Publication Details

The burden of traffic crashes on Appalachia: An overlooked health disparity in the region

Type: conferencePapers

Author(s): Harmon, Katherine J.; Kumfer, Wes

Pages: A1.1-A1

Publisher: BMJ Publishing Group Ltd

Url: http://injuryprevention.bmj.com/lookup/doi/10.1136/injuryprev-2020-savir.1

Publication Date: May-2020

Doi: 10.1136/injuryprev-2020-savir.1

Abstract: Statement of Purpose: The Appalachian Region (AR) has a higher premature fatality rate than the rest of the United States (US). While disparities related to chronic disease and other health conditions in Appalachia are well-described, an overlooked contributor to premature mortality are traffic crashes. Therefore, there is a need to examine the epidemiology of traffic fatalities in Appalachia and compare to the non-Appalachian US. Methods/Approach: We obtained 2013-2017 data from the Fatality Analysis Reporting System for the Appalachian and non-Appalachian US by county. To characterize differences between Appalachian and non-Appalachian counties, we calculated population-based fatality rates and rate ratios using multivariate Poisson regression. We also compared differences in crash characteristics using logistic regression.Results For the period 2013-2017, the traffic fatality rate was 22% higher in the AR than in the non-AR (aRR: 1.22, 95% CI: 1.21-1.24). Traffic fatality rates were higher across all age groups and genders. Compared to non-Appalachian counties, the AR had higher fatality rates among motor vehicle occupants (aRR: 1.36. 95% CI 1.33-1.38) and motorcyclists (aRR: 1.16, 95% CI: 1.11-1.21), but lower rates among non-motorists (aRR: 0.75, 95% CI: 0.72-0.79).  Appalachian fatalities were more likely to have been in a vehicle >20 years old (OR: 1.28, 95% CI: 1.20-1.36) and to not have been wearing a seatbelt at the time of crash (OR: 1.31, 95% CI: 1.26-1.36); however, fatalities were less likely to have been in an alcohol-involved crash compared to non-Appalachian fatalities (OR: 0.66, 95% CI: 0.63-0.69). Conclusion: Appalachia has a higher burden of traffic fatalities than the rest of the US. While more research is needed, potential explanatory factors include vehicle age and lack of seatbelt use.  Significance/Contribution to Injury and Violence Prevention Science: This is one of the first studies to perform an examination of the epidemiology of Appalachian traffic fatalities.

Conference name: Society for the Advancement of Violence and Injury Research (SAVIR) 2020 conference abstracts

Conference_proceedings_title: Oral Presentations