The purpose of this study was to examine whether residents born overseas had higher rates of death and hospital separation due to road crashes than those born in Australia. This study followed earlier research into the driving behaviour among women in Australia, where the self reported rate of motor vehicle accidents was significantly higher among those born in a non-English speaking country (BNESC), (Dobson, Brown, Ball, Powers & McFadden, 1999).
The study categorised those born overseas according to language of country of birth (English speaking, non-English speaking) and road convention in country of birth (left hand side, right hand side). Classification by language replicated the categorisation in the earlier study noted above. The cultural differences between Australia and non-English speaking countries are likely to be greater than those between Australia and other English speaking countries and these may contribute to differences in involvement in road crashes. A more obvious contributor to road safety outcomes concerns the road convention in the country of origin. Obviously, those familiar with traffic travelling on the left hand side of the road will have less difficulty in adapting to Australian conditions than those familiar with travel on the right hand side.
Data on deaths that occurred in Australia between 1994 and 1997 and hospital separations that occurred in New South Wales between 1 July 1995 and 30 June 1997 due to road crashes were analysed. The rates of death and hospital separation for various migrant groups adjusted for age and area of residence (country versus city) were calculated, using population data from the 1996 census.
There is no evidence to suggest that overseas born drivers are more likely than Australian born drivers to be involved in crashes resulting in death or serious injury. Overall, the mortality and hospital separation rates for those born overseas tended to be equal to or better than those for Australian drivers. In particular, female drivers born overseas tend to have lower rates of hospitalisation regardless of language or road convention. Male drivers from English speaking countries or those that drive on the left hand side of the road also have lower rates.
The most concerning results of the study were with respect to pedestrians. Pedestrians born in other English speaking and non-English speaking countries where the convention is to drive on the left hand side of the road were equally safe or safer than Australian born pedestrians. On the other hand, pedestrians born in countries with a right side driving convention were at significantly greater risk of being hospitalised or dying on the road relative to Australian born pedestrians. Road convention appears to have a greater influence on pedestrian safety than language in country of origin.
The difference in risk for the overseas born and locally born population is greatest for the 60 years and over age groups. Those in this age group who were born in countries that drive on the right hand side have at least 10 times the risk of being killed or injured as pedestrians when compared to the Australian born. The actual impact of this increased risk is exacerbated by demographic patterns. Pedestrian casualties for the overseas born comprised more older people than for the Australian born. Of the pedestrian deaths involving those from countries driving on the right hand side of the road 70% were 60 years of age or older compared to 32% for Australian born. The difference for hospital separations is less marked but in the same direction.
Results for passengers are of less interest as passengers rarely influence crash outcomes. The results suggest that males born overseas are under represented as passengers in terms of hospital admissions. In contrast female passengers are over represented in both deaths and hospital admissions when these women are from non-English speaking countries or from those that drive on the right hand side. This finding probably reflects differences in travel patterns for these groups.
These results rely on the assumption that driver licence rates, passenger behaviour and pedestrian activity are the same for both overseas and locally born residents. For example, if people born overseas are less likely to hold a licence the number of road crashes per 100,000 population could appear low while the number per licensed driver is actually as high or higher than that for Australian born drivers. Similarly if one group of pedestrians travels further, then their greater exposure to injury is not reflected in the rate of death or injury per capita.
It is of concern that while overseas born drivers are not over represented in trauma statistics, overseas born pedestrians clearly are. The reason for this may in part lie with the influence of spatial indicators on road related behaviour. Regardless of the side of the road on which traffic travels, there are various spatial cues which assist the driver. In the first place, the driver is always seated closest to the centre line of the road. Travelling with the driver adjacent to the curb is a clear indication that something is wrong. Furthermore, if a driver inadvertently strays to the wrong side of the road, oncoming traffic will be seen approaching directly prompting avoidance manoeuvres. Pedestrians lack such spatial cues to guide their behaviour. The pedestrian who looks the wrong way will be struck by a car that is not seen or even anticipated.
It is probable that pedestrian behaviour (looking to the left or to the right) is learnt at an early age and may be difficult to change. Certainly, educational material could be directed to increase public awareness of the issue for those most at risk. There is an obvious place for appropriate community based organisations to play a lead role in any communication strategy.
On the basis of these findings, it would appear that if the relative safety of those born in countries that drive on the right hand side of the road could be improved to match those born in Australia then 34 pedestrian lives would be saved each year and many more hospital admissions avoided. This is approximately a 10% reduction in the total pedestrian road toll for 2000.
The study categorised those born overseas according to language of country of birth (English speaking, non-English speaking) and road convention in country of birth (left hand side, right hand side). Classification by language replicated the categorisation in the earlier study noted above. The cultural differences between Australia and non-English speaking countries are likely to be greater than those between Australia and other English speaking countries and these may contribute to differences in involvement in road crashes. A more obvious contributor to road safety outcomes concerns the road convention in the country of origin. Obviously, those familiar with traffic travelling on the left hand side of the road will have less difficulty in adapting to Australian conditions than those familiar with travel on the right hand side.
Data on deaths that occurred in Australia between 1994 and 1997 and hospital separations that occurred in New South Wales between 1 July 1995 and 30 June 1997 due to road crashes were analysed. The rates of death and hospital separation for various migrant groups adjusted for age and area of residence (country versus city) were calculated, using population data from the 1996 census.
There is no evidence to suggest that overseas born drivers are more likely than Australian born drivers to be involved in crashes resulting in death or serious injury. Overall, the mortality and hospital separation rates for those born overseas tended to be equal to or better than those for Australian drivers. In particular, female drivers born overseas tend to have lower rates of hospitalisation regardless of language or road convention. Male drivers from English speaking countries or those that drive on the left hand side of the road also have lower rates.
The most concerning results of the study were with respect to pedestrians. Pedestrians born in other English speaking and non-English speaking countries where the convention is to drive on the left hand side of the road were equally safe or safer than Australian born pedestrians. On the other hand, pedestrians born in countries with a right side driving convention were at significantly greater risk of being hospitalised or dying on the road relative to Australian born pedestrians. Road convention appears to have a greater influence on pedestrian safety than language in country of origin.
The difference in risk for the overseas born and locally born population is greatest for the 60 years and over age groups. Those in this age group who were born in countries that drive on the right hand side have at least 10 times the risk of being killed or injured as pedestrians when compared to the Australian born. The actual impact of this increased risk is exacerbated by demographic patterns. Pedestrian casualties for the overseas born comprised more older people than for the Australian born. Of the pedestrian deaths involving those from countries driving on the right hand side of the road 70% were 60 years of age or older compared to 32% for Australian born. The difference for hospital separations is less marked but in the same direction.
Results for passengers are of less interest as passengers rarely influence crash outcomes. The results suggest that males born overseas are under represented as passengers in terms of hospital admissions. In contrast female passengers are over represented in both deaths and hospital admissions when these women are from non-English speaking countries or from those that drive on the right hand side. This finding probably reflects differences in travel patterns for these groups.
These results rely on the assumption that driver licence rates, passenger behaviour and pedestrian activity are the same for both overseas and locally born residents. For example, if people born overseas are less likely to hold a licence the number of road crashes per 100,000 population could appear low while the number per licensed driver is actually as high or higher than that for Australian born drivers. Similarly if one group of pedestrians travels further, then their greater exposure to injury is not reflected in the rate of death or injury per capita.
It is of concern that while overseas born drivers are not over represented in trauma statistics, overseas born pedestrians clearly are. The reason for this may in part lie with the influence of spatial indicators on road related behaviour. Regardless of the side of the road on which traffic travels, there are various spatial cues which assist the driver. In the first place, the driver is always seated closest to the centre line of the road. Travelling with the driver adjacent to the curb is a clear indication that something is wrong. Furthermore, if a driver inadvertently strays to the wrong side of the road, oncoming traffic will be seen approaching directly prompting avoidance manoeuvres. Pedestrians lack such spatial cues to guide their behaviour. The pedestrian who looks the wrong way will be struck by a car that is not seen or even anticipated.
It is probable that pedestrian behaviour (looking to the left or to the right) is learnt at an early age and may be difficult to change. Certainly, educational material could be directed to increase public awareness of the issue for those most at risk. There is an obvious place for appropriate community based organisations to play a lead role in any communication strategy.
On the basis of these findings, it would appear that if the relative safety of those born in countries that drive on the right hand side of the road could be improved to match those born in Australia then 34 pedestrian lives would be saved each year and many more hospital admissions avoided. This is approximately a 10% reduction in the total pedestrian road toll for 2000.
No comments:
Post a Comment