Road safety should be treated as public health problem

Among men, road injury was the third individual cause of health loss in 2016 as against the tenth leading cause in 1990. Non-communicable diseases and injuries are contributing to overall disease burden. There is rapid urbanisation and more traffic on the roads is a reality that cannot be wished away.

Written by Anuradha Mascarenhas | Published: December 5, 2017 1:20 pm
Among men, road injury was the third individual cause of health loss in 2016 as against the tenth leading cause in 1990. Among men, road injury was the third individual cause of health loss in 2016 as against the tenth leading cause in 1990.

A recent fact sheet from the World Health Organisation revealed that nearly half of those dying on the world’s roads were ‘vulnerable road users’ – which are pedestrians, cyclists, and motorcyclists. Road injuries caused 65 per cent more ill health, disabilities and early deaths in 2016 than they did in 1990.

From minor scrapes and cuts, low back muscle sprains to head injuries, the highest proportion of the disease burden due to road mishaps is in young adults. Road injuries are now ranked as the 10th leading individual cause of health loss in 2016, according to a government report that had 200 health scientists across 103 institutions in the country providing estimates of which disease caused the most burden in each state.

This effort was part of the India State-level Disease Burden initiative that was launched in October 2015 between the Indian Council of Medical Research, Public Health Foundation of India, and the Institute for Health Metrics and Evaluation. Released recently and published in The Lancet, experts have concluded that the leading individual cause of death in India in 2016 was ischaemic heart disease.

Poor health from disabling conditions due to road injuries has affected more men than women and despite the World Health Organisation recommending a safe system approach to road safety by ensuring a safe transport system for road users, little seems to have been done. Rankings for road injuries has climbed to the tenth leading individual cause of health loss in 2016 up from the 16th position in 1990.

Among men, road injury was the third individual cause of health loss in 2016 as against the tenth leading cause in 1990. While measures such as footpaths, cycling lanes, safe crossing points and others are crucial to eliminating fatal crashes and serious injuries among road users, Jammu & Kashmir, Uttarakhand, Haryana, and Punjab seem to have borne the worst brunt of losing healthy and productive years to these injuries. They have registered 1,200 disability-adjusted life years (DALYs) per lakh population and coming to a tad close to this group of states include Rajasthan, Manipur, Andhra Pradesh, Uttar Pradesh and Tamil Nadu where the DALY rate estimated due to road injuries was between 1,050 and 1,199 per lakh population. The DALY rate due to road injuries was estimated between 900 and 1,049 per lakh population in MP, Gujarat, Maharashtra, Odisha, and Jharkhand while it was lowest between 750 and 899 per lakh population in Delhi, Bihar, Tripura and Goa. In Assam, it was lower than 600.

Among the most common reasons given for these mishaps range from drunken driving, over speeding, not tying seat belts, potholes in the roads, driving in the wrong lane and others. Several campaigns have been undertaken to make roads safe, but precious lives continue to be lost.

You fall in a pothole or I do, everyone somewhere is going through this and numbers are telling us that it is a huge problem, asserts Prof Rakhi Dandona who is the Chairperson of Global Burden of Disease –Road Injuries group for the India State-level Disease Burden initiative. He said what is required is a change in the mindset.

In 2006, Dandona and other experts in the Medical Journal of India highlighted the gaps to make road safety even visible as a public health problem to policymakers in the country. There is a traditional view of human error as a major cause of road crashes. But this only pinpoints the lack of a scientific public health approach towards preventing such mishaps. A decade later, more data is being generated even more effectively to drive home the magnitude and impact of road injuries so that policymakers can intervene and reduce the high burden of mortality and morbidity due to road crashes.

Over the last 26 years, the country’s disease patterns have shifted: mortality due to communicable, maternal, neonatal, and nutritional diseases has declined and India’s population is living longer. Non-communicable diseases and injuries are contributing to overall disease burden. There is rapid urbanisation and more traffic on the roads is a reality that cannot be wished away.

The first global Decade of Action for Road Safety 2011-2020 has had several governments stepping up their commitment to saving lives on their roads. In the next three years, can a country with a population of 1.34 billion spread across 29 states and seven Union territories, focus on strengthening the three Es – Engineering, Education, and Enforcement then to fix roads and help save lives.

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