Pan American Health Organization

Health Status of the Population

Road traffic injuries

In the Americas, road traffic injuries killed 154,089 people in 2013, accounting for 12% of road traffic deaths worldwide. There has been a 3% increase in road traffic deaths, rising from 149,357 deaths in 2010. Road traffic deaths are higher in middle-income countries (73%) compared to high-income countries (26%), with a disproportionately high percentage of deaths relative to the level of motorization: 37% and 63% for middle-income and high-income countries, respectively. The Regional road traffic death rate is 15.9 per 100,000 population, which is lower than the global rate of 17.4. However, numbers vary significantly from country to country, with national rates ranging from a low of 6.0 in Canada to a high of 29.3 per 100,000 population in the Dominican Republic (see Figure 1).

Figure 1. Estimated road traffic death rates (per 100,000 population), by country, Region of the Americas, 2013


Source: Pan American Health Organization. Road safety in the Americas. Washington, D.C.: PAHO; 2013.

Vulnerable road users make up 45% of all road traffic deaths in the Region, broken down by category as pedestrians (22%), motorcyclists (20%), and cyclists (3%). The exception is North America (Canada and the United States of America), where deaths among car occupants (not vulnerable road users) are highest, 65%. Additionally, there was a 5% increase in the Region in motorcyclist deaths between 2010 (15%) and 2013 (20%). The data vary among vulnerable road users in all subregions. In the Latin Caribbean, 47% of road deaths occur among motorcyclists, while this rate is 23% in the Andean subregion and 25% in the Southern Cone. Among vulnerable road users, the proportion of pedestrian casualties is higher in Mesoamerica (34%), followed by the Andean subregion (29%) and the Non-Latin Caribbean (28%) (see Figure 2).

Figure 2. Proportion of reported road traffic deaths, by type of road user and subregion, Region of the Americas, 2013


Source: Pan American Health Organization. Road safety in the Americas. Washington, D.C.: PAHO; 2013.

Many countries suffer from underreporting of road traffic deaths and require quality data to better characterize the social determinants of road traffic injuries. Regionally, 21% of road traffic deaths fall under the road user category of “other or unspecified.” At the subregional level, the Mesoamerican and Andean subregions have the highest proportion of deaths classified as “other or unspecified,” at 37% and 33%, respectively.

The Region is experiencing a rise in motorization, with a vehicle ownership rate of 502.5 per 1,000 population in 2013, an increase since 2010 (460.08 per 1,000 population). The highest rates were found among high-income countries, led by the United States (828.1) and Canada (635.7), with the lowest rates in Saint Lucia (8.6) and Guyana (19.6). The type of vehicle owned also varies among subregions. North America (Canada and the United States of America) comprises more than half of the total number of registered four-wheeled cars in the Region; 93% of the North American fleet is four-wheeled cars. In the Latin Caribbean and Andean subregions, motorized two- and three-wheeled vehicles account for 49% and 46% of the vehicle fleet, respectively.

The implementation and enforcement of road safety legislation have been proven to be effective in reducing road traffic casualties. Some countries have national legislation covering risk factors (excessive speed and drunk driving) as well as protective measures (use of motorcycle helmets, seatbelts, and child restraints). The following current regulations deal with risk factors: six countries meet the criteria for best practices related to drunk driving (blood alcohol concentration limit ≤0.05 g/dl for general population and ≤0.02 g/dl for young/novice drivers) and five countries in the Region meet legislative criteria for best practices regarding vehicle speed management, with a national urban speed limit of 50 km/h, with local authorities allowed to reduce this limit. Legislation regarding protective measures shows that seven countries meet the criteria for helmet use (having helmet laws that meet best practices and applying helmet standards); 19 countries meet the criteria for seatbelt use laws that apply to both front and rear seat passengers and are in effect at all times; and 13 countries have child-restraint legislation that meets best practices. These laws restrict children under a certain age from sitting in the front seat, based on age, weight, and/or height.

As motorization increases in the Region, walking and cycling have become less common and more dangerous. The traffic mix in many countries causes pedestrians and cyclists to share the road with high-speed vehicles, forcing them to negotiate dangerous situations and fast-moving traffic. In the Region, 16 countries have policies in place that promote walking or cycling. Furthermore, 12 countries in the Region have enacted policies to promote development of separate lanes for vulnerable road users.

In response to the current toll of road traffic deaths in the Americas, PAHO is coordinating Regional efforts to reduce the burden of road traffic injuries through a range of multisectoral collaborations and initiatives. PAHO continues to provide technical support for the development of national plans, legislation improvements, publications, and monitoring and evaluation. For more information, please visit the PAHO website on road safety.

Regional Office for the Americas of the World Health Organization
525 Twenty-third Street, N.W., Washington, D.C. 20037, United States of America