Child and youth traffic injuries study suggests need for standardized traffic policies in Canada

Provinces with road traffic safety policies that are evidence-based had lower injury-related hospitalizations and deaths among children and youth, according to a new study by researchers at York University.

The national study, published in the journal BioMedCentral, looked at three indicators: injury-hospitalization, injury-death and the road traffic safety policies. This is the first Canadian study to compare data on hospitalizations and deaths alongside provincial policies.

Alison MacPherson
Alison Macpherson

Professor Alison Macpherson in York University’s School of Kinesiology & Health Science, Faculty of Health, and her former PhD student Liraz Fridman examined policies related to the safety of vehicle occupants, cyclists and pedestrians, and focused in on specific criteria such as graduated driver licensing, bicycle helmet legislation, pedestrian safety laws and booster seat legislation.

“We’re not saying there’s a causal relationship,” said Fridman, lead author of the study. “We are saying that policy is one indicator that may be playing a role in the reduction of injury over time. We found that provinces with stronger evidence-based policies in place are more likely to have lower rates of injury.”

Macpherson and her team looked at a national database from the Canadian Institute for Health Information (CIHI) and compared provinces’ road traffic hospitalizations over a seven-year period, from Jan. 1, 2006 to Dec. 31, 2012. Children and youth (ages 0 to 19 years) who were hospitalized after sustaining a road traffic-related injury were included in the study, for all provinces except Quebec, which is not required to report this data. Data on the number of transport-related childhood deaths was used to analyze the death rate during the same period.

The mortality rate from all road traffic-related injuries in Canada (excluding Quebec) was 4.5 deaths per 100,000 children/youth between 2006 and 2012. The highest mortality rate was 10.99 per 100,000 population in Saskatchewan and the lowest rate was 3.09 per 100,000 in Ontario.

“Our study suggested that evidence-based policies and strategies such as reduced speed limits in residential and school zones across provinces may be one effective way to reduce road traffic injuries,” said Macpherson, senior author of the study. “These findings also suggest that graduated driver licensing may be an important injury prevention policy that has the potential to reduce injury-related deaths.”

She said the study provides evidence to support the need for booster seat legislation and other road safety policies to be consistent across provinces.

Study highlights include:

  • Ontario had the lowest rate of child and youth deaths from road traffic-related causes. One of the first provinces to introduce graduated driver licensing, Ontario restricts novice drivers from being on the roads from 12 a.m. to 5 a.m.
  • Ontario and B.C. had the lowest average annual rates in occupant-related hospitalization over time. B.C.’s booster seat legislation has been in place since 1985, but was updated to reflect evidence-based best practice in 2008.
  • The only province with a significant reduction in pedestrian-related injuries was B.C., which has speed limits of 50 kilometres per hour in residential zones and 30 kilometres per hour in school zones.
  • All nine Canadian provinces included in the analysis showed a decrease in transport-related injury morbidity rates between 2006 and 2012.
  • All-cause transport-related injury hospitalization rates significantly decreased among children and youth over the seven-year study period.
  • Saskatchewan’s injury hospitalization rate was almost double the Canadian average.

According to statistics, road traffic collisions are the leading cause of injury death among Canadian children and youth (ages 1 to 19 years). The total economic burden to Canadians in 2010 from transport incidents for all ages was $4.2 billion. Motor-vehicle collisions accounted for 50 per cent of all transport-related injury costs, followed by pedal cyclists (14 per cent) and pedestrians (11 per cent).

“What we want to see happen is a harmonization of evidence-based road traffic safety policies across provinces,” said Fridman. “While transport-related injuries among Canadian children and youth are on the decline, there are still inconsistencies between road traffic safety policies across the country. This study highlights the need for these evidence-based policies to follow best practice guidelines and be standardized across Canada.”