Danger on wheels: characteristics of traffic fatality in Brazilian State capitals * Ana Carolina Soares Bertho 1 Larissa Quaglio Xavier 2 Júlia Cristo Santos Marques 2 Abstract Traffic accidents are a worldwide concern. In order to reduce the growing traffic violence, the United Nations created the Decade of Action for Road Safety 2011-2020. In Brazil, in 2013, over 42 thousand people died in traffic accidents and more than 173,000 people were injured in accidents; many were left with permanent sequelae. This study assesses how traffic accidents are affecting population in all Brazilian State capitals and in the Federal District, analyzing rates by sex, age and type of accident, analyzing the influence of per capita household income, population density and motorization rates. Traffic fatality data from Brazilian State capitals were obtained from Mortality Information System, available in Datasus website. Population and income data were taken from 2010 Demographic Census. Results show that traffic fatality rates for males are up to seven times greater than rates for females. No capital had female rates higher than 16 deaths per 100,000 inhabitants. On the other hand, no capital had male rates below 16 deaths per 100,000 inhabitants. Death rates are related to the number of motorcycles per 1,000 inhabitants and negatively related to population density. Although most of the victims were young people, mortality rates are higher for the elderly. 1 Researcher and Professor, National School of Statistical Sciences (ENCE), Brazilian Institute of Geography and Statistics (IBGE) – carolbertho@gmail.com 2 Undergraduate Student, National School of Statistical Sciences (ENCE), Brazilian Institute of Geography and Statistics (IBGE). * This paper is part of a project supported by CNPq (process 456539/2014-0). 1
Introduction Nearly 1.2 million people die each year due to traffic accidents (WHO, 2015). The number of people who die in traffic accidents in Brazil has been rising since the beginning of the year 2000 and, in 2013, more than 42 thousand Brazilians died due to this cause. Using mortality data from 2008, Chandran and colleagues (2013) showed that men had a reduction of approximately 0.8 years of life expectancy at birth due to deaths due to traffic accidents, while women had life expectancy reduced 0.2 years. The high mortality of men due to traffic accidents compared to women is not exclusive of Brazil. According to the Global Status Report on Road Safety 2015, 3 out of 4 road deaths are among men (WHO, 2015). During the last decade, the motorcycle has become a popular means of transportation among Brazilian young adults. Considered as more flexible in traffic and cheaper than the car, it has become an important asset to combat unemployment, since it enabled people to have access to jobs far from their homes and served as a working tool for people, who work as couriers. However, what seemed to be a solution has become a problem for it made users vulnerable to traffic accidents leading to fatalities (Silva et al., 2011). In developed countries, the automobile also became hegemonic, but there are differences when comparing with developing countries. In Europe, most of the population has private vehicles, but makes rational use of them, using public transport or non- motorized means. In the United States, cities are fully geared and designed for automobile use, with large roads for fast transit (called freeways) and few options for public transportation or bike paths (Vasconcellos; Carvalho; Pereira, 2011). Since 1990s, many studies (Söderlund; Zwi, 1995; Van Beeck; Kopitz; Cropper, 2005) showed the relationship between the decline in mortality from traffic accidents and improving economic conditions in developed countries. The association between increase in motorization rates (number of vehicles per thousand inhabitants) and growth in mortality from accidents is common. Nonetheless, these authors showed that at first, with the improvement of economic conditions of the population, there was an increase in the vehicle fleet and in mortality by traffic accidents. However, after reaching a certain per capita income level (which varies between US $ 3,000 and US $ 8,600 , according to the author), the mortality rates due to this cause began to decline, although the subsequent rate of motorization increased. 2
In Brazil, the car turned into "a mean of reproduction of the new middle class generated by the process of income concentration" (Vasconcellos, 2000, p.116). Without it, individuals could not satisfactorily perform the necessary displacements to do their everyday activities. For this reason, this author states that the purchase and use of the car cannot be seen as a personal decision, but rather a class decision. Since the choice for motorcycle use is conditioned by structural, mainly social, and economic issues, it would be a mistake to ignore the role of these aspects in the victimization of individuals. Based on those discussions, this study assesses how traffic accidents are affecting population in each Brazilian State capital, analyzing rates by sex, age and type of accident, analyzing the influence of per capita household income and other social characteristics on road safety. Materials and Methods In this study, data from the 26 Brazilian state capitals were used, in addition to the Federal District (Brasília). Traffic fatality data from those cities were obtained from Mortality Information System, which is processed, organized and published by the Health Ministry. To avoid random effects, the calculated averages of the deaths of the years 2009, 2010 and 2011 were used. Population data to estimate mortality rates were obtained from the 2010 Demographic Census. To calculate specific mortality rates by age, victims were aggregated in five age groups: 0 to 14 years; 15 to 29 years; 30 to 44 years; 45 to 59 years; 60 years and more. This specification is important because even though typically most victims were between 15 and 29 years-old (not only in Brazil, but also in other countries), this information is strongly influenced by the age composition of the population. Considering rates is an option to avoid bias. This evaluation is also important, because there are studies (Souza el al., 2003) that show that lethality, which means the risk of death after some injury, is three times higher for people aged 60 years or more compared to other age groups. In order to analyze types of victims based on the means of transport used at the time they had the accident, they were aggregated in four groups from ICD-10 (International Classification of Diseases 10 th Revision): Pedestrian injured in transport accident (V01-V09); pedal cyclist injured in transport accident (V10-V19); motorcycle rider (V20-V29); other victims (V30-V89), including occupants and drivers of cars, buses, trucks and pickup trucks. During the analysis process, it was necessary to add another group. A brief discussion about that issue is presented in “results and discussion”. 3
Demographic Census 2010 was used also to obtain the average household income per capita and population density for each capital. The data on the number of vehicles to calculate number of vehicles per 1,000 inhabitants and number of motorcycles per 1,000 inhabitants were obtained from the National Department of Traffic (Denatran). Results and Discussion Results show that traffic fatality rates for males are up to seven times greater than rates for females. No capital had female rates higher than 16 deaths per 100,000 inhabitants (Graphic 1). On the other hand, no capital had male rates below 16 deaths per 100,000 inhabitants. Porto Velho, the capital of the Rondônia State, presented higher rates for both men and women (57.3 and 15.5 deaths per 100,000 inhabitants, respectively). Capitals of the Northern Region of Brazil occupy the three first positions in mortality rate ranking by deaths due to traffic accidents. However, it is not possible to identify a defined pattern of mortality according to the Region. Salvador, in Bahia State, was the capital with the lowest rates (16.6 and 3.7 deaths per 100,000 inhabitants, respectively). Nevertheless, even in this case, the difference between the sexes is maintained, with 4.5 men for each woman who died because of traffic accidents. Graph 1 – Traffic fatality rates by sex per 100,000 inhabitants – Brazilian State capitals, 2010 Source: SIM/SVS/MS; Demographic Census 2010 (IBGE). 4
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