Safe mobility, socioeconomic inequalities, and aging: a 12-year multilevel interrupted timeseries analysis of road traffic death rates in a Latin American country

Abstract

As the resources for road safety in developing countries are scarce and unevenly distributed, vulnerable road users-such as the elderly- may be particularly at risk of road traffic deaths. To date, the impact of road safety measures over the rate of road traffic deaths in older adults (60 years or older), considering the within-country socioeconomic inequalities, has not been explored in developing nations. This study takes the Chilean case as an example -with its 2005 traffic law reform as one of the road safety measures investigated-, in which open data available from official national sources for all its 13 regions over the 2002-2013 period were used for a multilevel interrupted time-series analysis. A statistically significant secular reduction of the rates of road traffic deaths in the elderly population was found (incidence rate ratio [IRR] 0.95, 95% confidence interval [CI] 0.91 to 0.99), but no evidence for a significant intercept or slope change after the traffic law reform was observed. Regions with the highest number of traffic offenses prosecuted in local police courts had lower rates of road traffic deaths in older adults (IRR 0.95, 95% CI 0.90 to 1.00), and those regions in the third (IRR 1.61, 95% CI 1.16 to 2.25) and the fifth (IRR 1.66, 95% CI 1.08 to 2.54) quintiles of socioeconomic deprivation had higher rates of road traffic deaths in the elderly. Such findings strongly support the conceptualization of the road safety of seniors in developing countries as a social equity issue, with implications for the design of traffic regulations and road environments.