Linking transportation and population health to reduce racial and ethnic disparities in transportation injury: Implications for practice and policy

In both developing and advanced economies, it is commonly believed that lower income and minority populations are disproportionately at risk of being injured or killed in a motor vehicle crash, especially as pedestrians. However, this risk is rarely quantified with information about exposure. We argue that a combined transportation–population health framework is one way to quantify, and therefore prioritize, equity considerations in transportation safety decision-making. We illustrate this approach with an analysis that compares age-adjusted fatal and nonfatal injury rates per 100 million person-trips by race/ethnicity and sex for motor vehicle occupants, bicyclists, and pedestrians. We found that, per trip, whites are equally safe as pedestrians and motor vehicle occupants, whereas other racial and ethnic groups for whom we have data are less safe when they walk. In addition, black/African-American female motor vehicle occupants and pedestrians have higher inpatient injury risk than female travelers of other races and ethnicities (for whom we had sufficient data). Such differences in transportation injury risk by race and ethnicity warrant deeper analysis to understand the underlying reasons, such as whether certain groups of travelers are exposed to qualitatively different hazards when they travel. We discuss frameworks for including information about injury disparities in decision-making.