Memorandum from Dr Nicola Christie, University
of Surrey (RS 65)
PART A
1. General comments about targets: (Relating
to questions 1, 3, 7 of Transports Committees Terms of References).
(a) Political advocacy for road safety is essential.
In 2002, in his Bastille Day address the French President Chirac
announced that road safety was one of the top priorities of his
new Presidential term and encouraged his Ministry of Transport,
the police, public authorities and above all the French people
to take action to promote road safety. Two years later there was
an unprecedented 20% reduction in road traffic deaths.
(b) Targets are one aspect of political support
for road safety. However, how we measure and monitor targets is
important. In particular, to help judge safety we need to take
exposure into account ie the amount of driving; walking and cycling
that is carried out so that we can understand injury rates per
unit of exposure. This is particularly important in the context
of different government agendas which are trying to encourage
walking and cycling and use of public transport. We need to be
able to ask the question: are casualty rates increasing or decreasing
because the amount of car occupancy, walking and cycling has changed?
And how has this changed among different demographic groups? We
can also monitor whether we are achieving targets because we shifting
from less vulnerable modes such as walking and cycling to becoming
more protected as car occupants (Christie et al 2007a).
(c) Other countries such as USA have "behaviour
based" targets to increase the levels of seat belt wearing
(Christie et al 2004a), perhaps these could be considered
as motivators for stakeholders.
PART B
Specific comments (Relating to questions 1,
3, 6, 7 of Transports Committee's Terms of References).
THE SOCIO-ECONOMIC
CONTEXT OF
ROAD TRAFFIC
INJURY RISK
1. Why we need a target to focus activity
on road traffic injury reduction in deprived areas?
Road traffic injury is disproportionately high
among people living in the most deprived areas in England. It
is a major cause of health inequality and the consequences of
injury and bereavement may compound deprivation. The Department
for Transport's (DfT) (2002) target to tackle the road casualty
risk of the most disadvantaged in our communities was groundbreaking
and unique among OECD countries (Christie et al 2004b).
The target led to the DfT's demonstration project The Neighbourhood
Road Safety Initiative which finished in March 2007 (Christie
and Ward 2007).
The target for reducing the rate of casualties
in deprived areas has, apparently, been met. But in practice all
this has meant is that the rate of casualty reduction in the 88
local authorities in receipt of the regeneration money was around
4% more than the national rate of casualty reduction. Large inequalities
in risk still exist and they are seen among adults and children,
and, pedestrians and car drivers (Edwards et al 2006; Ward
et al 2007 a, b). Within these communities, people from
black and minority ethnic groups are more at risk of injury than
their white counterparts (Christie 1995; Christie et al (in press);
Thomson et al 2001).
For child pedestrians we do not compare well
with other OECD countries (Christie et al 2004a) and this
may be, in part, linked to factors associated deprivation.
2. Why are the risks of road traffic injury
higher in these areas?
The risks of road traffic injury for people
living in deprived areas relate to:
(a) The quality of the environment: they are
more likely to live in older areas where the road layout (the
Victorian grid iron pattern) gives rise to high vehicle speeds,
high traffic volume and more on street parking.
(b) Greater exposure to risk: less access to
a car and being more likely to walk and means higher exposure
to hazardous environments. Children are more likely to play in
the street and less likely to have access to more safe and secure
activities and spaces.
(c) Less safe behaviour in the community: people
in deprived areas report high levels of illegal and antisocial
driving behaviour which make their environments feel unsafe (Christie
et al 2007b).
This includes illegal parking; vehicle theft
and joy riding speeding around estates in cars and on motorised
two wheelers as a recreational activity often unlicensed, untaxed
and uninsured. These drivers feature disproportionately in hit
and run collisions and police pursuits (Knox 2003; Knox et
al 2003). In addition, safety behaviours such as wearing a
seat belt are much lower than the national average in deprived
areas particularly among black and minority ethnic groups (Christie
et al in press).
3. What policy approaches are needed to address
the high risks of traffic injury in deprived areas?
We do not yet have a clear understanding of
how to address the high road traffic injury risk in deprived areas
therefore the requisite "evidence base" for policy is
not complete. At a macro level any factors which reduce poverty
and income inequality may reduce injuries. At the micro level
research into the injury risk factors for the most disadvantaged
in society suggests that the following intervention approaches
need to be considered:
(a) The policy imperative to reduce health inequalities
caused by road traffic injury must be reinstated. If targets are
claimed to be met then the focus for activity at a local level
may be lost. The implementation of policy must encourage partnerships
to adopt a holistic approach to address root cause and symptom.
(b) Engineering and traffic management are still
powerful tools to reduce casualties. Interventions that reduce
the speed and volume of traffic in these areas will reduce injuries,
improve quality of life of people and make people feel more confident
about walking and cycling.
(c) The inaccessibility of proper driving tuition
and car ownership may compound deprivation, increasing crime and
injury risk for people living in deprived communities where the
majority are law abiding. Policies which facilitate access to
proper driving tuition and legitimate car use for people in deprived
areas could be encouraged.
(d) Safe, accessible, reliable and cheap public
transport should be a priority in deprived areas.
(e) Children need safe and secure access to play
spaces and facilities such as subsidised activities and safe and
secure park facilities ie the cleaner, safer, greener agenda needs
to be more fully implemented in deprived areas.
(f) Enforcement has a role to play in reducing
illegal use of motor vehicles and increasing the uptake of safe
behaviour.
(g) Education and publicity has a role communicating
risks and providing strategies to address risks. But more needs
to be understood about how to access and communicate with the
community in its diversity and help them take an active role identifying
the problems and solutions. In this respect the role of social
marketing needs to be explored.
(h) More research is needed to understand why
there is a lower uptake of safety road safety behaviour in deprived
areas especially among different ethnic groups.
(i) A holistic partnership approach is needed
to mesh the multiple government agendas of road safety, health,
inclusion, regeneration, liveability and crime reduction to treat
both root cause and symptom and reduce casualties in deprived
areas beyond 2010.
(j) All of these policy approaches also need
to be evaluated holistically in terms casualty reduction and quality
of life especially in relation to perceived safety, the accessibility
and affordability of transport, access to recreational facilities
and safe and secure public spaces.
REFERENCES
Christie N, Kimberlee R, Lyons R A, Towner E M L
, Ward H, (in press) Ethnicity, deprivation and road traffic injury
risk: a survey of risk and road safety and implications for injury
prevention. Accepted for publication in International Journal
of Health Promotion and Education.
Christie N, Cairns S, Towner E and Ward H (2007a).
How exposure information can enhance our understanding of child
traffic "death leagues". Injury Prevention 2007;13:125-129.
Christie N, Ward H, Kimberlee R, Towner E, Sleney
J (2007b). Understanding high traffic injury risks for children
in low socioeconomic areas: a qualitative study of parents' views.
Injury Prevention 2007;13:394-397; doi:10.1136/ip.2007.016659
Christie, N and Ward, H (2007). The Neighbourhood
Road Safety Initiative: Evaluation of the UK Government's response
to high road traffic injury risk in deprived communities. African
safety promotion: a journal of injury and violence prevention.
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Christie, N, Towner, E, Cairns, S, and Ward H (2004a)
Children's road traffic safety: an international survey of policy
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Christie, N, Towner, E, Cairns, S, and Ward H (2004b).
Children's road safety: international lessons for the UK. Road
Research Report No 50. Department for Transport.
Christie, N (1995). The high-risk child pedestrian:
socio-economic and environmental factors in their accidents. TRL
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Edwards, P, Roberts, I, Green, J, Lutchmun, S (2006)
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Knox, D, Turner, B, Silcock, D, Beuret, K, and Metha,
Jasel. 2003. Road Safety Research Report No 48: Research into
Unlicensed Driving—Final Report. DfT: London.
Knox, Duncan. (2003). Road Safety Research Report
No 38: Research Into Unlicensed Driving—Literature Review.
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Thomson, J A, Tolmie, A K, & Mamoon, T P (2001,
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Ward, H, Christie, N, Lyons, R, Broughton, J, Clarke,
D, and Ward P(2007a Trends in fatal car-occupant accidents Research
report 76. Department for Transport, London.
Ward, H, Lyons, R, Christie, N, Thoreau, R, and Macey,
S, (2007b). Fatal injuries to car occupants: analysis of health
and population data. Research report 77. Department for Transport,
London.
March 2008
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