World Health Day to concentrate on road mishaps

“Road Safety is No Accident” will be the theme for this year’s World Health Day, which takes place on April 7. Every year the World Health Organization (WHO), a part of the United Nations, picks one particular health problem that can be reduced with more public awareness and government action to be emphasized on World Health Day.

The first automobile accident death happened in 1896 in London, and since then motor vehicle accidents have risen to at least ninth place on epidemiologists’ list of leading contributors to the “Global Burden of Disease.” This burden is calculated by the lost years of human productivity either by way of deaths or by disabilities. In 1990 the Top 10 Leading Contributors to the Global Burden of Disease as estimated in a 1996 Harvard study were, in descending order: 1. lower respiratory infections; 2. diarrheal diseases; 3. perinatal conditions; 4. unipolar major depression; 5. ischemic heart disease; 6. cerebrovascular disease; 7. tuberculosis; 8. measles; 9. road traffic injuries and 10. congenital abnormalities. The same study projected that by 2020 traffic accidents would rise to third place, behind heart disease and depression.

The WHO estimates that road crashes killed 1.18 million people in 2002 and injured at least 20 million others. It identifies pedestrians, those who use two-wheeled vehicles, males, the elderly, and children in poor urban neighborhoods whose only playgrounds are the streets as the categories of people most at risk.

It may be a global trend, but there are wide local variations according to the lifestyles of different economies and cultures. In the United States, for example, most road fatalities are suffered by drivers or passengers in motor vehicles; while in Panama, most of those killed in traffic accidents are pedestrians. Where people live and how they get around to conduct their daily activities are obvious variables when considering the risks of death or injury on the road.

So might you think that the people at highest risk are in those industrialized countries where most adults own cars and drive to and from work? You would be wrong. Australia, New Zealand, Japan and the Western European countries have the safest roads, and the US and Canada are not far behind. In general, the casualty figures are much higher in low- and medium-income countries than the high-income countries. The main exceptions to the trend according to wealth are the oil-rich countries of North Africa and the Middle East. In Africa the risk of being killed or injured in a traffic accident is about double that in North America.

Why the counter-intuitive disparities? Mainly because the places that have the longest established automobile cultures have also been wrestling with the problems of traffic safety the longest. From a strictly financial point of view, the governments of these countries have found that investments in traffic safety more than pay for themselves by avoiding the lost productivity, costly social problems, health care expenses, litigation and insurance payments caused by accidents on the road.

The WHO will issue a World Health Day call for a broad package of governmental actions to reduce the health problems caused by traffic mishaps, under the general headings of reducing individuals’ exposure to road traffic, reducing the occurrence of crashes, reducing the harm done when crashes do occur and reducing post-crash harm. At the top of the list, the UN’s health agency urges better urban planning “so that where people live, work, go to school, and shop are close together and people do not have to travel long distances every day.” The recommendations also include such measures as improved road and motor vehicle design, motorcycle and bicycle helmet laws, restrictions on new drivers that diminish as they get more experience, and better emergency care for traffic accident victims.

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World Health Day focus on traffic accidents