(The carnage wrought by major economic change: ecological study of traffic related mortality and the reunification of Germany)
(Commentary: Road deaths in European countries)
(World Bank must do more to develop safe and sustainable transportation systems)
Based on the experiences of the reunification of Germany, researchers in this week's BMJ warn that during times of economic change and modernisation, deaths and injuries from road traffic accidents are a predictable side-effect of the sudden affluence which increases car ownership.
Dr Flaura Winston from The Children's Hospital of Philadelphia and University of Pennsylvania along with colleagues analysed deaths from car accidents in East and West Germany from 1985 to 1996 - ie both before and after reunification. After reunification, which caused a sudden, temporary affluence there was an associated four-fold increase in car accident fatalities between 1989-91.
The age group most affected, find Winston et al, was 18-24 year olds - death rates in 18-20 year olds increased eleven-fold during this period and eightfold in the 21-24 age group.
The authors conclude that a tragic consequence of the reunification of Germany was the dramatic increase in death rates of car occupants. They say that sudden economic change and availability of cars resulted in both a rise in vehicle ownership and an increase in the number of inexperienced drivers on roads that were ill prepared for the increased traffic.
Dr Winston and colleagues report that although modernisation of underdeveloped nations and their economies is ultimately beneficial, it can prove fatal without appropriate injury prevention measures. They say that public health and medical communities must take the lead in ensuring that economic change does not adversely affect the health and safety of the public.
Also see accompanying commentary to this paper by Professor Mark McCarthy and letter by Dr Ian Roberts.
Contact:
Dr Flaura K. Winston MD, PhD, Director, TraumaLink, The Children's Hospital of Philadelphia, Assistant Professor of Pediatrics, The University of Pennsylvania, 34th Street and Civic Center Boulevard, Abramson Pediatric Research Center, Suite 706, Philadelphia, PA 19104, USA flaura@mail.med.upenn.edu
Professor Mark McCarthy, Department of Epidemiology and Public Health, University College London Medical School, London m.mccarthy@ucl.ac.uk
Dr Ian Roberts, Director, Child Health Monitoring Unit, Department of Epidemiology and Public health, Institute of Child Health, London ian.roberts@ich.ucl.ac.uk