12.23.2019  /  PHFI Team
First comprehensive population-level estimates of road injury deaths by type of road users in each state of India
  • With 2.2 lakh road injury deaths in India in 2017, it was the leading cause of premature death among young males in India and the second leading cause for males and females combined.
  • Pedestrians and motorcyclists accounted for about two-thirds of all road injury deaths in India, and the death rate for motorcyclists and cyclists was higher in India than the global average.
  • The road injury death rate for various types of road users, including pedestrians, motorcyclists, cyclists and motor vehicle occupants, varied 4-8 fold between the states of India, highlighting the need for specific road safety planning in each state.
  • There has been a modest reduction in road injury death rate in India since 1990, but a much higher death rate reduction is needed to meet the SDG target.
  • Evidence-based road safety interventions, multi-sectorial approaches, stronger law enforcement, and ability of the health system to deal with injuries need to be strengthened across India.

New Delhi, 23 December 2019: The India State-Level Disease Burden Initiative released the first comprehensive population estimates of road injury deaths by type of road users in each state of India. The findings published in The Lancet Public Health present road injury deaths for different road users and by age and sex across the states of India. The research paper findings show that road injury was the leading cause of death in India among 15-39 year old males in 2017 and was the second leading cause for both sexes combined. More than half of all road injury deaths in India in 2017 were among pedestrians and motorcyclists. If the estimated trends of road injury deaths up to 2017 were to continue, no state in India is likely to meet the SDG 2020 target of reducing the road injury deaths by half from 2015 to 2020 or even by 2030.

On the release of these findings, Prof Vinod K. Paul, Hon’ble Member NITI Aayog said, “Road Injury is an economic and societal burden. Deaths from road injuries are preventable with stringent implementation of laws and policies by State Governments and implementing agencies. Ensuring timely access to healthcare services for road injury victims, post-crash care, augmenting the health system and co-ordination amongst the enforcement and implementation agencies can reduce the large burden India is facing. The 2030 Agenda for Sustainable Development has set an ambitious target of halving the global number of deaths and injuries from road traffic crashes by 2020 and our country will have to make strident efforts and implement systems to reduce the road death rate further.”

Prof Balram Bhargav, Secretary to the Government of India, Department of Health Research, Ministry of Health & Family Welfare, and Director General, ICMR said, “The number of deaths due to road injury in India is quite high. This research paper focuses on providing reliable and comprehensive data in the Indian context to inform and monitor progress to reduce the burden of road injury deaths. Comprehensive findings on road injuries from this study will not only facilitate effective road safety management but would also aid in building effective road injury prevention policies, evidence-based interventions and increase surveillance of road injuries at the state-level after diagnosing and analysing the causes of injuries. Efforts must be taken at all levels to reduce the burden from road injury deaths that our country is facing.”

Detailing the findings, the lead author of the study Prof Rakhi Dandona, Professor at the Public Health Foundation of India said, “India had 2.2 lakh deaths due to road injuries in 2017. Rapid urbanisation and economic growth in India has led to substantial increases in vehicle density and traffic mix but the infrastructure and levels of traffic law enforcement are struggling to keep pace with it, resulting in increased number of road injury deaths. Road injury needs multi-sectorial action across three levels— to prevent crashes from occurring, to prevent injury if a crash occurs, and then to prevent death or disability among those injured. For this to happen, we need to move from the fatalistic attitude conveyed by ‘accident’ to prevent this needless loss of lives. Road safety for pedestrians, motorcyclists, and cyclists needs to be prioritised to ensure that the youth of our country do not face untimely death.”

Dr Hendrik J Bekedam, WHO Representative to India said, “The study findings show that road injury is the leading cause of death in young men. The passage of the Motor Vehicles (Amendment) Act, 2019 is a landmark step by the Government of India that recognizes the significance of the matter and the urgency to act. Implementation is the key to ensure that people are safe on roads. Awareness campaigns to change road user behaviour combined with effective reinforcement and further analysis of key risk factors to inform policy and action will be crucial to improve road safety in India.”

Prof K Srinath Reddy, President, Public Health Foundation of India said, “Road traffic injuries are an entirely man made epidemic which should be eliminated through a mix of good public administration for providing better roads with good lighting, strong laws and regulations with strict enforcement and penalties for violations, public education on safe practices and sane civic conduct. The fact that we are markedly off track for the 2020 target set by the SDGs sounds the siren for accelerating actions to improve road safety and putting the brakes on the deadly and disabling dangers that befall pedestrians, cyclists, motorcyclists and automobile occupants.”

Prof Christopher J L Murray said, “India’s public health community cannot ignore these high death rates among cyclists and motorcyclists. Health policy makers, transportation officials, and other key stakeholders must work collaboratively to address this problem.”

The findings reported in the paper published today are part of the Global Burden of Disease Study 2017. The analytical methods of this study have been refined over two decades of scientific work, which has been reported in over 16,000 peer-reviewed publications, making it the most widely used approach globally for disease burden estimation. These methods enable standardized comparisons of the health loss caused by different diseases and risk factors, between different geographies, sexes, and age groups, and over time in a unified framework. A key metric used for this comparison is disability-adjusted life years (DALYs), which are the sum of the number of years of life lost due to premature death and a weighted measure of the years lived with disability due to a disease or injury.

Scientific paper published today:

India State-Level Disease Burden Initiative Road Injury Deaths Collaborators. Mortality due to road injuries in the states of India: the Global Burden of Disease Study 1990–2017. Lancet Public Health. 23 December 2019
http://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(19)30246-4/fulltext

Key findings from the research paper:

  • Of the total 219,000 road injury deaths in India in 2017, 77% were in males with the death rate three times higher compared to females.
  • Motorcyclist and cyclist road injury death rate were 69% and 33% higher in India compared to the global average.
  • Pedestrian road injury deaths were highest among older adults in India.
  • The road traffic injury death rate was relatively higher in the less developed states compared to more developed states. This rate reduced significantly in more developed states from 1990 to 2017 but did not change in the less developed states.
  • If the estimated trends of road injury deaths up to 2017 were to continue, none of the Indian states are likely to meet the SDG 2020 target of reducing the road injury deaths by half from 2015 to 2020 or even by 2030.
  • Road Injury death rate in males varied 3 fold across the states of India with the highest rates in the states of Uttarakhand, Punjab, Tamil Nadu, Jammu and Kashmir and Himachal Pradesh. The variations between the states for road injury death rates among the different types of road users were even higher at 4-8 fold.
  • The highest road injury death rates among females were in the states of Manipur, Jharkhand and Punjab.
  • Appropriate measures such as promoting evidence-based interventions, enforcing strong policies and stringent traffic laws will reduce the road injury deaths, which could help India achieve the SDG 2020 target at least by 2030.
  • More attention to reduce the vulnerable road user injury deaths (pedestrians, motorcyclists, and cyclists) in India is expected following the recent enactment of the Motor Vehicle Act 2019 that imposes strict penalties against traffic violations which is expected to facilitate better monitoring of road injury events.
  • Evidence-based road safety interventions, multi-sectorial approaches, strong policies, law enforcement and enhancing the role of the health system to deal with injuries are needed in each state of India to meet the SDG target of reducing road injury deaths.

These persons could be contacted for discussion on the findings and their implications:

Prof Balram Bhargava, Indian Council of Medical Research, New Delhi
Prof Rakhi Dandona, Public Health Foundation of India, Gurugram
Prof Gopalkrishna Gururaj, National Institute of Mental Health and Neuro Sciences, Bengaluru
Prof Rajesh Malhotra, All India Institute of Medical Sciences, New Delhi
Prof J S Thakur, Post Graduate Institute of Medical Education and Research, Chandigarh
Dr Hendrik J Bekedam, WHO India Country Office, New Delhi
Mr Amar Srivastava, Indian Road Safety Campaign, Gurugram
Dr R S Dhaliwal, Indian Council of Medical Research, New Delhi

About the India State-Level Disease Burden Initiative

The India State-Level Disease Burden Initiative is a collaborative effort between the Indian Council of Medical Research (ICMR), Public Health Foundation of India (PHFI), Institute for Health Metrics and Evaluation (IHME), and a number of other key stakeholders in India, including academic experts and institutions, government agencies and other organizations, under the aegis of the Ministry of Health & Family Welfare. About 300 leading scientists and experts representing close to 100 institutions across India are engaged with this collaborative work. The work of this Initiative is overseen by an Advisory Board consisting of eminent policymakers and involves extensive engagement of 16 domain expert groups with the estimation process. The Health Ministry Screening Committee at the Indian Council of Medical Research and the ethics committee of the Public Health Foundation of India approved the work of the India State-Level Disease Burden initiative.

The first set of findings by the India State-Level Disease Burden Initiative on the variations in epidemiological transition across the states of India were presented in a Report released by the Vice- President and Health Minister of India and in a scientific paper published in The Lancet in November 2017:

The Initiative has subsequently published detailed topic-specific papers in the Lancet journals in 2018 and 2019 on the state-level trends of cardiovascular diseases, diabetes, chronic respiratory diseases, cancer, suicide, air pollution, and malnutrition as well as a commentary in The Lancet on the relevance of these findings for health policy in India:

The Indian Council of Medical Research (ICMR), is the apex government body in India for the formulation, coordination and promotion of biomedical and health research. It is one of the oldest medical research bodies in the world. Besides the headquarters in New Delhi, ICMR has 26 research institutes, centres and units across India. ICMR funds both intramural and extramural research in India. The priorities of ICMR coincide with the national health priorities and have the goal of reducing the total burden of disease and to promote health and well-being of India’s population. As part of this agenda, ICMR is interested in improving the estimates of disease burden and risk factors in India, especially at the sub-national levels, for better health planning, policy framing and fund allocation. For more information please visit http://www.icmr.nic.in

The Public Health Foundation of India (PHFI) is a premier public health institution in India with presence across the country. It collaborates with multiple constituencies including Indian and international academia, state and central governments, multi- and bi-lateral agencies, and civil society groups. The vision of PHFI is to strengthen India’s public health institutional and systems capability and provide knowledge to achieve better health outcomes for all through strengthening training, research and policy development in public health. As part of this vision, PHFI has major interest in improving the robustness of sub-national disease burden estimates to inform health action and in evaluating the impact of large-scale population health interventions. For more information please visit www.phfi.org

The Institute for Health Metrics and Evaluation (IHME) is a global research institute at the University of Washington in Seattle that provides independent, rigorous, and comparable measurement of the world’s most important health problems and evaluates the strategies used to address them. IHME aims to identify the best strategies to build a healthier world by measuring health, tracking program performance, finding ways to maximize health system impact and developing innovative measurement systems to provide a foundation for informed decision-making that will ultimately allocate resources to best improve population health. For more information please visit www.healthdata.org

For more information, please contact:

Indian Council of Medical Research
Mr. Syed Adil Shamim Andrabi
syed.adil@icmr.gov.in
Mobile: +91 9599332718

Public Health Foundation of India
Ms. Gina Sharma
gina.sharma@phfi.org
Mobile: +91 9811887088

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