Worldwide, injuries from motor vehicles represent a significant public health challenge, in both developed and developing nations. Of particular concern is the forecasted increase in global road traffic injuries (RTIs), as increases in urban density and the number of automobiles outstrips the capacity of existing human resources and transport infrastructure. Concerted efforts at injury prevention from a population health perspective, including investments in road infrastructure and changes to social policy, are likely to reap greater health benefits than could be realized by using a downstream approach to RTI control, ostensibly at the site of trauma care. However, present models of RTI deterrence too often rely on describing prevention initiatives, with little attention paid to informing and supporting health and social policy. A theoretical model which combines the determinants of global road traffic injury, estimates of risk exposure, and the cost effectiveness of interventions would provide a semblance of clarity not yet achieved in current road safety practice. Drawing on the extant injury research literature, this paper will examine the theoretical and applied basis of RTI control, to support the development of an evidence-based model of global RTI prevention. The specific research objectives for the current study are as follows: (1) To provide an overview of the global burden of RTI in developed and developing nations; (2) To review the current research literature regarding the determinants of RTI; (3) To describe the significant theoretical developments in RTI control; (4) To examine the development of the Haddon matrix and its application to evidence-based policy initiatives; (5) To describe a modified version of the original Haddon matrix that incorporates prevalence data, risk assessment, and estimates of cost effectiveness in support of evidence-based policy decisions. The paper will culminate with three worked examples of the evidence-based revision of Haddon's matrix, using RTI prevention data from Australia, Norway and Ghana. The utility of the revised tool for policy decision-making will also be discussed. (A). For the covering abstract of the conference see E216632.
Abstract