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... Peltzman (1975) United States 19471972Eshler (1977) United States 19491976Hoxie et al. (1984) United States 19751982Joksch (1984) United States 19301982Partyka (1984 United States 1960 Wagenaar (1984) a United States ( Michigan) 1972Michigan)-1983 Zlatoper (1984) United States 19471980 Hoxie and Skinner (1985) United States 19751983 Mercer (1987) a Canada ( British Columbia) 1978 Evans and Graham (1988) a United States 1946States-1985States , 1975States-1984 Saffer and Chaloupka (1989) United States 19801985 Wagenaar and Streff (1989) United States 19761985 McCarthy and Ziliak (1990) United States (Californian cities) 1982-1985 Wagenaar et al. (1990) United States 19781988Zlatoper (1991 United States 1987Reinfurt et al. (1991) a United States 19601986 Leigh and Waldon (1991) a United States (District of Columbia) 1976Columbia)-1980 Partyka (1991) a United States 1960Pettitt et al. (1992 Australia ( Victoria) 1981McCarthy (1993 United States (Indiana counties) 1981-1989 ...
... Haque (1993) a Australia ( Victoria) 1966, 1985Keeler (1994) United States 1970, 1980 McCarthy (1994) United States ( Californian counties) 1981Ruhm (1995) United States 19751988Loeb (1995 United States ( Texas) 19821987Ruhm (1996 United States 19821988Johansson (1996 Sweden (7 counties) 1982Sweden (7 counties)-1991 Robertson (1996) United States 1975 Wilde and Simonet (1996) a Switzerland 1963Farmer (1997) a United States 1975Newstead et al. (1998) a Australia (Victoria) 1983Fridstrøm (1999) a Norway 1973Ruhm (2000) a United States 1972Scuffham (2003) a New Zealand 1970Tay (2003) a Australia (Victoria) 19831992Neumayer (2004) a Germany 19902000Van den Bossche et al. (2005) a Belgium 19902001Hermans et al. (2006) a Belgium 19741999Garcia-Ferrer et al. (2007) a Spain 1975Hu et al. (2008) China 19852005Wiklund et al. (2011 They differ in several aspects of methodology and may therefore be used as a basis for assessing the robustness of the relationship between economic recessions and changes in the number of traffic fatalities. If the results of the studies are similar, that indicates a more robust relationship than if the findings are inconsistent. ...
... Haque (1993) a Australia ( Victoria) 1966, 1985Keeler (1994) United States 1970, 1980 McCarthy (1994) United States ( Californian counties) 1981Ruhm (1995) United States 19751988Loeb (1995 United States ( Texas) 19821987Ruhm (1996 United States 19821988Johansson (1996 Sweden (7 counties) 1982Sweden (7 counties)-1991 Robertson (1996) United States 1975 Wilde and Simonet (1996) a Switzerland 1963Farmer (1997) a United States 1975Newstead et al. (1998) a Australia (Victoria) 1983Fridstrøm (1999) a Norway 1973Ruhm (2000) a United States 1972Scuffham (2003) a New Zealand 1970Tay (2003) a Australia (Victoria) 19831992Neumayer (2004) a Germany 19902000Van den Bossche et al. (2005) a Belgium 19902001Hermans et al. (2006) a Belgium 19741999Garcia-Ferrer et al. (2007) a Spain 1975Hu et al. (2008) China 19852005Wiklund et al. (2011 They differ in several aspects of methodology and may therefore be used as a basis for assessing the robustness of the relationship between economic recessions and changes in the number of traffic fatalities. If the results of the studies are similar, that indicates a more robust relationship than if the findings are inconsistent. ...
This paper presents analyses of how the economic recession that started in 2008 has influenced the number of traffic fatalities in OECD countries. Previous studies of the relationship between economic recessions and changes in the number of traffic fatalities are reviewed. Based on these studies, a causal diagram of the relationship between changes of the business cycle and changes in the number of traffic fatalities is proposed. This causal model is tested empirically by means of multivariate analyses and analyses of accident statistics for Great Britain and Sweden. Economic recession, as indicated both by slower growth of, or decline of gross national product, and by increased unemployment is associated with an accelerated decline in the number of traffic fatalities, i.e. a larger decline than the long-term trend that is normal in OECD countries. The principal mechanisms bringing this about are a disproportionate reduction of driving among high-risk drivers, in particular young drivers and a reduction of fatality rate per kilometre of travel, probably attributable to changes in road user behaviour that are only partly observable. The total number of vehicle kilometres of travel did not change very much as a result of the recession. The paper is based on an ITF-report that presents the analyses in greater detail.
... Furthermore, several traffic safety studies have recognized that other important and unobserved determinants of traffic safety may vary substantially from one geographic area to another as well as over time periods (for example, state-specific or year-specific cultural sentiment toward drunk driving). As in these studies (for example, Benson, Rasmussen, and Mast, 1999;Cook and Tauchen, 1984;Dee, 1999;Evans and Graham, 1988;Evans, Neville, and Graham, 1991;Mast, Benson, and Rasmussen, 1999;Ruhm, 1996;Young and Likens, 2000), the results presented here control for the influence of these unobserved and potentially confounding omitted variables through the use of state and year fixed effects. This study also presents some counterfactual evaluations that validate this study's key inferences by exploiting the patterns in the timing of alcohol involvement in fatal traffic accidents. ...
... 14 For example, NHTSA (1999) reports that, in 1988, 49 percent of the drivers killed during weekends were in accidents involving someone who was 12 Since 1975, NHTSA has obtained data on all traffic-related fatalities through its Fatal Accident Reporting System (FARS). The economic literature on traffic safety has focused almost exclusively on fatalities as the key dependent variable (for example, Chaloupka, Saffer, and Grossman, 1993;Cook and Tauchen, 1984;Dee, 1999;Evans and Graham, 1988;Evans, Neville, and Graham, 1991;Mast, Benson, and Rasmussen, 1999;Ruhm, 1996;Young and Likens, 2000). 13 Ruhm (1996) addressed this issue directly and finds that the omission of such controls can lead to confounded inferences about alcohol-related traffic safety policies. ...
... Two other binary indicators identify states that have increased their highest speed limit to 65 miles per hour or to 70 or more miles per hour. 17 Three other controls (vehicle miles traveled, the state unemployment rate, and real state personal income per capita) reflect road usage and the state macroeconomic environment and are typically associated with road congestion, alcohol use, and, by implication, safety on the roads (Evans and Graham, 1988). ...
Nineteen states have established Za ws that make it illegal per se to drive with a blood alcohol concentration (BAC) of 0.08. The controversy over extending this stricter definition throughout the nation has focused largely on whether the state Za ws have been effective at saving lives. Prior evidence on this question has been mixed as well as criticized on several methodological grounds. This study presents novel, panel-based evaluations of 0.08 BAC laws, which address the potential methodological limitations of previous studies. The results of this study indicate that 0.08 BAC laws have been effective in reducing the number of traffic fatalities, particularly among younger adults. These estimates suggest that the nationwide adoption of 0.08 BAC laws would generate substantial gains, reducing the annual count of traffic fatalities by at least 1200. (C) 2001 by the Association of Public Policy Analysis and Management.
... A possible factor may be the U.S. recession during this period. It is well-established that traffic fatalities drop during recessions and rise when the economy is strong (Evans and Graham, 1988;Ruhm, 1995). Some factors hypothesized to influence the decrease in fatal crashes in a poor economy include declines in commuting to work, alcohol-impaired driving, and speeding (Cotti and Tefft, 2011;Evans and Graham, 1988;Ruhm, 1995), which are types of driving that are less frequent among drivers 70 and older. ...
... It is well-established that traffic fatalities drop during recessions and rise when the economy is strong (Evans and Graham, 1988;Ruhm, 1995). Some factors hypothesized to influence the decrease in fatal crashes in a poor economy include declines in commuting to work, alcohol-impaired driving, and speeding (Cotti and Tefft, 2011;Evans and Graham, 1988;Ruhm, 1995), which are types of driving that are less frequent among drivers 70 and older. ...
... There is evidence that the association between traffic fatalities and the economy weakens with the increasing age of the vehicle occupant (Evans and Graham, 1988), and research has found that driver age plays a role in the effect of the unemployment rate on crashes and driving exposure. Cotti and Tefft (2011) modeled the relationship between traffic fatalities and economic indices during 2003-09 and found that increases in the unemployment rate were associated with lower traffic fatality rates per capita among ages 30-59, but not among those 60 and older. ...
Objective:
Previous research has shown that fatal crash involvement rates per licensed driver aged 70 and older declined significantly more per year in the United States than rates for middle-aged drivers aged 35-54 during 1997-2008, and per vehicle mile traveled from 1995-1996 to 2001-2002. Analyses of police-reported crash data during 1997-2005 indicated that the greater declines for older drivers were due to decreases in crash involvement and in the risk of dying in the crashes that occurred. The current study examined if trends in crash rates, crash involvements, and survivability persisted into more recent years.
Methods:
Trends for drivers 70 and older were compared with trends for drivers aged 35-54 for U.S. national fatal passenger vehicle crash involvements per 100,000 licensed drivers during 1997-2012 and for U.S. national fatal passenger vehicle crash involvements per vehicle miles traveled in 1995-1996, 2001-2002, and 2008. Using police-reported crash data during 1997-2008 from 20 U.S. states, trends in involvement rates in non-fatal crashes of various severities per 100,000 licensed drivers and changes in the odds of death and the odds of death or serious injury in a crash were compared between older and middle-aged drivers.
Results:
During 2007-2012, declines in national fatal crash involvement rates per licensed driver were similar for drivers 70 and older and middle-aged drivers (18 percent each). However, when considering the entire study period, fatal crash involvement rates continued to reflect a substantially larger decline for drivers 70 and older than for middle-aged drivers (42 vs. 30 percent per licensed driver during 1997-2012, 39 vs. 26 percent per vehicle mile traveled from 1995-2006 to 2008). When analyses of police-reported crash data were extended through 2008, non-fatal injury crash involvement rates per licensed driver declined more for older than for middle-aged drivers (39 vs. 30 percent), and unlike in prior research, average annual declines were significantly larger for drivers 80 and older. Property damage-only crash involvement rates similarly declined significantly more for older than for middle-aged drivers (15 vs. 3 percent). Drivers 70 and older in 1997 were 3.5 times more likely than middle-aged drivers to die in a crash, and this ratio declined to 3.2 by 2008.
Conclusions:
Although declines in fatal crash involvement rates in recent years have not differed between older and middle-aged drivers, this did not undo earlier gains for older drivers. The recent slowing in the relative magnitude of the decline for older drivers may be related to the differential effect of the U.S. recession on fatal crash involvements of drivers in these age groups. The decreased likelihood of being involved in a crash of any severity and increased survivability when a crash occurred held when examining data through 2008, and for drivers 80 and older, significant declines in crash involvement relative to middle-aged drivers extended to non-fatal injury crashes.
... Furthermore, several traffic safety studies have recognized that other important and unobserved determinants of traffic safety may vary substantially from one geographic area to another as well as over time periods (for example, state-specific or year-specific cultural sentiment toward drunk driving). As in these studies (for example, Benson, Rasmussen, and Mast, 1999;Cook and Tauchen, 1984;Dee, 1999;Evans and Graham, 1988;Evans, Neville, and Graham, 1991;Mast, Benson, and Rasmussen, 1999;Ruhm, 1996;Young and Likens, 2000), the results presented here control for the influence of these unobserved and potentially confounding omitted variables through the use of state and year fixed effects. This study also presents some counterfactual evaluations that validate this study's key inferences by exploiting the patterns in the timing of alcohol involvement in fatal traffic accidents. ...
... 14 For example, NHTSA (1999) reports that, in 1988, 49 percent of the drivers killed during weekends were in accidents involving someone who was 12 Since 1975, NHTSA has obtained data on all traffic-related fatalities through its Fatal Accident Reporting System (FARS). The economic literature on traffic safety has focused almost exclusively on fatalities as the key dependent variable (for example, Chaloupka, Saffer, and Grossman, 1993;Cook and Tauchen, 1984;Dee, 1999;Evans and Graham, 1988;Evans, Neville, and Graham, 1991;Mast, Benson, and Rasmussen, 1999;Ruhm, 1996;Young and Likens, 2000). 13 Ruhm (1996) addressed this issue directly and finds that the omission of such controls can lead to confounded inferences about alcohol-related traffic safety policies. ...
... Two other binary indicators identify states that have increased their highest speed limit to 65 miles per hour or to 70 or more miles per hour. 17 Three other controls (vehicle miles traveled, the state unemployment rate, and real state personal income per capita) reflect road usage and the state macroeconomic environment and are typically associated with road congestion, alcohol use, and, by implication, safety on the roads (Evans and Graham, 1988). ...
... In contrast to this work is a more recent group of papers that show mortality is procyclical . The basic statistical relationship has been documented for the United States (Ruhm, 2000) and several OECD countries (Gerdtham and Johannesson, 2005; Neumayer, 2004; Tapia Granados, 2005), and for many outcomes including deaths from heart disease, certain cancers, murder (Ruhm, 2000), motor vehicle fatalities (Evans and Graham, 1988), plus infant health 38 (Dehejia and Lleras-Muney, 2004), and self reported health status (Ruhm, 2003). The one death category that shows a decidedly counter-cyclical pattern is suicides (Ruhm, 2000). ...
... To see if this is the case, we compare the pro-cyclicality of mortality to the within-month cycle for the 15 cause of death categories presented inTable 4 , using MCOD data for the 1976- 2004 period. The methodology for analyzing the pro-cyclicality of mortality dates to Evans and Graham (1988), and is typified in Ruhm (2000). Using pooled time-series/cross-sectional data at the state level, mortality rates are regressed on state and year effects, demographic covariates, and a measure of the business cycle, which is typically the unemployment rate. ...
... Let M it be the mortality rate for state i in year t, defined as deaths per 100,000 people. Following Graham (1988) and Ruhm (2000), the model we estimate is of the form: 41 The disparity between the older literature on socioeconomic status and health and the more recent work on mortality and the business cycle is not all that surprising. Typical measures of socioeconomic status include variables such as education, wealth, income, or occupational status, which can all be considered measures of permanent income. ...
We document a within-month mortality cycle where deaths decline before the 1st day of the month and then spike after the 1st. This cycle is present across a wide variety of causes and demographic groups. A similar cycle exists for a range of activities, suggesting the mortality cycle may be due to short-term variation in levels of activity. We provide evidence that the within-month activity cycle is generated by liquidity. Our results suggest a causal pathway whereby liquidity problems reduce activity, which in turn reduces mortality. These relationships help explain the pro-cyclic nature of mortality.
... However, in the case of violent crimes, the effect is large in relative years − 1 and 0, before diminishing. In contrast, the effect on traffic crimes emerges in the baseline year and remains high through relative year 2. To some degree, the durability of the traffic violation effect might be related to re-employment in jobs requiring a longer commute ( Evans and Graham, 1988 ). We find somewhat stronger relative effects for crimes related to alcohol and drugs (Model 4), which peak in the baseline year before diminishing somewhat in successive years. ...
... Or it might be that the displaced workers take new jobs where they drive more or that are further away from home (with longer commute, cf. Evans and Graham, 1988 ), which also make them more exposed to being charged with traffic violations. ...
We estimate the job displacement effect on criminal behavior for young adult Norwegian men separated from their plant of employment during a mass layoff. Displaced workers experience a 20 percent increase in criminal charge rates in the year of displacement, with effects declining thereafter. Effects are particularly large for property crimes, consistent with the idea that displaced workers turn to acquisitive crimes to replace lost earnings. However, effects are also sizable for violent and alcohol/drug-related crimes, indicating other mechanisms at work. We find strong evidence that displacement increases crime effects through the increased availability of time, and supportive evidence that psychological factors (mental distress, self-control) also play a role.
... We also controlled for state by year beer tax rates in 2014 US dollars per gallon, which have been linked to alcohol consumption and traffic fatalities (33,34). Because economic conditions influence factors associated with crash risk, such as alcohol consumption and the number of miles driven, we controlled for county monthly unemployment rates, which measure the percentage of the labor force 16 years and older that is unemployed (35,36). Lastly, because the availability of taxis may influence the demand for Uber, we controlled for the yearly number of taxi drivers per 100,000 population employed in a county's metropolitan area weighted by the county's proportion of its metropolitan area's total population. ...
... We found a similar result in Model 3, which includes control variables. Consistent with prior evidence (33)(34)(35)(36), county unemployment rates and state beer tax rates were associated with decreases in traffic fatalities. The presence of Uber, however, had no statistically significant impact. ...
Uber and similar rideshare services are rapidly dispersing in cities across the United States and beyond. Given the convenience and low cost, Uber has been characterized as a potential countermeasure for reducing the estimated 121 million episodes of drunk driving and the 10,000 resulting traffic fatalities that occur annually in the United States. We exploited differences in the timing of the deployment of Uber in US metropolitan counties from 2005 to 2014 to test the association between the availability of Uber's rideshare services and total, drunk driving-related, and weekend- and holiday-specific traffic fatalities in the 100 most populated metropolitan areas in the United States using negative binomial and Poisson regression models. We found that the deployment of Uber services in a given metropolitan county had no association with the number of subsequent traffic fatalities, whether measured in aggregate or specific to drunk-driving fatalities or fatalities during weekends and holidays.
... In contrast to this work is a group of papers that show mortality is procyclical. The basic statistical relationship has been documented for the United States (Ruhm, 2000) and several OECD countries (Gerdtham & Johannesson, 2005;Neumayer, 2004;Tapia Granados, 2005), and for many outcomes including deaths from heart disease (Ruhm, 2000), traffic fatalities (Evans & Graham, 1988), infant health (Dehejia & Lleras-Muney, 2004), and self-reported health status (Ruhm, 2003). The one death category that shows a decidedly countercyclical pattern is suicide (Ruhm, 2000;Tapia Granados, 2008). ...
... To see if this is the case, we compare the procyclicality of mortality to the within-month cycle for the fifteen causeof-death categories presented in table 4, using MCOD data for the 1976-2004 period. The methodology for analyzing the procyclicality of mortality dates to Evans and Graham (1988) and is typified in Ruhm (2000). When pooled timeseries and cross-sectional data at the state level are used, mortality rates are regressed on state and year effects, demographic covariates, and a measure of the business cycle, which is typically the unemployment rate. ...
... Despite being the most relevant studies published to date, Dee (2001) and Eisenberg (2003) did not take into account the possible serial correlation that can arise when using differences-in-differences methods with a large panel and a highly time-correlated dependent variable. As a result, their estimates could 17 Cook and Tauschen (1984) and Evans and Graham (1988), to my knowledge, are probably the first studies to introduce fixed effects in the road safety literature. Ruhm (1996), for example, shows the goodness of this methodology in the evaluation of road safety measures. ...
... 29 World Health Organization Regional Office for Europe (HFA-DB Database). 30 See Evans and Graham (1988) and Ruhm (1995) for a more in-depth discussion of these relationships. ...
Road safety has become an increasing concern in developed countries due to the significant amount of fatalities and the associated economic losses. Only in 2005 these losses rose to 200,000 million euros, a considerable sum ¿ approximately 2% of GDP ¿ that easily justifies any public intervention. One measure taken by governments to address this issue is to enact stricter policies and regulations. Since drunk driving is one of the greatest concerns among public authorities in this field, several European countries have lowered their illegal Blood Alcohol Content (BAC) levels to 0.5 mg/ml during the last decade. This study is the first evaluation of the effectiveness of this transition using European panel-based data (CARE) for the period 1991-2003 with the differences-in-differences method in a fixed effects estimation that allows for any pattern of correlation (Cluster-Robust). The results reveal a positive impact on certain groups of road users and on the whole population when the policy is accompanied by enforcement interventions. Moreover, positive results appeared after a time lag of over two years. Finally, I state the importance of controlling for serial correlation in the evaluation of this type of policy. - La seguridad vial se ha convertido en una creciente preocupación en el mundo desarrollado por el gran número de víctimas mortales sufridas y por las pérdidas económicas que se derivan de ella. En el año 2005 éstas ascendieron a 200.000 millones de euros, una cantidad que supone el 2% del PIB europeo y que justifica la existencia de intervención pública. Los gobiernos se enfrentan a este reto fijando leyes y normativas más estrictas, especialmente en la lucha contra la conducción bajo los efectos del alcohol. La mayoría de países europeos decidieron a lo largo de la última década rebajar el nivel de alcohol en sangrepermitido hasta 0.5 mg/ml. Este trabajo evalúa por primera vez la eficacia de esta transición usando un panel de datos europeo (CARE) mediante el método de Diferencias en Diferencias y efectos fijos permitiendo cualquier patrón de correlación (Cluster-Robust).Los resultados muestran la existencia de un impacto positivo sobre ciertos grupos, mientras que la efectividad sobre el conjunto de usuarios solo se consigue donde la reducción en el nivel de alcohol en sangre se acompaña de medidas que fuerzan su cumplimiento. Además, el trabajo encuentra un retardo superior a dos años en dicha eficacia. Finalmente, también se destaca la importancia de controlar por la autocorrelación, habitualmente olvidada en laevaluación de esta política.
... There has been a long-held agreement that traffic fatalities decline during recessions and increase with a strong economy (Evans & Graham, 1988;Ruhm, 1995). As the economy has largely rebounded from the economic recession that began in 2008, and miles driven and traffic-related fatalities are in direct relationship to the strength of the economy, it is expected that the number of fatalities and miles driven would increase given the lower unemployment level of 4% in December 2018 versus 10% in December 2010 (United States Bureau of Labor Statistics [BLS], 2011, 2019). ...
Introduction:
With the growing older adult population due to the aging baby-boom cohort, there was concern that increases in fatal motor-vehicle crashes would follow. Yet, previous analyses showed this to be untrue. The purpose of this study was to examine current trends to determine if previous declines have persisted or risen with the recent increase in fatalities nationwide.
Methods:
Trends among drivers ages 70 and older were compared with drivers 35-54 for U.S. passenger vehicle fatal crash involvements per 100,000 licensed drivers from 1997 to 2018, fatal and all police-reported crash involvements per vehicle miles traveled using the 1995, 2001, 2009, and 2017 National Household Travel Surveys, and driver deaths per 1,000 crashes.
Results:
Since the mid-1990s, fatal crashes per licensed driver trended downward, with greater declines for drivers ages 70 and older than for middle-aged drivers (43% vs. 21%). Fatal crash rates per 100,000 licensed drivers and police-reported crash rates per mile traveled for drivers ages 70-79 are now less than those for drivers ages 35-54, but their fatal crash rates per mile traveled and risk of dying in a crash remain higher as they drive fewer miles. As the economy improved over the past decade, fatal crash rates increased substantially for middle-aged drivers but decreased or remained stable among older driver age groups.
Conclusions:
Fatal crash involvements for adults ages 70 and older has recently increased, but they remain down from their 1997 peak, even as the number of licensed older drivers and the miles they drive have increased. Health improvements likely contributed to long-term reductions in fatal crash rates. As older drivers adopt vehicles with improved crashworthiness and safety features, crash survivability will improve. Practical Application: Older adults should feel confident that their independent mobility needs pose less risk than previously expected.
... Although we have focused on the impact of legislation on traffic crash fatalities, it is important to also take into account the impact of factors beyond legislation in crashes. For example, negative economic indicators, such as high unemployment and/or low economic growth are associated with lower crash fatalities (Evans and Graham 1988;Wagenaar 1984), while urbanization is associated with lower rates of crash fatalities (O'Neill and Kyrychenko 2006). In fact, O'Neill and Kyrychenko (2006) find that the socioeconomic and demographic factors of percentage living in urban areas, median household income, percentage with a college degree, educational expenditures, and mean vehicle age account for roughly 60-70% of the variance in fatal crashes between states. ...
As part of the War on Drugs, many states passed legislation revoking the driver’s licenses of individuals convicted of drug crimes, even for drug offenses in which no driving offense occurred. These restrictions were supported at the national level, with federal legislation in 1992 requiring states to either pass laws suspending the license of anyone convicted of a drug offense for at least 6 months, or risk losing 10% of certain federal highway funds (although states could also formally “opt out”). Reentry advocates contend that these restrictions on driver’s licenses provide a hardship to individuals as they reenter society, making it more difficult for them to maintain stable employment, and placing additional stress on families that shoulder the responsibility of providing transportation. In response, some states have recently chosen to end restrictions on driver’s licenses for individuals that are convicted of non-driving related drug offenses. A critical part of this conversation however, is whether or not these laws have any safety benefits in terms of traffic accidents. We conduct a fixed effects analysis to determine the impact of these laws on both drug-related traffic fatalities, and all traffic fatalities.
... There is a fair amount of direct evidence in support of this mechanism. For example, Evans and Graham (1988) and Ruhm (1996) show that drinking and driving exhibit a pro-cyclical pattern, and Ruhm (2000) shows that motor vehicle fatalities are more sensitive to the business cycle than any other cause of death. Similarly, pollution may vary over the business cycle and contribute to mortality fluctuations. ...
It is well known that mortality rates are pro-cyclical. In this paper, we attempt to understand why. We find little evidence that cyclical changes in individuals' own employment-related behavior drives the relationship; own-group employment rates are not systematically related to own-group mortality. Further, most additional deaths that occur when the economy is strong are among the elderly, particularly elderly women and those residing in nursing homes. We also demonstrate that staffing in nursing homes moves counter-cyclically. These findings suggest that cyclical fluctuations in the quality of health care may be a critical contributor to cyclical movements in mortality.
... For example, as state unemployment levels rise, people drive less. Fewer miles driven usually translates into less crowded roads and smaller numbers of motor vehicle-related deaths (Evans & Graham, 1988;Leigh & Waldon, 1991). Fewer highway deaths, in turn, should reduce the need for patrol officers. ...
This study assesses the social, political, economic, and traffic-/travel-related predictors of sworn highway patrol and state police strength in the United States between 1981 and 2015. Fixed-effects estimates based on analyses of 1,635 state-years indicate that theoretical accounts centered on racial threat theory, partisan politics, and gendered politics in part explain variation in this outcome. Findings suggest that changes in population density, the tax base, the percentage of the population without a high school degree, violent crime rates, and spending on social welfare at the state level, as well as shifts in local law enforcement strength, also influence state police and patrol organization strength over this period. Surprisingly, fluctuations in the number of state traffic fatalities per million vehicle miles traveled and the number of driver’s licenses per 100,000 state population—two seemingly important traffic-/travel-related factors—have no impact on the rate of state police and patrol officers per 100,000 population.
... This is in line with the literature that finds that work-related, and other types accidents (e.g. due to drinking and driving behaviours) are likely to become more common during temporary expansions of economic activity (see, for instance, Evans and Graham, 1988;Ruhm, 1995). Dolan et al. (2014), however, finds that road traffic accidents increased substantially in Greece on the first two days following the announcements of austerity measures. ...
... Furthermore, researchers have shown that state macroeconomic factors are associated with road safety outcomes. 39,40 Thus, using US Bureau of Labor Statistics and Bureau of the Census data, we controlled for state annual unemployment rates by year and state per capita income by year, respectively. Finally, consistent with earlier traffic fatality research, we accounted for each state's exposure to crash risk by including state population estimates by year in our models. ...
We used a panel design and the Nationwide Inpatient Sample from 19 states between 2003 and 2010 to examine the impact of texting bans on crash-related hospitalizations. We conducted conditional negative binomial regressions with state, year, and month fixed effects to examine changes in crash-related hospitalizations in states after the enactment of a texting ban relative to those in states without such bans.
Results indicate that texting bans were associated with a 7% reduction in crash-related hospitalizations among all age groups. Texting bans were significantly associated with reductions in hospitalizations among those aged 22 to 64 years and those aged 65 years or older. Marginal reductions were seen among adolescents.
States that have not passed strict texting bans should consider doing so.
... Thus, during recessions, driving activity falls leading to fewer accidents and deaths. Partyka (1984), Evans and Graham (1988), Fowles and Loeb (1995), and Welki and Zlatoper (2007) found evidence of a negative relationship between the unemployment rate and various categories of highway fatalities. Loeb and Clarke (2007) point out the impact of income on accidents and fatalities is theoretically indeterminate. ...
This paper analyzes the determinants of motor vehicle fatalities in Kansas. The objectives of the study include the following: Formulate a theoretical model of the determinants of motor vehicle fatalities. Compare the empirical results of the study to other recent state studies of motor vehicle fatalities. The unemployment rate had the expected inverse relationship to fatalities but was statistically significant in only two of seven estimated models. Alcohol consumption and the speed limit on rural interstate highways had the expected positive relationship to fatalities. Other variables that were statistically significant included Kansas seat belt law dummy, the proportion of young and old drivers to the rest of the Kansas population, and the ratio of rural to urban driving. The study measured the effect of three measures of highway safety law enforcement on fatalities: Kansas police per 10,000 population, Kansas police per 100 miles of road, and Kansas per capita expenditure for police protection. All three had the expected negative sign and were highly significant.
... There is less driving during recessions, resulting in fewer accidents and deaths. Robertson (1984), Partyka (1984), Evans and Graham (1988), Fowles and Loeb (1995), and Welki and Zlatoper (2007) found evidence of a negative relationship between the unemployment rate and highway fatalities. Loeb and Clarke (2007) point out that the impact of income on fatalities is theoretically indeterminate. ...
Research on motor vehicle safety has involved virtually all modes of transportation. Most of these have been national in scope with relatively few studies focused on the determinants of motor vehicle fatalities at the state level. This paper investigates the determinants of motor vehicle fatalities across the states of California, Illinois, Louisiana, Pennsylvania, and Texas which collectively account for 27% of U.S. motor vehicle fatalities in 2006. A major conclusion is that fatalities and its determinants vary by state, and several of these determinants are subject to state policy control. As such, our coefficient estimates and econometric framework are relevant for designing policies intended to reduce motor vehicle fatalities.
... 6 This is in line with the literature that finds that work-related, and other types accidents (e.g. due to drinking and driving behaviours) are likely to become more common during temporary expansions of economic activity (see, for instance, Evans and Graham, 1988; Ruhm, 1995). Dolan et al. (2014), however, finds that road traffic accidents increased substantially in Greece on the first two days following the announcements of austerity measures. ...
While linkages between some macroeconomic phenomena (e.g. unemployment, GDP growth) and suicide rates in some countries have been explored, only one study, hitherto, has established a causal relationship between fiscal consolidation and suicide, albeit in a single country. This study examines the impact of budget consolidation on suicide mortality across all Eurozone peripheral economies, while controlling for various economic and socio-demographic differences. The impact of fiscal adjustments is found to be gender, age and time specific. In particular, fiscal consolidation has short-, medium- and long-run suicide increasing effects on the male population between 65 and 89 years of age. A one percentage point reduction in government spending is associated with an 1.39%, 2.35% and 2.64% increase in the short-, medium- and long-run, respectively, of male suicides rates between 65 and 89 years of age in the Eurozone periphery. These results are highly robust to alternative measures of fiscal consolidation. Unemployment benefits and substantial employment protection legislation seem to mitigate some of the negative effects of fiscal consolidation on suicide mortality. Plausible explanations for these impacts are provided and policy implications drawn.
... 20,23---25 Controlling for the state of the economy has been demonstrated to be important because the unemployment rate may reduce roadway fatalities if fewer drivers are on the road as a result of decreased economic activity. 31 Legal factors include the presence of seatbelt laws, handheld bans, blood alcohol concentration (BAC) limits and speed limits, and graduated driver licensing (GDL) programs. Drunk driving laws have been shown to be significant predictors of traffic fatalities. ...
Using a panel study design, we examined the effects of different types of texting bans on motor vehicular fatalities.
We used the Fatality Analysis Reporting System and a difference-in-differences approach to examine the incidence of fatal crashes in 2000 through 2010 in 48 US states with and without texting bans. Age cohorts were constructed to examine the impact of these bans on age-specific traffic fatalities.
Primarily enforced laws banning all drivers from texting were significantly associated with a 3% reduction in traffic fatalities in all age groups, and those banning only young drivers from texting had the greatest impact on reducing deaths among those aged 15 to 21 years. Secondarily enforced restrictions were not associated with traffic fatality reductions in any of our analyses.
... i) In line with part of the literature we found that income decline might lower risky behaviours such as excessive alcohol consumption, at least partly due to growing budget constraints (Evans and Graham, 1988;Freeman, 1999;Ruhm, 1995;Ruhm and Black, 2002). The estimated significant reduction in alcohol consumption in the countries with the lowest levels of social expenditures might in turn have been driving the reduction in cirrhosis and chronic liver disease mortality as well as on motor vehicle mortality (possibly as a result of less drunk driving). ...
There are great concerns and some initial country-specific, descriptive evidence about potential adverse health consequences of the recent Great Recession.
Using data for 23 European Union countries we examine the short-term impact of macroeconomic decline during the Great Recession on a range of health and health behaviour indicators. We also examine whether the effect differed between countries according to the level of social protection provided.
Overall, during the recent recession, an increase of 1 percentage point in the standardized unemployment rate has been associated with a statistically significant decrease in the following mortality rates: all-cause-mortality (3.4%), cardiovascular diseases (3.7%), cirrhosis- and chronic liver disease-related mortality (9.2%), motor vehicle accident-related mortality (11.5%), parasitic infection-related mortality (4.1%), but an increase in the suicide rate (34.1%). In general, the effects were more marked in countries with lower levels of social protection, compared to those with higher levels.
An increase in the unemployment rate during the Great Recession has had a beneficial health effect on average across EU countries, except for suicide mortality. Social protection expenditures appear to help countries "smooth" the health response to a recession, limiting health damage but also forgoing potential health gains that could otherwise result.
... 15 BMI is defined as weight in pounds divided by height in inches squared, and multiplied by 703. 16 Many prior studies examine the effects of recessions on alcohol use and alcohol-impaired driving (e.g., Evans and Graham 1988, Wagenaar and Streff 1989, Ruhm 1995, Ruhm and Black 2002. Because the MCBS Cost and Use data do not include information on alcohol consumption, we cannot examine drinking behaviors. ...
A number of studies report that U.S. state mortality rates, particularly for the elderly, decline during economic downturns. Further, several prior studies use microdata to show that as state unemployment rates rise, physical health improves, unhealthy behaviors decrease, and medical care use declines. We use data on elderly mortality rates and data from the Medicare Current Beneficiary Survey from a time period that encompasses the start of the Great Recession. We find that elderly mortality is countercyclical during most of the 1994-2008 period. Further, as unemployment rates rise, seniors report worse mental health and are no more likely to engage in healthier behaviors. We find suggestive evidence that inpatient utilization increases perhaps because of an increased physician willingness to accept Medicare patients. Our findings suggest that either elderly individuals respond differently to recessions than do working age adults, or that the relationship between unemployment and health has changed.
... For example, when more people are working, roadways are more congested, and this leads to an increase in the probability of being involved in a fatal auto accident. Evans and Graham (1988) and Ruhm (1995) show that drinking and driving exhibit a pro-cyclical pattern, and Ruhm (2000) shows that motor vehicle fatalities are more sensitive to the business cycle than any other cause of death. Similarly, pollution may vary over the business cycle and contribute to mortality fluctuations. ...
A growing literature documents cyclical movements in mortality and health. We examine this pattern more closely and attempt to identify the mechanisms behind it. Specifically, we distinguish between mechanisms that rely on fluctuations in own employment or time use and those involving factors that are external to the individual. Our investigation suggests that changes in individuals’ own behavior contribute very little to pro-cyclical mortality. Looking across broad age and gender groups, we find that own-group employment rates are not systematically related to own-group mortality. In addition, we find that most of the additional deaths that occur during times of economic growth are among the elderly, particularly elderly women, who have limited labor force attachment. Focusing on mortality among the elderly, we show that cyclicality is especially strong for deaths occurring in nursing homes, and is stronger in states where a higher fraction of the elderly reside in nursing homes. We also demonstrate that staffing in skilled nursing facilities moves counter-cyclically. Taken together, these findings suggest that cyclical fluctuations in the mortality rate may be largely driven by fluctuations in the quality of health care.
... 16 See Fell and Voas (2003) and Eisenberg (2003) for a literature review on the evidence of lowering BAC laws. 17 Cook and Tauschen (1984) and Evans and Graham (1988) are probably the first studies that introduced fixed effects in the road safety literature. Ruhm (1996), for example, shows the efficacy of this methodology in the evaluation of road safety measures. ...
... The term, W , in Eq. (2) introduces st controls for the other determinants of youth traffic fatalities that also vary within state over time. For example, these specifications include two measures for the state level of macroeconomic activity: the state unemployment rate and real state personal income per capita (Evans and Graham, 1988). Additionally, a binary indicator is also included for whether a state had a mandatory seat belt law. ...
This empirical study evaluates the policy responsiveness of teen drinking in models that can condition on the unobserved state-specific attributes that may have biased conventional evaluations. The results demonstrate that cross-state heterogeneity can be important and that beer taxes have relatively small and statistically insignificant effects on teen drinking. Models of youth traffic fatalities also indicate that the conventional beer tax elasticities are not robust to additional controls for omitted variables. The importance of these omitted variables is illustrated by a counterfactual which compares models of nighttime fatalities to those that occur in the daytime when the rate of alcohol involvement is substantially lower.
... Most prior research finds that these laws increased belt usage and reduced fatality risk (e.g., Sen, 2001). The next control variable, the state unemployment rate, is frequently included in such evaluations because it captures the cyclical variation in traffic safety related to the amount of road usage (e.g., Evans and Graham, 1988). We also include as controls three variables related to the key 7 drunk-driving laws that changed over this period (DeJong and Hingson, 1998). ...
This study presents panel-based evidence on the overall fatality consequences of recent speed-limit increases in the United States. The results suggest that higher speed limits had highly heterogeneous effects, generally increasing fatalities among women and the elderly but reducing them among males.
... Ruhm (2000) found that this basic relationship remains in regressions of state-level mortality rates on unemployment rates, state and year effects, as well as some demographic covariates. Similar relationships between mortality and measures of economic activity have been documented for several OECD countries (Gerdtham and Johannesson, 2005; Neumayer, 2004; Tapia Granados, 2004), health habits (Ruhm, 2003) and health outcomes (Ruhm, 2005), as well as a wide variety of causes of death including heart disease, certain cancers, murder (Ruhm, 2000), motor vehicle fatalities (Evans and Graham, 1988) and infant health (Dehejia and Lleras-Muney, 2004). ...
Many studies find that households increase their consumption after the receipt of expected income payments, a result inconsistent with the life-cycle/permanent income hypothesis. Consumption can increase adverse health events, such as traffic accidents, heart attacks and strokes. In this paper, we examine the short-term mortality consequences of income receipt. We find that mortality increases following the arrival of monthly Social Security payments, regular wage payments for military personnel, the 2001 tax rebates, and Alaska Permanent Fund dividend payments. The increase in short-run mortality is large, potentially eliminating some of the protective benefits of additional income.
... 16 See Fell and Voas (2003) for a literature review on the evidence of lowering BAC laws. 17 Cook and Tauschen (1984) and Evans and Graham (1988) ...
Road safety has become an increasing concern in developed countries due to the significant amount of mortal victims and the economic losses derived. Only in 2005 these losses rose to 200.000 million euros, a significant amount - approximately the 2% of its GDPthat easily justifies any public intervention. One tool used by governments to face this challenge is the enactment of stricter policies and regulations. Since drunk driving is one of the most important concerns of public authorities on this field, several European countries decided to lower their illegal Blood Alcohol Content levels to 0.5 mg/ml during the last decade. This study evaluates for the first time the effectiveness of this transition using European panel-based data (CARE) for the period 1991-2003 using the Differences-in-Differences method in a fixed effects estimation that allows for any pattern of correlation (Cluster-Robust). My results show the existence of positive impacts on certain groups of road users and for the whole population when the policy is accompanied by some enforcement interventions. Moreover, a time lag of more than two years is found in that effectiveness. Finally, I also assert the importance of controlling for serial correlation in the evaluation of this kind of policies.
The substantial decline in motor-vehicle fatal crashes over the period of 2008 to 2011 has been subjected to extensive research in the last few years. Staring from early 1970"s, road safety improvements have been associated with economic downfalls by looking into empirical historical evidence in many countries of the world. Following the consequences of a perceptible reduction in the number of fatality in the United States which concurred with a major economic recession at that period, some researchers are focusing on finding the relative influence of such hypothesis by means of mathematical and statistical modeling. Other studies have proposed improvements in existing fatality prediction techniques to help policymakers in implementing better safety countermeasures. This paper aims to present a comprehensive review of the studies attempting to correlate comparative variables including those subjected to the economic downturn with the reduction in fatal crashes. An expository analysis of different multidisciplinary models addressing the fatal crash issue will be conducted in order to sort difference in analogy within the approaches, and finally, a tentative methodology will be proposed as future research scope to address the current methodological issues.
The main objective of this study is to evaluate the effects of the Road Safety System Approach on serious road casualties: fatalities and serious injuries in Brunei (target group), using the Auto Regressive Integrated Moving Average (ARIMA) and Intervention Time Series Analysis methods with control group. Control group is used to consider the influences of other factors which have been eliminated prior to estimating the net effect of the Road Safety System Approach for the target group relative to the control group. It is found that a significant reduction in serious road casualties of 30% was achieved for the first 12-months after the introduction of the Road Safety System Approach through the reformed road safety initiatives in Brunei. This shows that Brunei’s road safety record is now similar to other high road safety performing countries. Brunei can also now be considered as a model for the trajectory of road safety in the entire South East Asian region.
Background:
The 2008 economic crisis may have had an impact on mental health but the studies on this topic are sparse, in particular among the working population. However, mental health at work is a crucial issue involving substantial costs and consequences. The aim of the study was to assess changes in behaviors and indicators of mental health in the French working population between 2006 and 2010, and to explore the differential changes according to age, origin, occupation, activity sector, public/private sector, self-employed/employee status and work contract.
Methods:
The data came from the prospective national representative Santé et itinéraire professionnel (SIP) survey, including a sample of 5600 French workers interviewed in 2006 and 2010. The behaviors and indicators of mental health studied were excessive alcohol consumption, smoking, sleep problems (sleep disorders and/or insufficient sleep duration), psychotropic drug use (antidepressants, anxiolytics and/or hypnotics), and poor self-reported health. Generalized estimating equations were used to analyze changes in behaviors and indicators of mental health, and the analyses were adjusted for age. Covariates (age, origin, occupation, activity sector, public/private sector, self-employed/employee status and type of contract) were added separately to assess differential changes.
Results:
Increases in excessive alcohol consumption among women, sleep problems among men, and smoking, insufficient sleep duration and poor self-reported health for both genders were observed in the French working population between 2006 and 2010. Some differential changes were observed, negative changes being more likely to affect young workers and workers with a permanent contract.
Conclusion:
Prevention policies should consider that behavior and indicators of mental health may deteriorate in times of economic crisis, especially among some sub-groups of the working population, such as young workers and workers with a permanent contract. These changes might foreshadow a forthcoming increase in mental disorders.
Risky health behaviors such as smoking, drinking alcohol, drug use, unprotected sex, and poor diets and sedentary lifestyles (leading to obesity) are a major source of preventable deaths. This chapter overviews the theoretical frameworks for, and empirical evidence on, the economics of risky health behaviors. It describes traditional economic approaches emphasizing utility maximization that, under certain assumptions, result in Pareto-optimal outcomes and a limited role for policy interventions. It also details non-traditional models (e.g. involving hyperbolic time discounting or bounded rationality) that even without market imperfections can result in suboptimal outcomes for which government intervention has greater potential to increase social welfare. The chapter summarizes the literature on the consequences of risky health behaviors for economic outcomes such as medical care costs, educational attainment, employment, wages, and crime. It also reviews the research on policies and strategies with the potential to modify risky health behaviors, such as taxes or subsidies, cash incentives, restrictions on purchase and use, providing information, and restricting advertising. The chapter concludes with suggestions for future research.
Using variation across geographic regions, a number of studies from the U.S. and other developed countries have found more deaths in economic upturns and less deaths in economic downturns. We use data from regions in Norway for 1977-2008 and find the same pro-cyclical patterns. Using individual-level register data for the identical population, we find that disadvantaged socioeconomic groups are not hit harder by pro-cyclical mortality than advantaged groups. We also find that other indicators of deteriorated health (than death), like becoming disabled, are pro-cyclical. Overall, our analysis suggests that pro-cyclical mortality is rather related to deaths of people already in deteriorated health than to people of low socioeconomic status.
We use micro-data to investigate the relationship between unemployment and mortality in the United States using Logistic regression on a sample of over 16,000 individuals. We consider baselines from 1984 to 1993 and investigate mortality up to ten years from the baseline. We show that poor local labor market conditions are associated with higher mortality risk for working-aged men and, specifically, that a one percentage point increase in the unemployment rate increases their probability of dying within one year of baseline by 6%. There is little to no such relationship for people with weaker labor force attachments such as women or the elderly. Our results contribute to a growing body of work that suggests that poor economic conditions pose health risks and illustrate an important contrast with studies based on aggregate data.
This paper analyzes the effects of cell phone usage and economic freedom on motor vehicle death rates by estimating regression models on data for three years across 38 countries. The models incorporate a representative set of motor vehicle fatality determinants. Results indicate that cell phone use has a statistically significant nonlinear impact on highway death rates and that economic freedom does not appear to have an effect.
This paper examines the impact of cell phone usage on truck accident rates in the United States using econometric models and specification error tests. The models focus on the potential nonlinear effect of cell phones on these accidents. The results indicate that increases in cell phone usage increase truck accident rates, but at a declining rate.
To reduce the annual toll of highway deaths, more than 30 states have passed laws mandating the use of safety belts. All have been effective at raising safety belt use; equipped with different provisions and enforced with unequal care, however, they have done so to different degrees. The article estimates the relationship between attained belt use and fatalities averted. Monthly 1982-1986 fatality, collision, belt use, and other data from 64 areas in nine states were collected, then analyzed using a Poisson multiple regression model. The analysis indicates that an increase in belt use from 14-40% averts about 13% of fatalities; a more pronounced increase to 50% averts about 18%. An increase from 50-75% averts about 16% of remaining fatalities. Three significant conclusions emerge. First, previous estimates appear to have understated, in general, the overall effectiveness of belt use laws. Second, the benefits of programs to boost safety belt use in this country from its current level of about 50% to up to 75%, estimated on the basis of more direct evidence from U.S. data than previously available, appear to be very large. Third, Poisson and other multiple regression models including explicit allowance for other causal factors can usefully complement other statistical approaches in traffic safety studies.
This paper examines the determinants of truck accidents in the United States using a time series data set covering the period 1970-2001. Along with other factors, the effect of the Motor Carrier Act of 1980, which deregulated the trucking industry, is examined for its impact on truck accidents. In addition, the model accounts for the effect railroad freight mileage has on truck accidents. Empirically, alcohol consumption, the unemployment rate, and railroad activity were found to have significant effects on truck accidents while deregulation of the trucking industry did not have a statistically significant adverse effect on these accidents.
This paper investigates to what extent and in what ways conditions related to the 2007-2008 recession reduced fatal crashes. It hypothesizes that the reduction in fatal automobile accidents operates through both the quantity of driving and changes in behaviors associated with driving. Using state-by-quarter fixed effects models, the study shows that unemployment rate increases significantly reduce fatal accidents. Decomposing the fatal accident rate into accidents per mile traveled and miles traveled per capita reveals that higher unemployment is significantly associated with fewer accidents per mile, and also reveals that fatal accidents associated with alcohol are more responsive to unemployment rate changes than are accidents overall. These results suggest that the recession’s “lost†fatal accidents occurred in areas hit harder by the recession and were in the form of fewer alcohol-related accidents per mile traveled rather than fewer miles traveled overall.
This paper analyzes the influence of highway safety regulation enforcement efforts on motor vehicle fatalities. It estimates a regression model in which such deaths depend on these efforts as well as economic conditions, driver characteristics, government regulations, and locational factors, using 1973–2000 annual Ohio data. Statistically significant results indicate that the enforcement measure of drunk driving arrests saves lives. They also suggest that highway deaths increase with the following: better economic conditions, greater alcohol consumption, larger proportions of young and old drivers, higher speed limits, and more driving on rural roads. The trend in deaths is downward.
Highway fatality rates vary significantly among jurisdictions. Before attributing these variations to policy differences, it is important to account for exogenous factors (e.g. weather) that are beyond the control of policy makers. A new method is developed to identify states that are doing better or worse than expected. The method is applied to the 48 contiguous American states using highway fatality data for the years 1975 to 1986. A fixed effects linear model is used to estimate the fatality rate for each state, taking into account exogenous factors. Results indicate that many states have higher or lower fatality rates than is expected based on a ranking of states according to crude fatality rates. Policy implications are discussed.
This paper uses seemingly unrelated regression analysis and annual Ohio data for 1975–2000 to estimate a model for six different types of motor vehicle fatalities: car occupants, light truck occupants, large truck occupants, motorcyclists, pedestrians, and pedalcyclists. It finds that while certain government highway safety regulations (e.g., speed limits) and enforcement activities (e.g., drunk driving arrests) have life-saving effects, not all groups are beneficiaries.
Several studies in low-income populations report the somewhat counterintuitive finding that positive income gains adversely affect adult health. The literature posits that receipt of a large portion of annual income increases, in the short term, risk-taking behaviour and/or the consumption of health-damaging goods. This work implies the hypothesis that persons with an unexpected gain in income will exhibit an elevated risk of accidental death-the fifth leading cause of death in the USA. We test this hypothesis directly by capitalizing on a natural experiment in which Cherokee Indians in rural North Carolina received discrete lump sum payments from a new casino.
We applied Poisson regression to the monthly count of accidental deaths among Cherokee Indians over 204 months spanning 1990-2006. We controlled for temporal patterns in accidental deaths (e.g. seasonality and trend) as well as changes in population size.
As hypothesized, the risk of accidental death rises above expected levels during months of the large casino payments (relative risk = 2.62; 95% confidence interval = 1.54-4.47). Exploratory analyses of ethnographic interviews and behavioural surveys support that increased vehicular travel and consumption of health-damaging goods may account for the rise in accident proneness.
Although long-term income gains may improve health in this population, our findings indicate that acute responses to large income gains, in the short term, increase risk-taking and accident proneness. We encourage further investigation of natural experiments to identify causal economic antecedents of population health.
In this article, we have investigated the pattern of road fatality in Brunei. It is seen from this analysis that road fatality in Brunei was one of the highest in the world in the early 1990s, but has been significantly reduced over the years, and is now one of the lowest in the world. Preliminary investigation shows that young male drivers are responsible for most road fatalities in Brunei. We have also fitted a linear regression model and found that road fatality is significantly positively related to people aged 18-24 years and new registered vehicles, both of which are expected to grow with the growth of population and economic development. Hence, road fatality in Brunei is also expected to grow unless additional effective road safety countermeasures are introduced and implemented to reduce road toll. Negative coefficient is observed for trend variable, indicating the reduction of road fatality due to the combined effects of improvements of vehicle safety, road design, medical facilities and road safety awareness among road user groups. However, short-term road fatality analysis based on monthly data indicates that the coefficient of the trend variable is positive, implying that in recent months road fatalities are increasing in Brunei, which is supported by media reports. We have compared Brunei's road fatality data with Australia, Singapore and Malaysia and found that Brunei's road fatality rate is lower than Singapore and Malaysia, but higher than Australia. This indicates that there are still opportunities to reduce road fatalities in Brunei if additional effective road safety strategies are implemented like in Australia without interfering in the economic and social development of Brunei.