The National Road Safety Strategy 2011—2020 stipulates that by 2020, Australia should aim to achieve a 30% reduction in the number of serious injuries and deaths on our roads each year. 1 People in rural and remote areas are significantly overrepresented in these numbers, meaning that road safety in the bush should be a particular focus for policymakers and researchers. The rate of serious road-related injury among those living outside major cities is nearly twice that of those living within them. 2 Country people are also more than three times more likely to die as a result of a transport accident than their city cousins. 3 The difference in outcomes for city and country people is particularly marked among young men; the death rate in transport-related accidents for young men aged 20—24 years living in the country is nearly four times higher than it is for those in the city. 4 These startling statistics can be attributed to a combination of factors, such as vehicle and road characteristics, transport habits, perceptions of risk and law enforcement rates. In country areas, for example, road conditions are more varied. Compared with urban areas, there are more dirt roads, more hazardous roadsides and generally poorer road geometry. There is a greater likelihood of colliding with livestock and wildlife, and more heavy agriculture and mining vehicles on the road. People in rural and remote areas also tend to travel longer distances than city people, and this places them at higher risk of fatigue and accidents. They generally travel at higher speeds and, as a consequence, have a greater risk of serious injury or fatality in the event of a crash. 5,6 They also tend to travel in vehicles that are not as safe as those used by city people. The lower socioeconomic status of people in rural and remote areas may mean that they own older vehicles (meaning fewer safety features), and may give vehicle maintenance a lower priority. The poorer condition of country roads also contributes to faster rates of deterioration of vehicles. Research data demonstrate just how substantial the differences are between country and city when it comes to road safety. In one study, for example, researchers found that the ratio of fatal crashes in rural areas compared with urban areas in Queensland was: • 12.1 times higher for fatigue-related crashes • 5.2 times higher for crashes where the victim was not wearing a seatbelt • 4.7 times higher for speed-related crashes and • 4.3 times higher for alcohol-related crashes. 5 Crashes in remote areas are also more likely to involve an unlicensed driver/rider. This in part reflects the lower levels of licence ownership. 7 Research also shows that there is much that can be done to improve road safety in rural and remote areas. Improvements to the physical features of rural roads, such as removing roadside hazards and having clearer road markings, have been shown to reduce the frequency and severity of rural road crashes. Expanding public and community transport options can provide a safe alternative to drink driving, driving without a license and driving while fatigued, and prevent vehicle overcrowding — all factors that contribute to road accidents. Ensuring that education programs are tailored to the specific needs of rural and remote people, and delivered through channels by which they normally receive their messages, is another important way of reducing risk behaviours, particularly among young men. Investment in better roads also has the potential to have a direct impact on rural people’s access to the health system, and therefore their health and wellbeing. With better roads, country people will be able to get to primary care and rehabilitation services more easily, and this may lead to better chronic disease prevention and management for people in the bush. With better roads, patient retrievals and patient transfers between facilities and the supply of essential medicines and equipment will all be quicker, and this may contribute to better health outcomes for acutely unwell people. Improving road infrastructure also has the potential to make it easier for health professionals to get to country areas — for example, locums and drive-in, driveout workers — and therefore may help address the chronic workforce shortages in rural and remote Australia. The Senate Standing Committee on Rural and Regional Affairs and Transport is currently holding an inquiry into aspects of road safety in Australia. The National Rural Health Alliance will make a submission to the inquiry and closely monitor its implications for the people of rural and remote Australia. (Author/publisher)
Samenvatting