Original Article

Demographic and Economic Correlates of Mortality Due to Traffic Accidents among Children Aged 1–14 Years in European Countries


Background: To evaluate the changes of mortality among children aged 1–14 yr due to road traffic injury and related demographic and economic factors in an ecological study undertaken in 33 European countries.

Methods: Information about mortality due to road traffic injury among children aged 1–14 yr in European countries was obtained from the WHO database. Changes in the mortality for the years 2000–2009 were estimated as linear regression. These deaths were correlated with demographic and economic factors.

Results: The greatest burden of child mortality due to road traffic accidents was observed in Baltic States, three times lower mortality levels than that in Northern States. Between 2000 and 2009, there was a significant reduction (P<0.05) in mortality among children aged 1–14 yr in Southern-West countries and Western countries, 1–4 yr in Central and Eastern countries, and 5–14 yr in Northern countries. Mortality due to road traffic injury among boys was strongly associated with the level of urbanization. Both sexes showed strong negative correlations with the economic level and strong positive correlations with income inequality.

Conclusion: Although in European countries the mortality of children due to traffic injury was considerably reduced, efforts should be made to educate and design a safe environment.

Sethi D, Towner E, Vincenten J et al (2008). European report on child injury prevention. World Health Organization.

Yin Z, Wu J, Luo J et al (2015). Burden and trend analysis of injury mortality in China among children aged 0-14 years from 2004 to 2011. BMJ Open, 5(7): e007307. doi: 10.1136/bmjopen-2014-007307.

Mokdad A, Forouzanfar M, Daoud F et al (2016). Global burden of diseases, injuries, and risk factors for young people`s health during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet, 387(10036): 2383-2401.

Peden M, Oyegbite K, Ozanne-Smith J et al (2008). World report on child injury prevention. Geneva: World Health Organization.

Rahbar M, Ahmadi M, Lornejad H et al (2013). Mortality causes in children 1-59 months in Iran. Iran J Public Health, 42(Supple1): 93-97.

Sidebotham P, Fraser J, Covington T et al (2014). Understanding why children die in high-income countries. Lancet, 384(9946): 915-927.

Grajda A, Kułaga Z, Gurzkowska B et al (2017). Trends in external causes of child and adolescent mortality in Poland, 1999–2012. Int J Public Health, 62(1): 117-126.

Dissanayake D, Aryaija J, Wedagama D (2009). Modelling the effects of land use and temporal factors on child pedestrian casualties. Accid Anal Prev, 41(5): 1016-1024.

European Commission. Traffic Safety Basic Facts – Children (2016). Available from:


Domżał-Drzewicka R, Saracen A, Rząca M et al (2016). Retrospective study of injury rates among children and adults in the Lublin Region of Poland. Ann Agric Environ Med, 23(2): 297-303.

World Health Organization. International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD–10). Version for 2016. Available from: http://apps.who.int/classifications/icd10/browse/2016/en.

World Health Organization (2009). European status report on road safety. Towards safer roads and healthier transport choices. World Health Organization.

Kim K, Ozegovic D, Voaklander D (2012). Differences in incidence of injury between rural and urban children in Canada and the USA: a systematic review. Inj Prev, 18(4): 264-271.

Kmet L, Macarthur C (2006). Urban–rural differences in motor vehicle crash fatality and hospitalization rates among children and youth. Accid Anal Prev, 38(1): 122-127.

Laflamme L, Hasselberg M, Burrows S (2010). 20 Years of research on socioeconomic inequality and children`s-unintentional injuries understanding the cause-specific evidence at hand. Int J Pediatr, 2010. pii: 819687. doi: 10.1155/2010/819687.

D’Souza A, Blakely T, Woodward A (2008). The effect of eradicating poverty on childhood unintentional injury mortality in New Zealand: a cohort study with counterfactual modelling. J Epidemiol Community Health, 62(10): 899-904.

MacKay M, Vincenten J (2012). Child Safety Report Card 2012: Europe Summary for 31 Countries. EuroSafe.

Macpherson A, To T, Parkin P (2004). Urban/rural variation in children’s bicycle-related injuries. Accid Anal Prev, 36(4): 649-654.

Fraga A, Fraga G, Stanley C et al (2010). Children at danger: injury fatalities among children in San Diego Country. Eur J Epidemiol, 25(3): 211-217.

Li M, Doong J, Chang K et al (2008). Differences in urban and rural accident characteristics and medical service utilization for traffic fatalities in less-motorized societies. J Safety Res, 39(6): 623-630.

Singh G, Azuine R, Siahpush M et al (2013). All-cause and cause-specific mortality among US youth: socioeconomic and rural–urban disparities and international patterns. J Urban Health, 90(3): 388-405.

Bakke H, Hansen I, Bendixen A et al (2013). Fatal injury as a function of rurality-a tale of two Norwegian counties. Scand J Trauma Resusc Emerg Med, 21: 14. doi: 10.1186/1757-7241-21-14.

Jiang X, Zhang Y, Wang Y et al (2010). An analysis of 6215 hospitalized unintentional injuries among children aged 0–14 in northwest China. Accid Anal Prev, 42(1): 320-326.

Hasselberg M, Laflamme L (2004). Children at risk in traffic: improvement potentials in the Swedish context. Acta Paediatr, 93(1): 113-119.

McGuffie A, Graham C, Beard D et al (2005). Scottish urban versus rural trauma outcome study. J Trauma, 59: 632-638.

Charzyńska-Gula M, Sygit K, Sygit M et al (2013). Problems of health education in rural areas in Poland. Ann Agric Environ Med, 20(3): 515-522.

International Road Traffic and Accident Database (2015). Road safety annual report 2015. Organization for Economic Co-operation and Development; International Transport Forum.

Patton G, Coffey C, Sawyer S et al (2009). Global patterns of mortality in young people: a systematic analysis of population health data. Lancet, 374(9693): 881-892.

Hardelid P, Davey J, Dattani N et al (2013). Child deaths due to injury in the four UK countries: a time trends study from 1980 to 2010. PLoS One, 8(7): e68323. doi: 10.1371/journal.pone.0068323.

Mitis F, Sethi D (2013). European facts and global status report on road safety 2013. World Health Organization.

Johnson J, Greaves L, Repta R (2009). Better science with sex and gender: facilitating the use of a sex and gender – based analysis in health research. Int J Equity Health, 8: 14-24. doi: 10.1186/1475-9276-8-14.

European Commission (2012). Children in road traffic. Deliverable 4.8c of the EC FP7 project DaCoTA. Available from:


Viner R, Coffey C, Mathers C et al (2011). 50-year mortality trends in children and young people: a study of 50 low-income, middle-income, and high-income countries. Lancet, 377(9772): 1162-1141.

Mytton J, Towner E, Powell J et al (2012). Taking the long view: a systematic review reporting long-term perspectives on child unintentional injury. Inj Prev, 18(5): 334-342.

Vision Zero. Traffic safety by Sweden (2017). Available from: http://www.visionzeroinitiative.com

European Transport Safety Council (2009). Reducing child deaths on European Roads. Brussels: European Transport Safety Council.

Myndigheten för Samhällsskydd och Beredskap (2011). Barns och ungas säkerhet. MSB. Available from: https://www.msb.se/RibData/Filer/pdf/26005.pdf (Swedish)

Childrens Safety Network (2014). Injury prevention. What works? A summary of cost-outcome analysis for injury prevention programs (2014 Update). Childrens Safety Network; Pacific Institute for Research Evaluation.

IssueVol 49 No 6 (2020) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/ijph.v49i6.3358
Children; Road traffic injuries; Inequalities in health; Urbanization; Economic status

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
GENOWSKA A, POLAK M, GOWORKO-SKŁADANEK B, SYGIT K, HUZARSKA D, SZAFRANIEC K. Demographic and Economic Correlates of Mortality Due to Traffic Accidents among Children Aged 1–14 Years in European Countries. Iran J Public Health. 2020;49(6):1069-1078.