BackgroundThe relationship between economic development and road safety at sub-national level has not been well established. This study aims to assess the relationships between economic growth (measured by gross regional product (GRP)) and road traffic fatalities (RTFs) and crash fatality ratio (CFR) at sub-national level in Russia.MethodsWe used published secondary data on annual RTFs and CFR obtained from the traffic police and socioeconomic development indicators from the statistics department for each Russian federal region (referred to in Russia as “subject”) for 2004–2011. We used multivariate fixed effects models for longitudinal data to examine the GRP-RTF and the GRP-CFR relationships excluding regions with extreme values. Time (in years) and a set of relevant socioeconomic variables (territory, population, number of privately owned cars, number of public buses, length of public motor roads, number of physicians, and budget expenditure on health care and physical wellness) were also included as covariates in the models.ResultsThe RTF rates decreased monotonically over time as GRP per capita increased in 66 studied regions during 2004–2011. This relationship was mainly explained by the number of privately owned cars and partially explained by year dummy variables, number of buses, and number of physicians. CFR also decreased monotonically as GRP per capita increased in 67 studied regions. This relationship between economic growth and CFR was fully explained by secular time trends. The year dummy effects on CFR were not mediated by other socioeconomic variables included in the study.ConclusionsFor the period of 2004–2011 in Russia, the reduction in RTFs is mostly explained by increasing the number of private cars, while the reduction of CFR is mostly associated with year-effects suggesting a process of diffusion of knowledge, which is not solely dominated by economic growth.