Norway has among the lowest rates of deaths per 100 000 people in road transport. Nevertheless, serious motor vehicle crashes are among the greatest avoidable toll on public health. Striking differences exist between the urban and rural death rates. The author examines national trends in injury risk due to serious private motor vehicle crashes by both place of accident and place of residence. Place of accident emphasizes local environments and site conditions with place-based and situational behaviour. Place of residence reflects vehicle occupants’ mobility and travel patterns in different areas and suggests that geographically rooted risk behaviour influences accidents. The analyses are split by urban, peri-urban, and rural types of residential area, based on population size and density. Nationwide road traffic accident data for the period 2000—2010 for private 4-wheel vehicle occupants are employed for calculating rates and proportion of casualties within and outside different types of residential area. Trends in health risks are presented in time series for motorized casualties and for males in the age group 16—24 years, by type of residential area. The proportions of casualties within versus outside their types of residential area are demonstrated. In addition, the quality of the data is discussed. Population based rates for the period 2000—2010 for all car occupants seriously injured or killed by urban, peri-urban and rural residential area are presented. In sparsely populated areas, the yearly rates fell from 24 to 17 per 100 000 population for rural residents, and from 12 to 5 for urban residents in the 10-year period. A rural to peri-urban to urban gradient was enhanced. The rate was threefold higher for rural casualties than for urban casualties. For males 16—24 years, the rates showed a smaller reduction. The proportions of rural casualties crashing in rural areas increased from 64% to 79% for all occupants in the period 2000—2010. The proportion of casualties involved in alcohol-impaired driving was stable. Absolute numbers were higher in the rural population, indicating drinking-driving dominated by rural males in rural accidents. Limitations exist in obtaining driving exposure measures in various areas. Population-based health risk differences accentuate rural areas as risk environments. Safety improvements have benefited urban areas and populations. Rural occupants’ mobility patterns imply higher mileages and speed in rural low-control system areas. (Author/publisher)
Samenvatting