Motor-Vehicle-Related Deaths Will Increase, Study Predicts
By Matthew L Wald Ashington
April 7, 2004
The New York Times
Motor vehicle crashes kill about 1.2 million people a year worldwide, and the number will rise to more than 2 million in 2020 unless new steps are taken, according to a study being released Wednesday by the World Health Organization and the World Bank.
The study predicts that road-traffic injuries will rise to the third largest cause of death and disability by 2020 — after heart disease and depression — from the ninth in 1990. One of the reasons it ranks so high is that many of the victims are young, which amplifies the loss of productivity and quality of life.
"All over the world, economic development is leading to more cars and more roads, but we've forgotten to match that with more safety," Dr. Étienne Krug, director of the department for injuries and violence prevention at the World Health Organization, said in an interview here.
Dr. Krug attributed the problem to "fatalism, and ignorance of how big the problem is and what can be done about it."
Attention to road safety varies widely, according to the study, so much so that the authors acknowledged that they had little idea about how many people were injured. The estimates ranged from 20 million to 50 million a year, they said. But an earlier W.H.O. study showed that almost one-quarter of those who sought medical attention from a clinic or hospital after a traffic accident were suffering from brain injuries.
The study said that road crashes should be ranked with cancer, heart disease and stroke as major threats to public health. The organization, an affiliate of the United Nations, issued its last major report on the subject more than 40 years ago.
The death and injury toll is directly related to poverty, according to the study, which predicts that between 2000 and 2020, motor-vehicle-related deaths will decline by 30 percent in high-income countries but increase 80 percent in poor ones.
In China, for example, road-traffic deaths more than tripled between 1975 and 1998, according to a study cited by the authors.
For 2000, the study put the death rate at 11.8 per 100,000 people in high-income countries, compared with 26.1 in Latin America and the Caribbean, 19.2 in the Middle East and North Africa and 19.0 in Eastern Europe and Central Asia.
The developing world has 20 percent of the cars but 80 percent of the dead, Dr. Krug said.
The study, mostly a compilation of smaller studies conducted around the world, points out that especially in low-income countries the victims are often pedestrians and cyclists and other people not in vehicles. In India, more than half of the dead were pedestrians; in the United States, less than 15 percent were, and 80 percent of the dead were in cars and trucks.
Part of the problem is money, Dr. Krug said. "Clearly, to repave and redesign all the roads of India would be hugely expensive," he explained. But he also noted that most cars already have seat belts and that enforcing laws against drunken driving is not very expensive.
In Thailand, he said, more than one-third of the deaths involve motorcyclists, most of whom do not wear helmets. Helmets are not expensive, he said, and helmet laws are easy to enforce.
Not all the hazard is from cars and trucks. Motorized two-wheelers and three-wheelers, like rickshaws and jitneys, make up 95 percent of motor vehicles in Vietnam. The study gave examples of steps taken to reduce deaths, like limitations on the size of motorcycle engines that beginners are allowed to ride and the installation of road devices designed to absorb shock when hit by a car. It also recommended a variety of other steps, including better land-use planning to reduce the need to travel.
