Reducing regional inequality in mortality from road traffic injuries through enforcement of the mandatory motorcycle helmet law in Taiwan

Abstract

Background This study was conducted to examine whether passage of the mandatory motorcycle helmet law in 1997 reduced the regional inequality in mortality from road traffic injuries (RTIs) across 22 cities/counties in Taiwan. Methods We calculated the absolute (between-group variance, BGV) and relative (rate ratio between the city/ county with the highest and lowest rate, RR) terms of inequality for the overall and motorcycle-related RTI mortality rates, the rate of helmet use and three other explanatory factors associated with RTI mortality at the city/county level from 1997 through 2008. Results The BGV of the overall and motorcycle-related RTI mortality rates across the 22 cities/counties showed persistently decreasing trends from 1997 to 2008; however, the RR of RTI mortality first increased and then levelled off from 2002. The decreasing trend in inequality was most prominent in males aged 0e24 years. The BGV and RR of the rate of motorcycle helmet use decreased after passage of the law but increased from 2002 onwards. Conclusion In Taiwan, passage of the mandatory motorcycle helmet law reduced the regional inequality in RTI mortality; however, a resurgence in regional inequality in the helmet use rate years after passage of the helmet law was noted. It is therefore necessary to monitor the helmet use rate after passage of such a law to ensure the effect of a reduction in regional inequality in RTI mortality.

Social inequality in motorcycle helmet use: when a reduction in inequality is not necessarily good news

“…By contrast with the great increase in helmet use rates (from 45% in 1997 to 92% in 2002) in years immediately after the helmet law was passed in 1997,6 we noted a mild decrease of helmet use rates in this study, from 92% in 2001 to 89% in 2009. Different indicators of socioeconomic position showed divergent changes in social equality in helmet use: urbanisation level and income level displayed a significant reduction of social inequality, yet education level showed a significant increase of social inequality.…”

“…With regard to the rigorousness of police ticketing non-helmet use, a previous study in Taiwan using the Police Traffic Accident Registry data indicated that relaxation of law enforcement by police in some counties resulted in a correspondingly greater decline of helmet use 6. A study in Thailand revealed high disparity in helmet use (from 36% in South region to 82% in Bangkok) and highly associated with regional conviction rate of motorcyclists.…”

“…Studies have revealed a subsequent reduction in motorcycle head injuries and fatalities 7–11. Despite this great public health achievement, a recent study indicated that regional inequalities in the rate of helmet use have increased since 2002 6. One limitation of this study was that personal information on socioeconomic position was not available in the Police Traffic Accident Registry data.…”

“…The mandatory motorcycle helmet law effectively increased the helmet use rate from 45% in 1997 to 92% in 2002, according to the Police Traffic Accident Registry data 6. Studies have revealed a subsequent reduction in motorcycle head injuries and fatalities 7–11.…”

Rising mortality from injury in urban China: demographic burden, underlying causes and policy implications

“…32,33,44,45 In Taiwan, China, for example, a 1997 law making helmet use mandatory has substantially lowered mortality from road traffic injury. 19,46 Furthermore, community interventions should concentrate on local environments and on raising public awareness surrounding safety and how to prevent injuries, especially among children and migrants. Education for injury prevention has given good results and is affordable in developing countries.…”