[Deaths from traffic injuries and social inequality in Colombia, 2019Mortalidade por acidentes de trânsito e desigualdades sociais na Colômbia, 2019]

Undercounts stemming from misclassification derived from fatal injuries in traffic crashes in Colombia, 2010 to 2021

OBJECTIVES

To identify and address potential misclassification of traffic fatalities in Colombia from 2010 to 2021.

METHODS

For an ecological study, we employed national records and databases. A database was consolidated to include information on the fatality occurrence site, area, place of death, year of occurrence, marital status, age, and enrollment in social security. Generalized linear regression models were used to detect and adjust possible errors in records due to misclassification starting from existing data, allowing reclassification with a high probability of specific garbage codes being valid, potentially associated with mortality caused by traffic.

RESULTS

In 2010; there was a mortality rate of 13.3 deaths per 100,000 population, while in 2021; it was 15.1/per 100,000 population. In 2020; from the effects of pandemic-related confinement, the risk came down to 11.5/100.000 population. With the imputation, these records increased from 14.9 (2010) to 16.4 (2021); the most notable rise was among motorcyclists, who contributed 62%, with a marked increase in 2021:13/100.000 population, while pedestrians contributed 27.2%, cyclists: 4% and vehicle occupants: 6.5%.

CONCLUSIONS

Over the past decade, Colombia has stood out as one of the few countries worldwide that have been unable to reduce traffic-related mortality. The potential underestimation of the problem likely exacerbates this challenge due to record misclassification or measurement errors, which may be as high as 10%. Motorcyclists are particularly vulnerable, facing a significantly increased risk of death. To address this critical issue, cross-sectoral and inter-institutional policies, and plans are urgently needed to mitigate the high incidence of motorcycle fatalities and break the cycles of poverty and orphanhood they can cause.

Trends in traffic accident mortality and social inequalities in Ecuador from 2011 to 2022

BACKGROUND

Traffic accidents (TA) remain a significant global public health concern, impacting low-and middle-income countries. This study aimed to describe the trend in TA mortality and inequalities in Ecuador for 2011-2022, distributed by year, gender, age group, geographical location, type of accident, and social inequalities.

METHODS

An ecological study was conducted using INEC national-level data on TA fatalities in Ecuador. Mortality rates were calculated per 100,000 population and analyzed by year, gender, age group, geographic region, and accident type. Annual percentage variation (APV) was determined using linear regression models. Inequality analyses examined associations between TA mortality and socioeconomic factors like per capita income and literacy rates. Complex measures such as the Slope Inequality Index (SII) were calculated to assess the magnitude of inequalities.

RESULTS

There were 38,355 TA fatalities in Ecuador from 2011 to 2022, with an overall mortality rate of 19.4 per 100,000 inhabitants. The rate showed a non-significant decreasing trend (APV - 0.4%, p = 0.280). Males had significantly higher mortality rates than females (31.99 vs. 7.19 per 100,000), with the gender gap widening over time (APV 0.85%, p = 0.003). The Amazon region had the highest rate (24.4 per 100,000), followed by the Coast (20.4 per 100,000). Adults aged ≥ 60 years had the highest mortality (31.0 per 100,000), followed by those aged 25-40 years (28.6 per 100,000). The ≥ 60 age group showed the most significant rate decrease over time (APV - 2.25%, p < 0.001). Pedestrians were the most affected group after excluding unspecified accidents, with a notable decreasing trend (APV - 5.68%, p < 0.001). Motorcyclist fatalities showed an increasing trend, ranking third in TA-related deaths. Lower literacy rates and per capita income were associated with higher TA mortality risks. Inequality in TA mortality between provinces with the highest and lowest per capita income increased by 247.7% from 2011 to 2019, as measured by the SII.

CONCLUSION

While overall TA mortality slightly decreased in Ecuador, significant disparities persist across demographic groups and geographic regions. Older adults, males, pedestrians, and economically disadvantaged populations face disproportionately higher risks. The increasing trend in motorcycle-related fatalities and widening socioeconomic inequalities are particularly concerning.

[Trends in motorcycle road deaths in Colombia, 2008-2021Tendências de mortalidade por acidentes de motocicleta na Colômbia, 2008-2021]

Objective

To identify trends in motorcycle road deaths in Colombia between 2008 and 2021.

Methods

An observational and descriptive study of trends in motorcycle road deaths was conducted using official death records from 2008 to 2021. Jointpoint Poisson regression analysis was performed to detect inflection points in mortality rates specific to age, sex, and area of residence.

Results

A total of 28 200 motorcycle road deaths were identified during the period; 24 271 men and 3 929 women died. Of the deaths, 74.1% occurred in urban areas and 25.9% in rural areas. In rural areas, there was an increasing trend in fatalities in young adults of both sexes during the period. The same occurred in men over 65 years of age. In urban areas, there was an upward trend in fatalities in the age group from 45-64 for both sexes during the period. Only one inflection point was detected, in 2015, showing a downward trend in adolescent females.

Conclusion

The trend in motorcycle road deaths in Colombia continued to rise during the 2008-2021 period, both in rural areas for young adults and in urban areas for middle-aged adults.