Volume 17, Issue 4 (9-2025)
jorar 2025, 17(4): 217-227 |
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Nozarian M H, Karimi F, Rajaie S. The Intra-city/Extra-city Paradox in Iran's Road Safety: Disparities in Accident Frequency and Fatality Rates. jorar 2025; 17 (4) :217-227
URL: http://jorar.ir/article-1-1053-en.html
URL: http://jorar.ir/article-1-1053-en.html
Research Center for Emergency and Disaster Resilience, Red Crescent Society of the Islamic Republic of Iran, Tehran, Iran
Abstract: (23 Views)
INTRODUCTION: Road traffic accidents represent a significant public health challenge globally, and Iran continues to experience disproportionately high rates of traffic-related morbidity and mortality. This study presents a provincial-level analysis of road traffic accidents in Iran during the 2022–2023 period.
METHODS: A retrospective analysis was conducted using data from the Statistical Center of Iran, encompassing all recorded road traffic accidents across 31 provinces during the March 2022 to March 2023. Descriptive statistics, accident and fatality rate calculations, independent-samples t-tests, and Pearson correlation analyses were performed to compare intra-city and extra-city patterns. Statistical significance was defined as p<0.05. Data processing and statistical analyses were carried out using Excel 2019 and SPSS 26, while geographic visualizations were developed using Datawrapper.
FINDINGS: In 2022, a total of 2,119,406 road traffic accidents occurred in Iran, leading to 18,799 deaths and 379,020 injuries. Although intra-city areas accounted for the majority of accidents (81.8%; n = 1,733,200), extra-city crashes were markedly more severe. The fatality rate in extra-city areas was 37.48 per 1,000 accidents, compared with 2.5 per 1,000 in intra-city areas (p < 0.001), indicating that extra-city crashes are approximately 15 times more likely to result in death. Significant regional heterogeneity was also observed: Tehran Province reported the highest number of accidents (514,498), whereas Sistan and Baluchistan exhibited the highest fatality rate (167.76 per 1,000 accidents). A negative correlation was identified between total accidents and fatality rates across provinces (r =–0.42, p =0.018), suggesting that provinces with fewer accidents often experience more severe outcomes when crashes occur.
CONCLUSION: The results reveal a pronounced intra-city/extra-city divide, where extra-city crashes are 15 times more fatal, alongside severe provincial disparities and highlight the need for differentiated prevention strategies, emphasizing improvements in extra-city infrastructure, enforcement, and emergency response capacity—particularly in high-risk regions.
Keywords: Road Traffic Accidents; Injury Prevention; Mortality; Public Health; Intra-city/Extra-city Disparities; Geographical Analysis; Epidemiology.
METHODS: A retrospective analysis was conducted using data from the Statistical Center of Iran, encompassing all recorded road traffic accidents across 31 provinces during the March 2022 to March 2023. Descriptive statistics, accident and fatality rate calculations, independent-samples t-tests, and Pearson correlation analyses were performed to compare intra-city and extra-city patterns. Statistical significance was defined as p<0.05. Data processing and statistical analyses were carried out using Excel 2019 and SPSS 26, while geographic visualizations were developed using Datawrapper.
FINDINGS: In 2022, a total of 2,119,406 road traffic accidents occurred in Iran, leading to 18,799 deaths and 379,020 injuries. Although intra-city areas accounted for the majority of accidents (81.8%; n = 1,733,200), extra-city crashes were markedly more severe. The fatality rate in extra-city areas was 37.48 per 1,000 accidents, compared with 2.5 per 1,000 in intra-city areas (p < 0.001), indicating that extra-city crashes are approximately 15 times more likely to result in death. Significant regional heterogeneity was also observed: Tehran Province reported the highest number of accidents (514,498), whereas Sistan and Baluchistan exhibited the highest fatality rate (167.76 per 1,000 accidents). A negative correlation was identified between total accidents and fatality rates across provinces (r =–0.42, p =0.018), suggesting that provinces with fewer accidents often experience more severe outcomes when crashes occur.
CONCLUSION: The results reveal a pronounced intra-city/extra-city divide, where extra-city crashes are 15 times more fatal, alongside severe provincial disparities and highlight the need for differentiated prevention strategies, emphasizing improvements in extra-city infrastructure, enforcement, and emergency response capacity—particularly in high-risk regions.
Keywords: Road Traffic Accidents; Injury Prevention; Mortality; Public Health; Intra-city/Extra-city Disparities; Geographical Analysis; Epidemiology.
Keywords: Road Traffic Accidents, Iran, Injury Prevention, Mortality, Public Health, Intra-city/Extra-city Disparities, Geographical Analysis, Epidemiology.
Article Type: Research article |
Subject:
Trauma, Triage etc.
References
1. World Health Organization. Global status report on road safety 2018. World Health Organization; 2019.
2. Peden MM. World report on road traffic injury prevention. World Health Organization; 2004.
3. Bougna T, Hundal G, Taniform P. Quantitative analysis of the social costs of road traffic crashes literature. Accident Analysis & Prevention. 2022; 165:106282. [DOI:10.1016/j.aap.2021.106282]
4. Naghavi M, Shahraz S, Bhalla K, Jafari N, Pourmalek F, Bartels D, Puthenpurakal JA, Motlagh ME. Adverse health outcomes of road traffic injuries in Iran after rapid motorization. Arch Iran Med. 2009;12(3):284-94.
5. Lankarani KB, Sarikhani Y, Heydari ST, Joulaie H, Maharlouei N, Peimani P, Ahmadi SM, Khorasani-Zavareh D, Soori H, Davoudi-Kiakalayeh A, Masoumi G. [Traffic accidents in Iran, a decade of progress but still challenges ahead (Persian)]. Medical journal of the Islamic Republic of Iran. 2014; 28:96.
6. Tafti MR, Ostovar A, Moghaddam SS, Shobeiri P, Ehrampoush MH, Salmani I, Khajeaminian MR, Fallahzadeh H, Tafti AD. [Burden of road traffic injuries in Iran: a national and subnational perspective, 1990−2019 (Persian)]. Injury prevention. 2023; 29(2):101-10. [DOI:10.1136/ip-2022-044677]
7. Razzaghi A, Soori H, Kavousi A, Abadi A, Khosravi AK, Alipour A. [Risk factors of deaths related to road traffic crashes in World Health Organization regions: A systematic review (Persian)]. Archives of Trauma Research. 2019;8(2):57-86. [DOI:10.4103/atr.atr_59_19]
8. Khorasani-Zavareh D, Mohammadi R, Khankeh HR, Laflamme L, Bikmoradi A, Haglund BJ. [The requirements and challenges in preventing of road traffic injury in Iran (Persian)]. BMC public health. 2009:23;9(1):486. [DOI:10.1186/1471-2458-9-486]
9. Kolivand P, Saberian P, Azari S, Namdar P, Karimi F, Parvari A, Ehsanzadeh SJ, Raei B, Raadabadi M, Rajaie S. [Road traffic injuries in Iran: epidemiology and equitable distribution of emergency services (Persian)]. Bulletin of Emergency & Trauma. 2024;12(4):177.
10. Shafabakhsh GA, Famili A, Bahadori MS. [GIS-based spatial analysis of urban traffic accidents: Case study in Mashhad, Iran (Persian)]. Journal of traffic and transportation engineering (English edition). 2017;4(3):290-9. [DOI:10.1016/j.jtte.2017.05.005]
11. Aghajani MA, Dezfoulian RS, Arjroody AR, Rezaei M. [Applying GIS to identify the spatial and temporal patterns of road accidents using spatial statistics (case study: Ilam province, Iran) (Persian)]. Transportation Research Procedia. 2017 ;25:2126-38. [DOI:10.1016/j.trpro.2017.05.409]
12. Adeloye D, Thompson JY, Akanbi MA, Azuh D, Samuel V, Omoregbe N, Ayo CK. The burden of road traffic crashes, injuries and deaths in Africa: a systematic review and meta-analysis. Bulletin of the World Health Organization. 2016 Apr 21;94(7):510. [DOI:10.2471/BLT.15.163121]
13. Chandran A, Hyder AA, Peek-Asa C. The global burden of unintentional injuries and an agenda for progress. Epidemiologic reviews. 2010;32(1):110-20. [DOI:10.1093/epirev/mxq009]
14. Statistical Center of Iran. Road Traffic Accident Statistics: 2022. Tehran: Statistical Center of Iran; 2023. Available from: https://amar.org.ir/statistical-information/statid/ 28440
15. Azami-Aghdash S, Sadeghi-Bazargani H, Shabaninejad H, Gorji HA. [Injury epidemiology in Iran: a systematic review (Persian)]. Journal of injury and violence research. 2017;9 (1):27. [DOI:10.19082/3630]
16. Razzaghi A, Soori H, Kavousi A, Abadi A, Khosravi A. [Factors with the highest impact on road traffic deaths in Iran; an ecological study (Persian)]. Archives of academic emergency medicine. 2019;7(1):38.
17. Yousefifard M, Toloui A, Ahmadzadeh K, Gubari MI, Neishaboori AM, Amraei F, Safari S, Baratloo A, Rahimi-Movaghar V, Hosseini M. [Risk factors for road traffic injury-related mortality in Iran; a systematic review and meta-analysis(Persian)]. Archives of academic emergency medicine. 2021;9(1):e61.
18. Ehsani JP, Michael JP, Mackenzie EJ. The future of road safety: challenges and opportunities. The Milbank Quarterly. 2023;101(Suppl 1):613. [DOI:10.1111/1468-0009.12644]
19. Azami-Aghdash S, Sadeghi-Bazarghani H, Heydari M, Rezapour R, Derakhshani N. [Effectiveness of interventions for prevention of road traffic injuries in Iran and some methodological issues: a systematic review(Persian)]. Bulletin of Emergency & Trauma. 2018;6(2):90 [DOI:10.29252/beat-060202]
20. Seif M, Edalat S, Shirazi AM, Alipouri S, Bayati M. [Prediction of the burden of road traffic injuries in Iran by 2030: prevalence, death, and disability-adjusted life years (Persian)]. Chinese journal of traumatology. 2024;27(4): 242-8 [DOI:10.1016/j.cjtee.2024.02.004]
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