Road traffic injury risk in Norway, road safety strategies and public health perspectives.

In Norway, elements of health policy have been aimed at various strategies for health risk reduction. Such strategies have to take several aspects of efficiency as well as equality into consideration. The Vision Zero, visioning zero fatal road injuries and disabilities in Norway by year 2030, introduced a new impetus in road traffic safety promotion with a strong focus on risk minimising. The aims of the study are to present some possible and partial effects of interventions for reducing road traffic injuries (casualties) in Norway in the period 1998 to 2004 and further discuss some public health consequences in a geographical perspective. Nationwide data on killed and seriously injured motorised road users within the period 1998 to 2004 are presented. Trends in injury patterns in terms of proportions and rates are presented by place of accident or place of residence. A marked decline is observed in serious injuries in densely populated areas, especially urban areas, while sparsely populated areas show only a small reduction. Elements of a geographical redistribution of risk in disfavour of sparsely populated (urban) areas emerge. The rural population experiences a higher injury rate, by sex and age-adjusted population rates. Urban-peri-urban-rural gradients and differences may be associated with broader physical risk environment factors influencing the system risk factors and possibly socio-cultural factors related to risk-taking behaviour. The proportion of crashes involving non-belted casualties and suspicion of alcohol has not been significantly reduced in the period in spite of being targeted. Risk-taking driving is mostly a rural phenomenon, and appropriate countermeasures do not seem to have achieved the demanded results. The findings are discussed in a risk-minimising and equality perspective, reflecting issues related to urban-rural tendencies to a geographical redistribution of risk and characteristics of the environment that may influence risk-taking behaviour. Some possibilities and limitations in the scope for further progress in road traffic safety promotion are outlined. (A). For thecovering abstract of the conference see E216632.