The impact of rurality on child road traffic death in high-income countries

Abstract

Introduction: Despite the importance of child road traffic death, a limited number of studies have investigated rural child road traffic death in high income countries.

Objective: This review estimated the impact of rurality on child road traffic deaths and other potential risk factors in high-income countries.

Design: We searched Ovid, MEDLINE, CINAHL, PsycINFO and Scopus databases and extracted studies focusing on the association between rurality and child road traffic death published between 2001 and 2021. Available data were extracted and analysed, to evaluate the impact of rurality on child road traffic death and explore other risk factors of child road traffic deaths.

Findings: We identified 13 studies for child road traffic death between 2001 and 2021. Eight studies reported the impact of rurality on child road traffic death, and all of them alleged that the mortality rate and injury rate of children was significantly higher on rural road than on urban road. The impact of rurality varied between studies, from 1.6 times to 15 times higher incidence of road traffic death in rural areas. Vehicle type, speeding cars, driver loss of control, alcohol and drug use road environment were identified as risk factors of child road traffic death. Conversely, ethnicity, seat belts, nondeployed airbag, child restraint, strict driver licence system, camera law and accessibility of trauma centres were considered protective factors. Other factors, including age, gender and teen passengers, appeared ambiguous for child road traffic death.

Discussion: Rurality is one of the most important risk factors of child road traffic death. Therefore, we should consider the impact that rurality has on child road death and resolve the gap between rural and urban areas in order to prevent child road traffic death effectively.

Conclusion: The findings of this literature review will assist policy-makers to prevent child road traffic death by focusing on rural regions.

Keywords: countryside; regional; remote; traffic accident; traffic incidence.