Road Safety in the

Americas
Dr. Alberto Concha-
Eastman PAHO / WHO
Washington, DC
http://www.paho.org
http://www.who.int/violence_injury
_prevention/en/
conchaal@paho.org
 Content
1. Highlights of the WHO & WB World
Report on Road Traffic Injuries
Prevention

2. The magnitude of the problem in the

Americas as of 2003- Mortality, injuries,
risk factors, who are affected

3. Priority areas for policy in LAC and

PAHO/WHO recommendations

4. Bogota case
WRRTIP
5 chapters:
concepts,
global burden,
determinants,
interventions,
conclusions &
recommendations
The majority of road traffic injuries occur in low-
and middle-income countries
 Most injured are vulnerable road users

Netherlands

Japan

Norw ay

Australia

U.S.A.

Malaysia

Thailand

Colombo, Sri Lanka

Bandung, Indonesia

Delhi, India

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Pedestrians Bicyclists Motorized 2-wheelers Motorized 4-wheelers Other

Road safety is a shared responsibility

GOVERNMENT &
LEGISLATIVE BODIES

USERS / CITIZENS
MEDIA

ROAD INJURY
INDUSTRY
PREVENTION POLICY
PROFESSIONALS

POLICE AND DMV NGOs, SPECIAL

INTEREST GROUPS
Road traffic injuries are a public health problem

Public Health

Injury Surveillance Advocacy

Research Services

Prevention & Control Policy

Evaluation
WORLD HEALTH DAY 2004 AT PAHO/WHO HQ IN DC
The Road Traffic Injury Problem in the
Americas
• Fatalities: estimated 133,783 people
in 2002.
• Ranked as the 10th leading cause of
death in the region.
• 7th leading cause of DALYs lost.
• Number of injured: estimated at 1.2
million people.
• Economic and social costs
• Alcohol related: 30% - 45%
Sources: World Health Organization/World Bank, World report on road traffic injury prevention,
prevention, 2004. Source for road traffic injuries was
Constance, P., The preventable plague, IDBAmérica Magazine,
Magazine, January-February 2000.
 Road traffic fatalities (per 100,000) in the Americas, by level
of risk, latest available year
Range of fatality rates Countries
(per 100,000)
< 10.0 (Low risk) Anguilla, Argentina, Bolivia, Canada, Chile, Dominica,
Haiti*, Nicaragua, Paraguay, Saint Kitts and Nevis, Saint
Vincent and the Grenadines
10.0-20.0 (Medium Antigua and Barbuda, Aruba, Bermuda, Brazil, Cayman
risk) Islands, Colombia, Costa Rica, Cuba, Dominican
Republic, Ecuador, El Salvador, Honduras, Jamaica,
Mexico, Panama, Peru, Puerto Rico, Saint Lucia, Trinidad
and Tobago, United States, Uruguay, Virgin Islands (UK)
> 20.0 (High risk) Bahamas, Belize, Guatemala, Guyana, Venezuela

* It is likely number of fatality cases for Haiti was underreported.

 Age specific death rates from motor vehicle traffic accidents.
Brazil, 2000

45
rate per 100,000 population

40
35
30
25
20
15
10
5
0
<1 1_4 5_14 15_24 25_44 45_64 65 over
age group

Both Male Female

Source: Health Analysis and Information Systems Area. Deaths from motor vehicle traffic accidents in selected
countries of the Americas. PAHO Epidemiological Bulletin. Vol. 25 (1): 2-5, 2004.
 Motor vehicle-related fatal injuries by victim
Cali – Colombia. 1993 – 2002 – in percentages

Victim/ 93 94 95 96 97 98 99 00 01 02

Year
Pedestria 49.5 43.3 48.8 47.4 42.1 48.1 44.4 42.1 52.6 48.9
ns
Motorcyc 23.6 33.4 33.5 29.0 30.1 26.7 26.8 31.0 20.0 26.8
list
Occupant 6.9 15.1 11.0 15.3 17.6 13.8 19.3 15.2 12.6 11.9

Cyclists 6.9 8.0 6.3 8.1 9.8 11.1 8.7 11.5 12.6 12.4

Source: CISALVA, PAHO/WHO CC

 Type of road user as a proportion of all road
traffic fatalities+ in the Americas, latest
available year
Canada
Colombia
Costa Rica
El Salvador
Jamaica
Mexico*
Saint Lucia
Trinidad and Tobago
United States*

0% 20% 40% 60% 80% 100%

Pedestrians Drivers Passengers

Cyclists Motorcyclists Other/Not specified

+ Road user categories were not uniform across all country data.
* Data for Mexico and the United States did not differentiate between drivers and passengers. “Drivers” bar for these two countries corresponds to the total of drivers and passenger fatalities.
Sources: Data compiled from the following sources. Canada, 2002—Canadian Motor Vehicle Traffic Collision Statistics 2002, http://www.tc.gc.ca/roadsafety/tp/tp3322/2002/page3.htm;
http://www.tc.gc.ca/roadsafety/tp/tp3322/2002/page3.htm;
Colombia, 2002—Instituto Nacional de Medicina Legal; Costa Rica, 2003—INEC; El Salvador, 2003—National Police; Jamaica, 2003—Ministry of Health (original figures from National Police
Headquarters); Mexico, 2000—Consejo Nacional de Prevención de Accidentes; Saint Lucia, 2001—Royal St. Lucia Police Force (Traffic Department); Trinidad and Tobago, Office of the
Commissioner of Police; United States, 2002—NHTSA.
 Gender as a proportion of all road traffic
fatalities, Americas, 2000

100%
90%
80%
70%
60%
Female
50%
Male
40%
30%
20%
10%
0%
l* a a a * a a a * a
tina raz i m bi R ic ub dor aic agu am eru* uel
n C u a P nez
r ge B olo s ta c J am ic ar Pan
A C C o E N Ve

Sources: see tables that follow.

 Road traffic fatality rates (per 100,000
population), by gender and age group in the
Americas, 2002
40.0
35.0
30.0
25.0
Male
20.0
Female
15.0
10.0
5.0
0.0
0-4 5-14 15-29 30-44 45-59 60 and
over

Source: WHO Global Burden of Disease project, 2002, Version 1.

 World Health Day / Week, 2004

Risk factors:

• Everybody is at risk
• Being migrant from rural to urban
• Illiteracy: difficulty to understand “urban codes”
• Drinking and driving

Pan American
Health
Organization
2004
Recommendations applicable to all
countries
• Speed
• Alcohol
• Seat belts
and infants
rear seats
• Helmets
• Visibility

Pan American
Health
Organization
2004
 WHO / PAHO main message for policy
implications

Road crashes are

another form of
social inequality

Pan American
Health
Organization
2004
 WHO / PAHO main message for policy
implications

Road safety is a
public policy issue:
leadership is
required
Pan American
Health
Organization
2004
 Road safety areas of work
Legislation and policy
- ALCOHOL CONTROL
- Protection and care of
victims
- Improve Insurance
coverage
- Law enforcement
Pan American
Health
Organization
2004
 Road safety

- A successful case:
Bogotá, Colombia, 10
years of continued
multisectorial
approach
Pan American
Health
Organization
2004
 Public Policies on Road safety in Bogota
1995-2003
Aim: influencing positive changes on people
behavior

1. Mayor’s leadership. Road safety is not only a

“public health and traffic concern” but people
behavior related:
Media messages and testimony

2. Gather reliable and timely data and encourage

research

3. Work intersectorially
Pan American
Health
Organization
2004
 Public Policies on Road safety in Bogota
1995-2003
Aim: influencing positive changes on people
behavior

4. Alcohol consumption control.

•Early closing of bars and the like.
•Drunk drivers control and
punishment
•“Designated driver” sustained
campaigns

5. Public space recovery for pedestrians

Pan American
Health
Organization
2004

and
 Public Policies on Road safety in
Bogota 1995-2003
Aim: influencing positive changes on people
behavior

6. Firing corrupted traffic police

officers.

7. Development of a new public

transportation system: Transmilenio.

8. Designated new lanes for cyclists

Pan American
Health
Organization
2004
 Public Policies on Road safety in Bogota
1995-2003 –
Aim: influencing positive changes on people
behavior

9. Mimes and civic guides (Misión Bogotá)

(focused on pedestrians crossing and seat belt use).

10. Restricted vehicles at rush hour

11. One day with no private cars” on the streets

12. Critical spots highlighted

13. Accountability and public scrutiny of public policies

(media involvement)
Pan American
Health
Organization
2004
PUBLIC SPACE RECOVERY

BEFORE
PUBLIC SPACE RECOVERY

AFTER
PUBLIC SPACE RECOVERY

BEFORE
 AFTER
PUBLIC SPACE RECOVERY
 BEFORE

PUBLIC SPACE RECOVERY

PUBLIC SPACE RECOVERY

AFTER
MAIN TRANSMILENIO ROAD: OUTCOMES AFTER
ONE YEAR from 2000 to 2001
1600
TRANSMILENIO
1352
1400

1200
YEAR 2000

1000 936
832
800

600

400 260
238
190
200 95
2001

67
4 4
0
Crashes Pedestrians Injured Killed Muggings
Hit by cars
Fuente: Medicina Legal y Policía Metropolitana
 WHO / PAHO main message

Road crashes are

preventable

Then ….
Pan American
Health
Organization
2004
 WHO / PAHO main message

Our common goal is:

To reduce mortality,
injuries and
disabilities
Pan American
Health
Organization
2004
WHO / PAHO main messages

FOR SAFER ROADS

IN THE AMERICAS
LET US WORK
TOGETHER

THANKS