Abstract
Road traffic injury (RTI) is a frequently overlooked issue in the literature of global health. This perspective examines the ways in which wealth inequality exacerbates RTI risk characterization in the specific model of Vietnam. The framework of the Equality-Sustainability Hypothesis, as suggested by Cushing et. al, is used, with a specific focus on three factors: political misrepresentation, discrepancy in consumption intensity, and lack of social cohesion. Policies regarding helmet coverage, healthcare infrastructure, road quality and social psychology are critically analyzed, with sources drawn primarily from epidemiological study designs. Such analyses provide the basis for various policy suggestions towards the end of the perspective that focus specifically on wealth inequality as the primary point of intervention. Overall, this perspective suggests that the Equality-Sustainability Hypothesis holds true in the example of RTIs in Vietnam, which is specifically referred to as a “Vehicle Gap”, and that this hypothesis be made more comprehensive by liberalizing its definition of environment to also include man-made infrastructure.
Highlights
The global issue of road safety lies at the intersection of environmental health and political economy
The standard literature already establishes that increased road traffic injury (RTI) risk and prevalence[2] in the Global South are caused by unsustainable models of economic development and rapid motorization, which is further supported by the fact that developing countries in South East Asia and Africa have the highest prevalence of RTIs and RTIs per capita, respectively[3]
Cushing et al provides a template for this analysis via the Equality-Sustainability Hypothesis, which states that inequality tends to degrade the environment and jeopardize the health of all citizens; the three ways by which this occurs is (1) disproportionate political representation, in which the poor disproportionately suffers from environmental risks due to displacement of pollution and lack of representation, (2) differences in consumption intensity, in which wealthy lifestyles and unequal purchasing capacity promote economic choices that are environmentally toxic, and (3) the undoing of social cohesion in civil society, in which erosion of trust for public institutions due to inequality subvert critical agendas for environmental protection[4]
Summary
The global issue of road safety lies at the intersection of environmental health and political economy. The correlation of both findings propose the hypothetical framework that hospitalization is an inaccessible and a financially demanding and avoided course of action, explaining the poor’s high RTI mortality in Vietnam in relation to unaffordable post-trauma care costs Such statistics support the hypothesis that those who lack the purchasing power to afford treatment are more likely to avoid hospitalization and not survive from a given accident. Through a site analysis study, Mark King notes that “centralized control over road safety expenditure [disrupts] the funding of additional traffic enforcement activities by the NTSC”13, highlighting the bureaucratic limitations on NTSC’s road safety advocacy This structural distance means that the political core misses the full scope of the issue at hand, and cannot address this inequity-based epidemic swiftly. Perhaps this bureaucracy may be needed for other purposes, but, all else being equal, it prohibits the engagement of government in an epidemiological crisis
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