Epidemiology and risk of road traffic mortality in South Africa

In view of the large and increasing road traffic fatality burden in South Africa, this study describes the distribution of the risk of fatal road traffic injuries according to population and rural-urban characteristics in the country, between 2002 and 2006. Two different exposure-based rates relating to population counts and vehicle ownership were calculated to quantify and explicate traffic fatality risk. Demographic, road user and temporal characteristics were examined, as were a number of measures relating to the geography of road traffic fatality risk, which has not been previously examined for South Africa. Geographical analysis was undertaken at the District Council Municipality (DC) census level where four area-based measures of rurality were computed: percentage rural population, average population size (of Main Place census areas within each DC), crude population density and person-weighted population density. There were substantial variations in risk associated with population, temporal and seasonal characteristics, and measures of rurality. Some large rural-urban disparities that differed by road user categories and also by the measures used to quantify risk and to define rurality, were apparent between the DCs. The findings provide new insights on the distribution of road traffic fatalities in South Africa that should guide intervention strategies targeted at addressing this considerable public health challenge.