Rebecca B. Naumann

Incidence and Total Lifetime Costs of Motor Vehicle–Related Fatal and Nonfatal Injury by Road User Type, United States, 2005

Objectives: To estimate the costs of motor vehicle–related fatal and nonfatal injuries in the United States in terms of medical care and lost productivity by road user type. Methods: Incidence and cost data for 2005 were derived from several data sources. Unit costs were calculated for medical spending and productivity losses for fatal and nonfatal injuries, and unit costs were multiplied by incidence to yield total costs. Injury incidence and costs are presented by age, sex, and road user type. Results: Motor vehicle–related fatal and nonfatal injury costs exceeded

The impact of alcohol and road traffic policies on crash rates in Botswana, 2004-2011: A time-series analysis

99 billion. Costs associated with motor vehicle occupant fatal and nonfatal injuries accounted for 71 percent (

Using baseline and formative evaluation data to inform the Uganda Helmet Vaccine Initiative

70 billion) of all motor vehicle–related costs, followed by costs associated with motorcyclists (

Older adult pedestrian injuries in the United States: causes and contributing circumstances.

12 billion), pedestrians (

Injuries and the Built Environment

10 billion), and pedalcyclists (

Healthcare utilization and costs among older adult female drivers and former drivers

5 billion). Conclusions: The substantial economic and societal costs associated with these injuries and deaths reinforce the need to implement evidence-based, cost-effective strategies. Evidence-based strategies that target increasing seat belt use, increasing child safety seat use, increasing motorcyclist and pedalcyclist helmet use, and decreasing alcohol-impaired driving are available.

Disparities in Motor Vehicle–Related Deaths Among Females—United States, 2005–2009

In Botswana, increased development and motorization have brought increased road traffic-related death rates. Between 1981 and 2001, the road traffic-related death rate in Botswana more than tripled. The country has taken several steps over the last several years to address the growing burden of road traffic crashes and particularly to address the burden of alcohol-related crashes. This study examines the impact of the implementation of alcohol and road safety-related policies on crash rates, including overall crash rates, fatal crash rates, and single-vehicle nighttime fatal (SVNF) crash rates, in Botswana from 2004 to 2011. The overall crash rate declined significantly in June 2009 and June 2010, such that the overall crash rate from June 2010 to December 2011 was 22% lower than the overall crash rate from January 2004 to May 2009. Additionally, there were significant declines in average fatal crash and SVNF crash rates in early 2010. Botswanas recent crash rate reductions occurred during a time when aggressive policies and other activities (e.g., education, enforcement) were implemented to reduce alcohol consumption and improve road safety. While it is unclear which of the policies or activities contributed to these declines and to what extent, these reductions are likely the result of several, combined efforts.

The Intersection of Road Traffic Safety and Public Health

Motorcycles are an important form of transportation in Uganda, and are involved in more road traffic injuries than any other vehicle. The majority of motorcycles in Uganda are used as motorcycle taxis, better known locally as boda bodas. Research shows that a motorcycle helmet is effective at reducing a rider’s risk of death and head injury. As part of the Uganda Helmet Vaccine Initiative (UHVI), researchers collected baseline and formative evaluation data on boda boda operators’ helmet attitudes, beliefs, and behaviors to inform UHVI activities. Researchers collected data on motorcycle helmet-related attitudes and beliefs through focus group discussions and structured roadside interviews, and researchers conducted roadside observations to collect data on helmet-wearing behaviors. Of the 12,189 motorcycle operators and passengers observed during roadside observations, 30.8% of drivers and <1% of passengers were wearing helmets. The most commonly reported helmet-wearing barriers from the focus group discussions and structured roadside interviews were: (1) ‘Helmet is uncomfortable’, (2) ‘Helmet is too hot’, (3) ‘Helmet is too expensive’, and (4) ‘Helmet is of low quality’. Researchers incorporated findings from the formative research into the UHVI campaign to increase motorcycle helmet use. Radio messages addressing helmet comfort and cost were widely aired throughout Kampala, Uganda. In addition, campaign staff held nine boda boda operator workshops, covering approximately 900 operators, in which the facilitator addressed barriers and facilitators to helmet use. Each workshop participant received a high-quality tropical motorcycle helmet. UHVI will continue to use a data-driven approach to future campaign activities.

Comparing fatal alcohol-related road traffic crashes in Botswana pre- and post-passage of a national alcohol levy

As the US population ages, more older adults will face transportation and mobility challenges. This study examines the characteristics and contributing circumstances of nonfatal older adult pedestrian injuries. Data were obtained from the National Electronic Injury Surveillance System-All Injury Programme (NEISS-AIP) for the years 2001 through 2006. Cases included persons aged 65 years and older who were nonfatally injured on a public roadway. The results indicated that on average, an estimated 52,482 older adults were treated in emergency departments each year for nonfatal pedestrian injuries. Falling and being hit by a motor vehicle were the leading mechanisms of injury, resulting in 77.5% and 15.0% of older adult pedestrian injuries, respectively. More than 9000 older pedestrian fall-related injuries each year involved a kerb. It is concluded that the growth in the older adult population could add to the overall burden of these nonfatal pedestrian injuries. Making transportation and mobility improvements, including environmental modifications, is important for preventing these injuries.

Motorcycle injuries across the USA, 2001–2008: injury comparisons and projections

Injuries are not accidents. Injuries occur for identifiable reasons, many of which are related to factors in the built environment. Injuries are a major cause of death, disability, and suffering, and therefore a leading public health priority. Most injuries are preventable. Injury prevention strategies that modify the environment to reduce risk and increase safety are among the most successful. Data on environmental factors that contribute to injuries can be used in designing environments to be protective. Once environmental risk factors are identified, collaboration with planners, engineers, architects, and manufacturers is needed to produce safer designs. Engineers, city planners, policymakers, and the public need to be educated about their role in creating built environment design changes to prevent injuries.