than Children in the UK.Practical ApplicationsThis startling statistic suggests an immediate need to explore further the causes and potential solutions to these disparities. This is especially important if countries, including the US, are to achieve the ambitious goals set out in Zero Vision initiatives.     

Risk factors for being the at-fault driver: A case–control study

Objective: It is estimated that road traffic accidents are globally responsible for approximately 1.2 million deaths and 20 to 50 million injuries. About 70% of traffic incidences (TIs) occur in developing countries and among countries with high TI rates; Iran is the first. The aim of this study was to measure the association between being responsible for a traffic accident and some vehicle, human; and environmental related factors in Yasuj, a city with a high incidence of road traffic injuries and deaths in Iran.

Methods: This is a time-, date-, and place-matched case–control study conducted in 2015 using all traffic accidents registered and investigated by police during 2012. In total, 194 drivers were considered the at-fault driver in a traffic accident and the 194 drivers in the same collisions were included in the analysis.

Results: Based on the results from multivariate conditional logistic regression, significant associations between vehicle maneuver (OR_{Turn to right or left/Moving forward} = 11.10, 95% confidence interval [CI], 1.77–69.58, P = .01) and age (odds ratio [OR] = 1.11, 95% CI, 1.004–1.22, P = .04) and the chance of being an at-fault driver were found.

Conclusion: Driver behavior–related interventions including training and law enforcement seem to be more effective in reducing road traffic accidents in Iran.     

我国区域道路交通安全形势对比与影响因素分析

根据2007年的政府统计数据,将全国划分为4个社会经济发展区域,并对比各区域道路交通的发展状况与安全形势,然后运用SPSS统计软件分析道路交通安全评价参数与社会经济发展水平之间的相关性。发现社会经济发展梯次靠前的区域,其道路交通与安全状况也相对较好;GDP、人口、机动车保有量、机动车驾驶证普及率、道路条件和交通运输规模等因素分别对交通事故的死亡人数、万车死亡率、亿元GDP死亡率和百公里道路死亡率等指标具有显著影响。针对各区域的道路交通安全现状,必须进一步加快交通基础与安全设施建设,建立和完善交通事故紧急救援体系,加强交通安全宣传、教育、管理以及区域间的交流与合作。     

Investigation on road traffic safety of the mountain areas in southwest China based on Wulong County, Chongqing Municipality

OBJECTIVE: To study the present situation, characteristics, and main problems of the traffic safety in the mountain areas of Southwest China. METHODS: A study was done on the traffic status of Wulong County, Chongqing Municipality, by means of document review, field investigation, and inquiry. RESULTS: The traffic crashes and deaths in Wulong County were increasing since 1999. From 1997 to 2001, there occurred 126 severe and very severe traffic crashes resulting in 175 deaths and 411 serious injuries, which accounted for 9.4% of total crashes, 96.1% of total deaths, and 48.4% of total serious injuries, respectively. The severe and very severe traffic crashes were highest in 2000. One part for 83 km in length accounting for 3.0% of No. 319 National Highway was responsible for 54.5% of very severe traffic crashes, which closely related to conditions of the road itself and its environment and defective execution of traffic laws. CONCLUSIONS: Wulong County, one of the mountain counties in Southwest China, is now facing a complex and serious road traffic situation and serious traffic safety, with a high incidence of severe and very severe road traffic crashes. The crashes closely relate to imperfect road design, defective execution of traffic laws, imperfect management, and environmental factors.     

基于熵权-TOPSIS的陕西省各市区道路交通安全评价

为评价陕西省各市区道路交通安全状况,选取了十亿地区生产总值死亡人数、平均每起事故死亡人数、致死率、万车死亡率和十万人口死亡率5个相对评价指标,应用熵权-TOPSIS法对陕西省10个地级市的道路交通安全水平进行了综合评价。结果表明,陕西省各市区道路交通安全水平与地区生产总值、人口数量、机动化水平等社会经济因素具有较强的相关性,不同市区道路交通安全水平存在明显的差异。     

Trends in motor vehicle crash mortality in Europe, 1980-2007

Recent trends (1980-2007) in mortality from road traffic crashes in European countries, and, for comparative purposes, in the USA and Japan were reviewed. Data came from the World Health Organisation database. Age-standardised rates, at all ages and at 15-24, 25-64, ?65 years, were computed. Joinpoint regression analyses to evaluate significant changes in trends were performed. In the European Union as a whole rates declined from 20.2 in 1987 to 13.5/100,000 in 2007 in men, and from 6.3 to 3.7/100,000 in women; European Union rates remained lower than USA, but higher than Japanese ones. In 2007, the highest male rates were in Lithuania (36.7/100,000), the Russian Federation (35.2), Ukraine (29.8), and Latvia (28.5), and the lowest ones in the Netherlands (6.2) and Sweden (6.9); the highest female rates were in the Russian Federation (11.3), Lithuania (9.7), Belarus, Latvia, and Ukraine (around 8), and the lowest ones in Switzerland (1.7), the UK, and Nordic countries (around 2). Mortality from motor vehicle crashes declined in northern and western European countries and - though to a lesser extent - in southern European countries, too. Mortality trends were also favourable in the Czech Republic and Poland since the mid 1990’s, whereas they were still upwards in Romania and the Russian Federation. No trend was observed in Hungary and Ukraine. Trends were consistent in various age groups considered. Thus, additional urgent and integrated intervention is required to prevent avoidable deaths from motor vehicle crashes, particularly in selected central and eastern European countries.     

Evaluation of a hospital-based injury surveillance system for monitoring road traffic deaths in Phuket,Thailand

Objectives: The objective of this study was to evaluate and injury surveillance (IS) system’s ability to monitor road traffic deaths and the coverage of road traffic injury and death surveillance in Phuket, Thailand.

Methods: U.S. Centers for Disease Control and Prevention guidelines on surveillance system evaluation were used to qualitatively and quantitatively evaluate IS. Interviews with key stakeholders focused on IS’s usefulness, simplicity, flexibility, acceptability, and stability. Active case finding of 2014 road traffic deaths in all paper and electronic hospital record systems was used to assess system sensitivity, positive predictive value, and data quality. Electronic data matching software was used to determine the implications of combining IS data with other provincial-level data sources (e.g., death certificates, electronic vehicle insurance claim system).

Results: Evaluation results indicated that IS was useful, flexible, acceptable, and stable, with a high positive predictive value (99%). Simplicity was limited due to the burden of collecting data on all injuries and use of paper-based data collection forms. Sensitivity was low, with IS only identifying 55% of hospital road traffic death cases identified during active case finding; however, IS cases were representative of cases identified. Data accuracy and completeness varied across data fields. Combining IS with active case finding, death certificates, and the electronic vehicle insurance claim system more than doubled the number of road traffic death cases identified in Phuket.

Conclusion: An efficient and comprehensive road traffic injury and death surveillance system is critical for monitoring Phuket’s road traffic burden. The hospital-based IS system is a useful system for monitoring road traffic deaths and assessing risk behaviors. However, the complexity of data collection and limited coverage hinders the ability of IS to fully represent road traffic deaths in Phuket Province. Combining data sources could improve coverage and should be considered.     

A 6-year survey of road traffic accidents in Southwest China: Emphasis on traumatic brain injury

Background: The objective of this study is to provide an up-to-date overview of the patterns of injuries, especially traumatic brain injury (TBI) caused by RTAs and to discuss some of the public health consequences. Methods: A scientific team was established to collect road traffic accidents occurring between 2013 and 2018 in Chongqing, Southwest China. For each accident, the environment-, vehicle-, and person- variables were analyzed and determined. The overall injury distribution and TBI patterns of four types of road users (driver, passenger, motorcyclist and pedestrian) were compared. The environmental and time distribution of accidents with TBI were shown by bar and pie chart. The risks of severe brain injury whether motorcyclist wearing helmets or not were compared and the risk factors of severe TBI in pedestrian were determined by odds ratio analysis. Results: This study enrolled 2131 accidents with 2741 persons of all kind of traffic participants, 1149 of them suffered AIS1+ head injury and 1598(58%) died in 7 days. The most common cause of deaths is due to head injury with 714(85%) and 1266(79%) persons died within 2 hours. Among 423 persons suffered both skull fracture and intracranial injury, 102 (24.1%) have an intracranial injury but no skull fractures, while none of the skull fractures without intracranial injury was found. Besides, motorcyclists without a helmet were at higher risks for all the brain injury categories. The risk of pedestrian suffering severe TBI at an impact speed of more than 70 km/h is 100 times higher than that with an impact speed of less than 40 km/h. Conclusion: It is urgently needed to develop a more reliable brain injury evaluation criterion for better protection of the road users. We believe that strengthening the emergency care to head injury at the scene is the most effective way to reduce traffic fatality.     

Socio-cultural characteristics of high versus low risk societies regarding road traffic safety

In this study, 15 Western European countries were compared for two periods, 1989–1991, and 1997–1999. The aim was to better understand the relation between different socio-cultural factors, regulations related to traffic safety, and fatal traffic deaths. The question is also posed whether such factors are functional in the search for a safety typology aimed to characterize nations with regard to safety.Despite increased similarity regarding traffic regulation, the differences regarding fatal deaths in motor vehicle road accidents remain among the countries studied. The only studied factor that has changed its relation to motor traffic accidents during the two periods is number of cars which has lost its importance.The conclusion of the study is that type of religion and wealth of the country seem to be the most important factors. Type of religion in the country seems to have an impact on values related to safety. Being a Catholic country or not seems to be as important as being a wealthy country or not. Being a non-wealthy Catholic country leads to more traffic accidents than being a wealthy Catholic country. Being a wealthy Catholic country, however, does seem to lead to more traffic accidents than being a similar wealthy but non-Catholic country.A safety typology with three to five categories is found. The most outspoken categories are Catholic, Protestant and Mixed. The five categories should be Non-wealthy Catholic, Wealthy Catholic, Anglo-Saxon, Safe Protestant and Continental Protestant. The typology have similarities to typologies which have been developed in welfare research.     

Underage drinking: frequency, consequences, and interventions

OBJECTIVES: To examine the frequency of underage drinking, driving after drinking and alcohol-related crashes, trends in these behaviors, and promising interventions. METHODS: We examined drinking and drinking- and-driving behaviors reported in the United States in the 2001 U.S. National Household Survey of Drug Abuse, the Centers for Disease Control and Prevention 2001 Youth Risk Behavior Survey, the 1992 National Longitudinal Alcohol Epidemiologic Study, and the 1999 National Survey of Drinking and Driving conducted for the National Highway Traffic Administration. We also examined the 1999 European School Survey Project on Alcohol and Other Drugs. Alcohol-related fatal crashes were examined from the U.S. Fatality Analysis Reporting System. Evaluation of interventions to reduce teenage drinking and driving after drinking were reviewed. RESULTS: In the United States, 19% of youth ages 12-20 consumed five or more drinks on an occasion in the past 30 days. Although European nations have lower legal drinking ages (16-18) than in the United States (21), similar proportions engage in underage drinking. In two-thirds of European countries, a greater percentage of 15-16 year-olds drank five or more drinks on an occasion in the past month than in the United States. In both the United States and Europe, the earlier people begin to drink, the greater the likelihood of developing alcohol dependence and other alcohol-related problems, including alcohol-related crash involvement, during adolescence and adult years. During the past 20 years alcohol-related traffic deaths among people younger than 21 have been cut in half in the United States, but progress has halted since 1995 and the problem is still large. Interventions shown by research to reduce alcohol-related crashes among youth include raising the legal drinking age to 21, zero tolerance laws, and some interventions that are family, school, or community based. CONCLUSIONS: Despite research showing that a variety of interventions can reduce underage drinking and alcohol-related crash fatalities, the frequency of these behaviors remains high and the average age of drinking initiation is declining in the United States. Efforts are needed to enhance publicized enforcement of underage drinking laws. Comprehensive community interventions that include enforcement of these laws also are needed.     

Evaluation of the effectiveness of traffic calming measures on vehicle speeds and pedestrian injury severity in Ghana

Objectives: Each year, pedestrian injuries constitute over 40% of all road casualty deaths and up to 60% of all urban road casualty deaths in Ghana. This is as a result of the overwhelming dependence on walking as a mode of transport in an environment where there are high vehicular speeds and inadequate pedestrian facilities. The objectives of this research were to establish the (1) impact of traffic calming measures on vehicle speeds and (2) association between traffic calming measures and pedestrian injury severity in built-up areas in Ghana.

Method: Vehicle speeds were unobtrusively measured in 38 selected settlements, including 19 with traffic calming schemes and 19 without. The study design used in this research was a matched case–control. A regression analysis compared case and control casualties using a conditional logistic regression.

Results: Generally, the mean vehicle speeds and the proportion of vehicles exceeding the 50?km/h speed limit were significantly lower in settlements that have traffic calming measures compared to towns without any traffic calming measures. Additionally, the proportion of motorists who exceeded the speed limit was 30% or less in settlements that have traffic calming devices and the proportion who exceeded the speed limit was 60% or more in towns without any traffic calming measures. The odds of pedestrian fatality was significantly higher in settlements that have no traffic calming devices compared to those that have (odds ratio [OR]?=?1.98; 95% confidence interval, 1.09–4.43). The protective effects of a traffic calming scheme that has a speed table was notably higher than those where there were no speed tables.

Conclusion: It was clearly evident that traffic calming devices reduce vehicular speeds and, thus, the incidence and severity of pedestrian injuries in built-up areas in Ghana. However, the fact that they are deployed on arterial roads is increasingly becoming a road safety concern. Given the emerging safety challenges associated with speed calming measures, we recommend that their use be restricted to residential streets but not on arterial roads. Long-term solutions for improving pedestrian safety proposed herein include bypassing settlements along the highways to reduce pedestrians’ exposure to traffic collisions and adopting a modern way of enforcement such as evidence-based laser monitoring in conjunction with a punishment regime that utilizes the demerit points system.     

Can fear of going to jail reduce the number of road fatalities? The Spanish experience

The goal of this article is to evaluate the impact of the drastic Spanish Penal Code reform on the number of road deaths in Spain and the time that the effects might last. This is achieved by means of multivariate unobserved component models set up in a state space framework estimated using maximum likelihood. In short, with this reform Spain might be considered to be closing the final gap that kept it apart from other developed countries as far as the road accident rate is concerned. We have found two different types of effects on Spanish road traffic fatalities. Initially, a month before the reform was passed there was a 24.7 percent fall in Spanish road deaths. After the Bill had been passed and for the following thirteen months, the reduction stayed at a constant sixteen percent. This reform has reduced Spanish road fatalities by 534 in all between November 2007 and December 2008 and the effects will foreseeably continue during 2009.     

城市道路的人员疏散风险评价研究*

为量化评价城市道路在人员疏散过程中存在的风险,以支持城市道路规划,以及有效开展应急疏散管理,提出1种城市道路的人员疏散风险评价方法。该方法设定多种影响因素,构建道路疏散风险评价函数,并结合临界簇模型,运用实时交通态势数据与动态人口数据,评估不同时间的道路疏散风险。以上海市外环线内区域为研究区,开展道路疏散风险综合评价与突发事件情景下的道路疏散风险评价。结果表明:该方法可以有效综合多种影响因素,空间量化表达道路的人员疏散风险。评价结果能够为城市道路设施规划提供帮助,为提升城市应急疏散管理效率,降低事故的伤亡与损失提供决策依据。     

道路交通安全管理规划理论体系研究

道路交通安全是道路交通系统的重要组成部分,也是世界各国极为关注的议题之一。道路交通安全管理得到世界各国政府的高度重视,而作为道路交通安全管理的道路交通安全管理规划就显得尤为重要。笔者结合我国的道路的实际情况和国外理论实践的借鉴以及自己的一些想法对我国道路交通安全管理规划的基本理论体系做了一个初步的研究。从整体上分析道路交通安全管理规划的组织机构;阐述了规划的主要内容和技术路线;提出了道路交通安全管理规划的总体设计;从分析道路交通安全管理规划的流程和技术方法的基础上建立规划的基本框架;着重介绍道路交通安全管理规划的核心内容;最后阐述了道路交通安全管理规划的实施与滚动,系统地介绍和探讨了道路交通管理规划的基本理论体系。     

The sources of the Kuznets relationship between the road deaths to road injuries ratio and economic growth

Introduction: Past empirical studies indicated that there is a Kuznets or reverse U-shaped relationship between road deaths and per capita income, such that the number of road death increases at a low level of per capita reverse U-shaped relationship was observed between road injuries and per capita income. While these studies explored the impact of per capita income on road deaths and road injuries, no studies have examined the relationship between per capita income and road death to road injury ratio (DPI). Method: Using a fixed effects panel regression analysis from 67 countries spanning over a period of five decades (1960–2013), the present study sought to explore the impact of per capita gross domestic product (per capita GDP) on the DPI ratio and the underlying factors responsible for the relationship. Results: Our result suggests that per capita GDP followed a reverse U-shaped relationship with DPI. Moreover, the relative improvements in higher mobility roads as compared to improvements in higher accessibility roads, motorcycle ownership to passenger car ownership ratio, percentage of population living in an urban area, infant mortality rate, and the percentage of population below 15 years of age and above 64 years of age contributed to this relationship. Practical Applications: This implies that, at lower level of economic growth where road deaths exceed road injuries, countries should implement low-cost measures to combat road deaths cases. Such measures include mandating wearing of quality helmets and daytime running headlights for motorcycles. On the other hand, at higher level of economic growth where road injuries surpass road deaths, countries are encouraged to devote more resources to improving medical technology and services to treat road injury victims, mandating seatbelt use, as well as enhancing and promoting public transportation service.