Regional disparities in road traffic injuries and their determinants in Brazil, 2013.

Ana Lúcia Andrade,Polyana Maria Pimenta Mandacarú,Otaliba Libanio Morais Neto,Rafael Alves Guimarães,Gabriela Camargo Tobias

doi:10.1186/s12939-016-0433-6

Ana Lúcia Andrade, Polyana Maria Pimenta Mandacarú + Show 3 more

Open Access

https://doi.org/10.1186/s12939-016-0433-6

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Abstract

BackgroundIn recent decades middle-income countries have experienced a rapid increase in the number of cars and motorcycles. Increased deaths and hospitalizations due to road traffic injuries (RTI) has been observed in several countries as a result. In this study we assessed the determinants of RTIs in Brazil by mode of transportation and compared differences in RTI rates among macro-regions.MethodsWe used data from the National Health Survey (NHS) conducted in 2013 by the Brazilian Institute of Geography and Statistics and the Ministry of Health. NHS is a comprehensive household survey which includes a representative sample (N = 60,198) of individuals aged 18 years or older. The prevalence and determinants of RTI were estimated according to different modes of transport (car/van, motorcycle, and other) and regions of the country. Bivariate and multivariable logistic regression models were applied to assess crude and adjusted odds ratios, respectively, and their 95 % CI for RTI determinants.ResultsThe prevalence of RTI for the Southeast, South, Central-West, Northeast and North regions of Brazil was 2.4 %, 2.9 %, 4.4 %, 3.4 % and 4.8 %, respectively, pointing to important differences among regions. High percentages of motorcyclists were observed in the Northeast and North regions. For motorcyclists, factors associated with RTIs were being male (OR = 2.6;95 % CI:2.3;3.0), aged 18–29 (OR = 3.2; 95 % CI:2.7;3.8) and 30–39 years (OR = 2.0;95 % CI:1.7;2.5), black (OR = 1.4;95 % CI:1.1;1.7), having elementary educational (OR = 1.5;95 % CI:1.1;1.9), reporting binge drinking behavior (OR = 1.3;95 % CI:1.1;1.5), and living in the Central-West (OR = 2.0;95 % CI:1.6;2.5), Northeast (OR = 1.8;95 % CI:1.5;2.1) and North (OR = 2.0;95 % CI:1.6; 2.5) regions of the country. The independent variables associated with RTI for car/van occupants were being male (OR = 1.7;95 % CI:1.4;2.1), aged 18–29 (OR = 1.5;95 % CI:1.1;2.0) and 30–39 years (OR = 2.5;95 % CI:1.9;3.2), reporting binge drinking behavior (OR = 2.0;95 % CI:1.6;2.5) and living in the South region (OR = 1.6;95 % CI:1.3;2.1).ConclusionsThere were considerable regional disparities in RTI rates across Brazil’s regions. Motorcyclists contributed to the high RTI rates in these regions as did demographic factors and behaviors such as alcohol use. These findings can help guide interventions to reduce the burden of RTIs in Brazil.

Highlights

In recent decades middle-income countries have experienced a rapid increase in the number of cars and motorcycles
Motorcyclists contributed to the high road traffic injuries (RTI) rates in these regions as did demographic factors and behaviors such as alcohol use
These findings can help guide interventions to reduce the burden of RTIs in Brazil

Summary

Introduction

In recent decades middle-income countries have experienced a rapid increase in the number of cars and motorcycles. In recent decades in Brazil there has been an increase in the motorization rates of cars and motorcycles as a consequence of rapid economic growth This was accompanied by an increase in the average income of Brazil’s poorest population, rapid urbanization, and economic measures to encourage the production of cars and motorcycles. Car production increased by 315 % during that period [5] These factors have shifted the mobility pattern of Brazil’s low and middle-income populations from public to private transport [6]. The effects of this rapid increase in motorization in Brazil include increased traffic congestion, environmental pollution, and injuries and deaths due to road traffic crashes [7,8,9]

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