Road Safety in Mexico

Dr. Arturo Cervantes Trejo

General Director of the National Council for Injury Prevention in Mexico (STCONAPRA)

1. Initial situation, epidemiology

2. Strategies and programs

3. Achievements and results

4. Conclusions and challenges

2

Agenda

1. Initial situation,

epidemiology

Road safety has entered the agenda of many countries, being

a public health problem

4

3

2

1

Nú

mer

o d

e d

efu

nci

on

es (

mill

on

es)

Deaths related to AIDS

1.8

Traffic Accidents MalariaTuberculosis

1.3 1.3

<1

In 2009, traffic accidents generated nearly1.3 million deaths and more than 20 million

people with injuries in the World

SOURCE: Decade of Action for Road Safety 2011-2020 (www.decadeofaction.org)

1. 62% of worldwide deaths occur in 10

countries.

2. Mexico is 7th place worlwide

3. 142,252 deaths in Latin America

4. +5 millions injured

5. Minimum RS investment

5

Road safety context

Place Illness or Injury

1 Ischemic heart disease

2 Cerebrovascular disease

3 Lower respiratory tract infection

4 EPOC

5 Diarrhoeal diseases

6 HIV/AIDS

7 Tuberculosis

8 Trachea, bronchus or lung cancer

9 Road Traffic Injuries (RTI)

10 Prematurity and low birth weight

Place Illness or Injury

1 Ischemic heart disease

2 Cerebrovascular disease

3 EPOC

4 Lower respiratory tract infection

5 Road Traffic Injuries (RTI)

6 Trachea, bronchus or lung cancer

7 Diabetes mellitus

8 Hypertensive cardiovascular disease

9 Stomach cancer

10 HIV/AIDS

2004 2030

Global expectations

7

• Accidents 4 millions

• Hospitalizations 350,000

• Disabilities 40,000

• Deaths rate 22.8 / 100,000

• Estimated annual cost $126 mil millones

• Affected population 5 a 35 años

Road accidents in Mexico

Fuente: INEGI Bases de mortalidad 2009.

Motor Vehicle Homicide

Pedestrian ran over Suicide

Drowning/Suffocation

Orden Total 0 - 4 5 - 14 15 - 29 30 - 44 45 - 59 60 - 74 75 +

1

2

3

4

5

6

7

8

9

10

Deaths from external causes

Posición

1Infecciones

respiratorias

agudas bajas

559

Accidentes de

vehículo de

motor (tránsito)

338

Accidentes de

vehículo de

motor (tránsito)

518

Accidentes de

vehículo de

motor (tránsito)

1,770Agresiones

(homicidios)2,766

Agresiones

(homicidios)3,005

Agresiones

(homicidios)2,824

Agresiones

(homicidios)2,723

2Accidentes de

vehículo de

motor (tránsito)

504 Leucemia 283 Leucemia 275Agresiones

(homicidios)1,577

Accidentes de

vehículo de

motor (tránsito)

2,258

Accidentes de

vehículo de

motor (tránsito)

1,899

Accidentes de

vehículo de

motor (tránsito)

1,695

Cirrosis y otras

enfermedades

crónicas del

hígado

1,520

3Malformacione

s congénitas

del corazón

467

Infecciones

respiratorias

agudas bajas

214

Lesiones

autoinfligidas

intencionalmen

te (suicidios)

192

Lesiones

autoinfligidas

intencionalmen

te (suicidios)

703

Lesiones

autoinfligidas

intencionalmen

te (suicidios)

717 VIH/SIDA 762 VIH/SIDA 904

Accidentes de

vehículo de

motor (tránsito)

1,465

4Enfermedades

infecciosas

intestinales

330

Malformacione

s congénitas

del corazón

122Agresiones

(homicidios)185

Ahogamiento y

sumersión

accidentales

387

Infecciones

respiratorias

agudas bajas

417

Lesiones

autoinfligidas

intencionalmen

te (suicidios)

655

Cirrosis y otras

enfermedades

crónicas del

hígado

820Diabetes

mellitus926

5Ahogamiento y

sumersión

accidentales

297

Ahogamiento y

sumersión

accidentales

121

Ahogamiento y

sumersión

accidentales

168 Leucemia 363Nefritis y

nefrosis394

Infecciones

respiratorias

agudas bajas

594

Infecciones

respiratorias

agudas bajas

635 VIH/SIDA 891

6Desnutrición

calórico

protéica

225Agresiones

(homicidios)82

Infecciones

respiratorias

agudas bajas

166Nefritis y

nefrosis328 VIH/SIDA 311

Diabetes

mellitus334

Lesiones

autoinfligidas

intencionalmen

te (suicidios)

577

Enfermedades

isquémicas del

corazón

824

7 Leucemia 219

Desnutrición

calórico

protéica

81Nefritis y

nefrosis128

Infecciones

respiratorias

agudas bajas

191

Ahogamiento y

sumersión

accidentales

296

Cirrosis y otras

enfermedades

crónicas del

hígado

327

Enfermedades

isquémicas del

corazón

545

Infecciones

respiratorias

agudas bajas

774

25 a 29 años 30 a 34 años 35 a 39 años1 a 4 años 5 a 9 años 10 a 14 años 15 a 19 años 20 a 24 años

Leading cause of Death

10

8,000

10,000

12,000

14,000

16,000

18,000

20,000

1981-1987Periodode descenso

1988-2009Periodode aumento

Road Traffic Death . 1980 a 2009.Source. Deaths database, INEGI, 1980-2009.

+46%

-21%

Road Traffic Deaths

11

94% of accidents occur in urban areas– 6% on highways.

61% of death in situ occur on roads– 39% urban areas.

36% - vulnerable users.

(pedestrian, cyclists, motorcyclists).

Source. Traffic accidents in urban and suburban areas. INEGI, 2009.Federal Preventive Police, 2009.

Road Safety in Mexico, 2010

12

12

Road Safety in Mexico

13

13

Road Safety in Mexico

14

Road Safety in Mexico

15

Road Safety in Mexico

16

16

Source: Road Safety situation in Mexico. National Observatory for Injuries. 2010. Deaths rate per 100,000 people.

Road Safety in Mexico, 2010

2. Startegy and

program

17

Ministerial Conference United Nation

Decade of Action

1. Public health approach.

2. Based on scientific evidence.

3. Multisectoral approach.

20

20

Imesevi Model

RISK FACTORS

21

• National BAC Program

• Road Safety Audits

• IMESEVI Instructors

• IMESEVI Target population

• First Respondents

• Injury Observatory

National Training System

National BAC Program

23

23

23

National Observatory of Injury

3. Achievement and

results

24

25

Ministers Meeting for violence and injury prevention in the

Americas, Merida, Mexico, March 2008

26

• Hidalgo

• Chihuahua

• Baja California

• Baja California Sur

• Veracruz

• Sonora

• Tlaxcala

• Jalisco

• Guanajuato

• Michoacán

• Morelos

• Colima

• Zacatecas

• San Luis Potosí

26

State Observatories

27

27

Epidemiological Investigation

28

28

Source: Results from baseline IMESEVI, Cenapra-PAHO 2008

0%10%20%30%40%50%60%70%80%90%

Me

xic

o C

ity

Gu

an

aju

ato

Ja

lisc

o

Nu

ev

o

Le

ón

Driver Front Back

68 %

33 %

5 %

Epidemiological Investigation

29

29

29

Fuente. Levantamiento de la línea base y segunda medición de los factores de riesgo para la seguridad vial, ST del CONAPRA, 2011.

Con base en mediciones realizadas en 24 municipios de México.

53%Use seatbelt

18%Use child

restraint seat

13%Drive while intoxicated

71%Use helmet

Measuring risk factors

Leaders

Trainers

Multipliers

General Population

450

900

160,000

64

407 Road Safety Audits in 28 states.

1,200 certified emergency medical attention.

30,000 first respondents (paramedics)

National Training System

32

32

• 22 states

• 129 municipalities

• 280 equipment

• 650 certified persons

• + 25 millions pesos (~ 2 million USD)

National BAC Program

BAC control

34

Continuous

improvement training

and programs.

Improve police image

744

600

500

550

600

650

700

750

800

2008 2009

Reduce

144

Deaths

(19%)

Deaths by traffic accidents on 10,000 Km. of road during

july - august 2008 & 2009

Source: SSP, 2009.

Surveillance & prevention results

36

Source . Ministry of Public Security of the Federal District. 2010.

Local BAC programs

09/02/2012 37

719

290

0

100

200

300

400

500

600

700

800

Deaths

2002

2008

Reduce

429

Deaths

(40%)

Bac control results in Mexico City

38

5983

6419

5462

4531

2368

0

1926

1364

920758

2718

3189

2787

2361

1170

45 37 39 35 140

1000

2000

3000

4000

5000

6000

7000

2006 2007 2008 2009 2010

Accidentes

Accidentes asociados al alcohol

Lesionados

Muertos

• 61% less alcohol-related accidents

- 24%

Local programs, Aguascalientes

39

Transportation Services Law reform, Traffic and

transportation of the state of Jalisco (Ley

salvavidas)

Strengthening the legal framework

40

Source. Consejo Estatal para la Prevención de Accidentes del Estado de Jalisco. 2010.

472

435

405

153

121 127

0

50

100

150

200

250

300

350

400

450

500

2008 2009 2010

Muertes por ATVMMuertes por ATVM con alcohol en sangre

• 17% less alcohol-related fatalities

- 14%

- 17%

Local Program, Guadalajara

41

41

• San Marcos Fair, Aguascalientes

• 50% reduction in accidents related to alcohol

• Cuahutémoc City, Chihuahua

• -44% deaths (n=70/39)

• Navolato, Sinaloa

• + 20% use of seatbelt

And much more…

Success of local IMESEVI programs

May 11, 2011Decade of Action

for Road Safety

2011-2020

launched in

110 countries.

La década por la seguridad vial 2011-2020

44

45

46

• National and Regional target was set to reduce by 50% thenumber of death caused by traffic accidents (save thousand of lives over the next 10 years)

• The Declaration of Road Safety of Mexico City was signed by representatives of 18 Latin American countries in line with the World Plan commitment to road safety of the United Nations.

•The private sector joined the Road Safety Actions

•Academic and civil society also joined

Road Safety Week Agreemts

47

48

49

50

• Publication of the National Road

Safety Strategy 2011 - 2020 (6 of june 2011)

• The National Conference of Governors

adhered to the Startegy

• Declaratoria Declaration of

the Congress of the Decade for Road

Safety in Mexico 2011 – 2020 (March of 2011)

Public Policy Achievements

3. Conclusions and

challenges

51

Decade of Action for Road Safety 2011-2020/7

52

0

0.2

0.4

0.6

0.8

1

1.2

1.4

1.6

1.8

2

2011 2012 2013 2014 2015 2016 2017 2018 2019 2020

Nu

mb

er

of d

eat

hs

(mill

ion

s)

Years

5 millions lives saved

Expected increase if no action

Expected incline if action is taken

In March 2010, the General Assembly of the Organization of the United Nations declared the Decade of Action

for Road Safety 2011-2020, with the aim of stabilizing and then reducing the expected numbers of fatalities in traffic

accidents throughout the world before 2020.

/7 Source: Decade of Action for Road Safety 2011-2020 (www.decadeofaction.org)

Seatbelt Child Restraint Seat Drinking-Driving Speed Helmets

Low-cost engineering Safe vehicles Pre-hospital care/ trauma

LawsSurveillanceStandardsBehaviors

Road Safety Best Practices

Having drinking-driving laws and enforcement reduced deaths on highways of more than 20% in some countries

In Australia, drinking-driving deaths declined by 36% in New South Wales, Tasmania by 42% and 40% in Victoria, after alcohol tests.In Guadalajara, Leon, Aguascalientes, etc. There are very good results.The cost benefit reaches 1:56.

National Road Safety Strategy 2011-2020/8

56

Strengthening

the

management

capacity of

road safety

Modernizing

road

infrastructure

and safer

transport

Encourage use

of safer

vehicles

Improve the

behavior of road

users to have an

impact on the

risk factors that

promote the

occurrence

of traffic accidents

Strengthening

trauma

care and acute

conditions by

improving health

care services

and hospital pre-hospital

1 2 3 4 5

Mexico joined the Decade of Action for Road Safety, signing an agreement betweenthe Ministries of Communications and Transport and Health to implement theNational Road Safety Strategy 2011-2020.

The Strategy is aligned to the one established by the UN, under five main pillars:

/8 Source: AGREEMENT which discloses the National Road Safety

Startegy Strategy 2011-2020,published in the Official Journal of the Federation

on June 6, 2011.

Evolution in the number of road deaths per year in ZM from France, 1970-2009

Prevention works

58

Esp

añ

a;

-51%

Leto

nia

; -5

4%

Esto

nia

; -5

0%

Po

rtu

gal;

-50%

Fra

ncia

; -4

8%

Lit

uan

ia;

-48%

Italia;

-43%

Irla

nd

a;

-42%

Ale

man

ia;

-40%

Su

ecia

; -3

9%

Eslo

ven

ia;

-38%

Eslo

vaq

uia

; -3

6%

EU

-27;

-36%

Bélg

ica;

-36%

Fin

lan

dia

; -3

6%

País

es B

ajo

s;

-35%

Rein

o U

nid

o;

-35%

Au

str

ia;

-34%

Hu

ng

ría;

-34%

Lu

xem

bu

rgo

; -3

3%

Rep

úb

lica C

heca;

-32%

Din

am

arc

a;

-30%

Ch

ipre

; -2

8%

Gre

cia

; -2

3%

Po

lon

ia;

-17%

Bu

lgari

a;

-11%

Ru

man

ia;

14%

Malt

a;

31%

-60%

-50%

-40%

-30%

-20%

-10%

0%

10%

20%

30%

40%

European Comparison, 50% reduction

54% of deaths are related to alcohol.

Mexico City in 2008:

• 50% of deaths are related to alcohol

• 21% of emergency rooms sign in have levels of alcohol in their blood.

Source: Serie histórica, 2005-2008, Servicio Médico Forense

(SEMEFO) de Distrito Federal.

Alcohol and accidents

Since .02% OH driving capabilities are reduced

The probability to loose vehicle control and crash increases from 0.05%.

The probability to die in a car accident when the driver has .15% is 380 times higher.

60

Drinking and driving

61

9% drive a car after drinking.

16% get in a car with a drunk driver

Among women consumption increased from 7.5% to 16.2%.

Drinking and driving

62

62

Nota. Note. Based on estimates of ST CONAPRO whereas 41.5% (7.080) of casescategorized as "other accidents"

correspond to RTI giving a total of 21.170 cases in 2008.

Main challenges

Un México sano es un México fuerte

Subsecretaría de Prevención y Promoción de la Salud