Geographic Variations in Mortality from Motor Vehicle Crashes

TLDR

Differences in road characteristics, travel speeds, seat‑belt use, vehicle types, and emergency care availability may explain geographic mortality disparities. The authors calculated population‑based death rates for motor vehicle occupants from 1979‑1981 and mapped them by county across the 48 contiguous states. Mortality was highest in low‑density counties (r = −0.57) and inversely correlated with per‑capita income (r = −0.23), with rates varying over 100‑fold—from 558 per 100,000 in Esmeralda County, Nevada, to 2.5 per 100,000 in Manhattan, New York. N Engl J Med 1987; 316:1384–7.

Abstract

Using a new technique to study the mortality associated with motor vehicle crashes, we calculated population-based death rates of occupants of motor vehicles during the period 1979 through 1981 and mapped them according to county for the 48 contiguous states of the United States. Mortality was highest in counties of low population density (r = -0.57; P<0.0001) and was also inversely correlated with per capita income (r = -0.23; P<0.0001). Death rates varied more than 100-fold; for example, Esmeralda County, Nevada, with 0.2 residents per square mile (2.6 km2), had a death rate of 558 per 100,000 population, as compared with Manhattan, New York, with 64,000 residents per square mile and a death rate of 2.5 per 100,000. Differences in road characteristics, travel speeds, seat-belt use, types of vehicles, and availability of emergency care may have been major contributors to these relations. (N Engl J Med 1987; 316:1384–7.)