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