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Australian Indigenous HealthBulletin
 
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spacing1Summary of road safety among Indigenous peoples

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Introduction

There were around 1,600 road deaths in Australia in 2007 [1] and over 30,000 serious injuries in 2005-06 [2]. This means that approximately every 22 minutes someone is killed or seriously injured on Australia's roads. The government estimates that the cost of road crashes is around $18 billion per year [3]. This includes hospital and medical costs and working hours lost.

In Australia from 2001 to 2006, Indigenous people had a higher rate of injury and death from road accidents than non-Indigenous people [4].

Impact of road injury

Road injury affects the community in many different ways. Apart from the direct physical effects of road injury (deaths and injuries), there are also the psychological effects of a road accident, such as grief and depression, as families try to cope with the death or disability of a family member [5].
Other consequences of road injuries:

Not a lot of research has been done in the area of Indigenous road safety until quite recently. Just how many Indigenous people are affected by road injuries has been hard to determine, for two main reasons:

Usually, unless a person is identified as being Indigenous, they are automatically classified as non-Indigenous. This means that Indigenous people are not always properly identified, which leads to a lower number of Indigenous people counted in road crashes than actually are involved. It is possible that identification of Indigenous status may be better in remote areas than in urban areas [6].

Western Australia, South Australia, the Northern Territory and Queensland are the only four states where reporting of Indigenous status is believed to be fairly accurate [4]. However, for the reasons given above, the actual numbers could be up to 30% higher than the numbers reported. The numbers used in this section are as published, not altered to account for this possible under-reporting.

Mortality

The leading causes of death from transport injury for Indigenous people are:

Table 1: Numbers of Indigenous and non-Indigenous deaths from transport injuries for WA, SA, NT and Qld (2001-02 to 2005-06)
Cause of injury Indigenous Non-Indigenous
Number % Number %

Source: [4]
* Small counts were omitted from original source so some columns may not add up
** Other transport includes water and air transport

Land transport 337 96.8 3215 91.1
Motor-vehicle crashes
204 58.6 2531 71.7
Pedestrians
117 33.6 408 11.6
Other land transport*
5 1.4 274 7.7
Unspecified
11 3.2 117 3.3
Other** transport - - 198 5.7
All transport 348 100 3530 100

Motor vehicle crashes

Greater proportions of Indigenous people (26%) than non-Indigenous people (9%) die from crashes where only one vehicle is involved (such as roll-overs) [4].

Pedestrians

For every non-Indigenous pedestrian who is killed there will be at least 9 Indigenous pedestrians who die. The numbers are higher for Indigenous pedestrians in every age group particularly those aged 35 to 54 years (see Table 2).

Table 2: Age-specific death rates* for motor-vehicle crashes and pedestrian deaths, by Indigenous status, and rate ratios,** for WA, SA, NT and Qld 2001-02 to 2005-06

Age group (years)

Motor-vehicle crashes Pedestrian incidents
Indigenous rate Non-Indigenous rate Rate ratio Indigenous rate Non-Indigenous rate Rate ratio

Source: [4]
* Rates are per 100,000 population
** The ‘rate ratio’ is the Indigenous rate divided by the non-Indigenous rate

0-4
7.8 2.9 2.7 6.7 0.7 9.6
5-14
5.8 4.7 1.2 4.4 1.8 2.4
15-24
93.1 60.1 1.6 19.7 5.3 3.7
25-34 70.8 108.6 0.7 31.5 3.6 8.8
35-44 82.7 24.1 3.4 74.7 2.8 26.7
45-54 56.9 39 1.5 57 2.9 19.7
55-64 57.7 22.1 2.6 33 4 8.3
65+ 37.3 12.9 2.9 20.8 3.7 5.6
All ages 25.3 13.4 1.9 14.5 1.9 7.6

Crash statistics collected over 20 years show that pedestrian deaths and single vehicle crashes have continued to cause the greatest number of Indigenous deaths relating to road transport [4][7][8][9][10][11].

Hospitalisation

The most recent information published on Indigenous people sent to hospital because of transport accidents is from 2001-02 to 2005-06 [4]. The information is collected only from WA, SA, the NT and Qld because these are the only states where Indigenous status is properly identified. Sixty percent of the Indigenous population of Australia and 38% of the total Australian population live in these states.

The data show that 4,938 Indigenous people were hospitalised during this period due to land transport injuries (3,338 males and 1600 females). Thirty five of these people died while in hospital (0.7%). Indigenous people who were sent to hospital were mostly:

For Indigenous people in car accidents, passengers were more often seriously injured or killed than drivers. By contrast, non-Indigenous drivers were more often injured or killed than passengers.

Factors contributing to road injury

Possible reasons for the difference in number of road injuries between Indigenous and non-Indigenous people are as follows:

These commitments often require travelling long distances during times of stress, to places where roads are rough and hard on vehicles. Due to the high cost of travel, large numbers of people often travel together in older vehicles not suited to rough roads or to carrying many people at once [12].

The following sections describe the factors that may lead to road injury, grouped according to whether they are human, environmental or vehicle factors. A separate section summarises factors that may play a part after the crash (post-crash factors).

Human factors

The main human factors involved in road crashes include:

For Indigenous drivers, in particular, the main human factors involved are:

Environmental factors

The following environmental factors relate particularly to rural and remote areas of Australia:

Table 3: Land transport deaths of Indigenous people by remoteness area of residence (cases): NT, WA, SA and Qld, 2001-02
Area of residence Male Female % Indigenous cases
per remoteness area
Source: [4]
Major cities 35 13 3%
Inner regional 22 7 3%
Outer regional 18 22 6%
Remote 35 24 25%
Very remote 114 43 64%
Total 227 116 9%

Vehicle factors

Vehicle-related crashes are those that have been caused (or partly caused) by the poor condition of the vehicle. There is no evidence that vehicle-related factors cause more Indigenous road crashes than non-Indigenous road crashes, but vehicles in poor condition are certainly more involved in crashes in rural and remote Australia than in urban areas [13][7]. It has been suggested that people of lower socioeconomic status (on lower incomes or unemployed) are more likely to have cars that are older and in poor condition [13][12].

Risk factors after the crash

When crashes occur in rural and remote areas, emergency responses (ambulance and police) are slower because of the large distances [16]. As well, Indigenous people in rural areas are less likely to use mainstream health care services even when they are available [13]. This may be due to:

Prevention and management in Indigenous road safety

The development of programs and projects to help prevent road crashes and injuries depend on a very good understanding of the factors contributing to road injuries. In an effort to improve Indigenous road safety, various governments have attempted to improve:

Most community-based Indigenous road safety programs that have been created, aim to educate people about:

In the past, most Indigenous road safety programs have not been designed by Indigenous people [13]. Now, however, it is understood that the best road safety programs for Indigenous Australians are those that are led by a community-based road safety educator and involve consultation with Indigenous people, group work and ‘hands-on' learning [9].

Since 2000, several states have developed road safety programs and resources that are aimed at the Indigenous population, most of which have been developed using advice from Aboriginal community members.

Examples include:

For detailed information on these resources, please see the HealthInfoNet road safety promotion resources page

Although a greater proportion of road crashes occur in rural areas, not many road safety policies and interventions have been designed specifically for rural and remote populations and problems [16]. The main reasons for this are:

One of the few studies looking at rural and remote road safety was done in 2003. It aimed to find out what causes serious road rural crashes in northern Queensland. The Rural and Remote Road Safety Research Program was a joint program between the Centre for Accident Research and Road Safety - Queensland (CARRS-Q) and the Rural Health Research Unit (RHRU) at James Cook University. This program developed recommendations to improve rural and remote road safety in four main areas:

  1. human factors - such as recommendations for drivers and motorcyclists and specific recommendations for Indigenous people
  2. environmental factors - such as recommendations for speed limits and emergency services
  3. data collection - more is needed
  4. educational programs [17]

Safe system principles

Human, environmental, and vehicle factors (discussed above) all have an impact on road safety so that approaches to improving road safety should include all three factors [3].

The Safe System is a ‘complete' approach to improving road safety by looking at the overall management of the system rather than the separate parts. This requires cooperation between groups such as transport agencies, urban planners, environmental agencies, industry and regional development organisations [3].

The Safe System approach promotes a better understanding of how all the different parts of the road system work together:

Linking different activities from all areas of road safety will hopefully result in fewer deaths and injuries [18]. Road users still need to be responsible for their own safety under the Safe Systems approach - no matter how good a road is, crashes will still happen if the users do not follow the rules. But if people are aware of the risks associated with road travel they are able to make better decisions about their own behaviour.

Australia's approach to road safety improvement is based on the theory of the Safe System. However, there is still much to be done to make the Safe System a part of regular practice [3].

Policies and strategies

Road safety strategies and policies are mostly run by states, territories and local governments, which conduct their own road safety programs.
The Federal Government is responsible for:

National Road Safety Strategy 2001-2010

In November 2000, Australia adopted the National Road Safety Strategy 2001-2010. This strategy provides a plan for all levels of government (federal, state/territory and local governments) and other organisations involved in road safety to work together [5]. The main aim of the strategy is to reduce the annual number of road deaths by 40%, from 9.3 per 100,000 people in 1999 to no more than 5.6 in 2010.

The Australian Transport Safety Bureau develops Road Safety Action Plans every two years. These Action Plans have specific targets that can be measured, and will help to achieve the objectives of the National Road Safety Strategy 2001-2010 [5]. For example, one target is to add centre lines to major undivided rural roads, another is to increase random drug testing. The action plans are reviewed at the end of each two-year period.

The National Road Safety Action Plan: 2009 and 2010 is the final two-year plan to come out of the 2001-2010 strategy. The plan:

The National Road Safety Strategy 2001-2010 recognises road safety for Indigenous people as a particular concern [20].

Indigenous road safety forum

The Federal Department of Infrastructure, Transport, Regional Development and Local Government, with assistance from the states and territories, holds an Indigenous road safety forum once every two years. The Forum aims to improve on ideas and programs in Indigenous road safety. People attending this forum are from organisations that play an important role in Indigenous road safety, from federal, state and territory transport, health, safety, police, and sport and cultural affairs agencies.

The 4th Indigenous Road Safety Forum, in Cairns, Queensland, in October 2008, provided an opportunity for people to share ideas and experiences, and to help communities introduce practical solutions to Indigenous road safety problems.

The forum included these topics:

This forum, as with previous forums, noted that although national data on Indigenous road safety is not very accurate or complete, the numbers suggest that the rate of Indigenous road deaths is much higher than the non-Indigenous rate.

The forum included workshops on:

The thoughts and ideas that came out of these workshops will be considered by the Indigenous Road Safety Working Group. The same Working Group will also check on whether recommendations from the forum are put into practice.

There have been no published recommendations from the forum, however a progress report on the recommendations from the 3rd Indigenous Road Safety Forum held in Broome in 2006 is available.

Concluding comments

Reducing the number of road injuries in the Indigenous community requires prevention and management programs. To be successful, these programs need strong leadership and a good working relationship between different areas and levels of government. The transportation sector (who are directly responsible for road safety) will need to work closely with the police, local government, the health sector and other relevant groups .

In addition, the Indigenous community will need to play a key role in developing and running programs and projects to improve Indigenous road safety.

References

  1. Department of Infrastructure Transport Regional Development and Local Government (2008) Road deaths Australia: 2007 statistical summary. Canberra: Australian Government
  2. Harrison JE, Berry JG (2008) Serious injury due to transport accidents, Australia, 2005–06. Adelaide: Research Centre for Injury Studies
  3. Australian Transport Council (2008) National road safety action plan 2009 and 2010. Canberra: Australian Transport Council
  4. Harrison JE, Berry JG (2008) Injury of Aboriginal and Torres Strait Islander people due to transport, 2001-02 to 2005-06. Canberra: Australian Institute of Health and Welfare
  5. Australian Transport Safety Bureau (2004) Road safety in Australia: a publication commemorating World Health Day 2004: Indigenous people. In: Road safety in Australia: a publication commemorating World Health Day 2004. Canberra: Australian Transport Safety Bureau: 228-233
  6. Australian Institute of Health and Welfare (2007) Rural, regional and remote health: a study on mortality (2nd edition). Canberra: Australian Institute of Health and Welfare
  7. Centre for Accident Research and Road Safety - Queensland (CARRS-Q) (2006) Rural and remote road safety research project: five year crash and area profile of North Queensland. Brisbane: Centre for Accident Research and Road Safety - Queensland (CARRS-Q)
  8. Berry JG, Nearmy DM, Harrison JE (2007) Injury of Aboriginal and Torres Strait Islander people due to transport, 1999-00 to 2003-04. Canberra: Australian Institute of Health and Welfare
  9. Styles TO, Edmonston C (2006) Australian Indigenous road safety: 2005 update. Canberra: Australian Transport Safety Bureau
  10. Cercarelli L (1999) Road crash hospitalisations and deaths in Western Australia involving Aboriginal and non-Aboriginal people, 1988 to 1996. Perth: Department of Public Health, The University of Western Australia
  11. Lehoczky S, Isaacs J, Grayson N, Hargreaves J (2002) Hospital statistics: Aboriginal and Torres Strait Islander Australians, 1999-2000. Canberra: Australian Bureau of Statistics and Australian Institute of Health and Welfare
  12. Helps YLM, Moller J, Kowanko I, Harrison JE, O’Donnell K, de Crespigny C (2008) Aboriginal people travelling well: issues of safety, transport and health. Canberra: Department of Infrastructure, Transport, Regional Development and Local Government
  13. Macaulay J, Thomas R, Mabbot N, Styles T, Edmonston C, Sheehan M, Schonfeld C (2003) Australian Indigenous road safety: contract report. Vermont South, Victoria: ARRB Transport Research
  14. Tiong FCK (1997) Involvement of South Australian Aboriginal people in road traffic crashes 1989-1996. Adelaide: Transport South Australia
  15. Harrison J, Miller E, Weeramanthri T, Wakerman J, Barnes T (2001) Information sources for injury prevention among Indigenous Australians: status and prospects for improvements. Canberra: Australian Institute of Health and Welfare
  16. Centre for Accident Research and Road Safety - Queensland (CARRS-Q) (2008) Rural and remote road safety research program: major recommendations. Brisbane: Centre for Accident Research and Road Safety - Queensland (CARRS-Q)
  17. Vicroads arrive alive (2008) Arrive alive: towards a safe system. Retrieved 4 Mar 2008 from http://www.arrivealive.vic.gov.au/about/towards_a_safe_system/towards_a_safe_system.html
  18. Australian Transport Safety Bureau (2004) Summary of outcomes from 2004 Indigenous Road Safety Forum. Retrieved from http://www.infrastructure.gov.au/roads/safety/indigenous_road_safety/summary_indig_forum.aspx
  19. Australian Transport Council (2000) National Road Safety Strategy 2001-2010. Canberra: Australian Transport Council
  20. Thomson N, ed. (2003) The health of Indigenous Australians. South Melbourne: Oxford University Press

© Australian Indigenous HealthInfoNet 2013 
This product, excluding the Australian Indigenous HealthInfoNet logo, artwork, and any material owned by a third party or protected by a trademark, has been released under a Creative Commons BY-NC-ND 3.0 (CC BY-NC-ND 3.0) licence. Excluded material owned by third parties may include, for example, design and layout, images obtained under licence from third parties and signatures.

 

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    Last updated: 8 July 2009
     
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