Fatal Injuries to Car Occupants: Analysis of Health and Population Data

In 2000 the Government set the following casualty reduction targets (from baseline 1994–98 average) to be achieved by 2010:

• A 40% reduction in the number of people killed or seriously injured in road accidents;

• A 50% reduction in the number of children killed or seriously injured in road accidents; and

• A 10% reduction in the slight casualty rate, expressed as the number of people slightly injured per 100 million vehicle kilometres.

In 2002, an additional target was set to reduce casualties in deprived areas of England more rapidly than in England as a whole by 2005, compared with the baseline average for 1999–2001.

The first and second three-year reviews of the Government’s road safety strategy and targets for 2010 indicate that progress towards meeting the targets is good. However, the previous picture of fatality trends following those of serious casualties no longer applies, and since the mid-1990s the two trends have diverged, with the annual number of deaths falling more slowly. The number of deaths began to rise again in 2001 and 2003, before falling in 2004 and 2005. If the current trend continues, fatalities will only reduce to about 19% below the 1994–98 baseline by 2010.

It is against this background that the Department for Transport commissioned a research programme to investigate trends in fatal car-occupant accidents by examining a wide range of factors that may explain the trends, including accident characteristics, survivability of crashes, changes in exposure, and changes in risk affected by characteristics such as licence holding and the types of vehicles driven.

The road safety casualty reduction targets are based on police data. However, in addition to this data, health data can provide insights into the role medical care plays in the survivability of road accidents and, because the line between death and very serious injury is a fine one, it is instructive to look at health data trends in severe casualties to see if they mirror some of the patterns of fatal casualties. Population data can provide information on mortality and social class in order to explore whether a social gradient class exists for car-occupant fatalities.