Kavi Bhalla's research while affiliated with University of Chicago and other places
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Publications (89)
Objective:
To evaluate road safety in member countries of the Association of Southeast Asian Nations and estimate the benefits that vehicle safety interventions would have in this group of countries.
Methods:
We used a counterfactual analysis to assess the reduction in traffic deaths and disability-adjusted life years (DALYs) lost if eight prove...
Background
There are large discrepancies between official statistics of traffic injuries in African countries and estimates from the Global Burden of Disease (GBD) study and WHO’s Global Status Reports on Road Safety (GSRRS). We sought to assess the magnitude of the discrepancy in Ethiopia, its implications and how it can be addressed.
Methods
We...
Background
Despite several global resolutions to improve road safety, road traffic injuries (RTI) have continued to grow in many countries, indicating gaps in evidence on intervention that work.
Method
We developed an Evidence Gap Map (EGM) to identify existing evidence from all effectiveness studies and systematic reviews related to road safety i...
Background
The adherence to speed limits can reduce deaths associated with road traffic injuries (RTIs) by more than a quarter. This study aimed to evaluate the effective factors on the speeding behavior of Iranian taxi drivers around fixed speed cameras.
Method
Telematics devices used in this study collected the location and speed of the vehicles...
Background:
Aggressive driving is the leading behavior resulting in fatal or nonfatal disabling injuries. Therefore, programs with the main focus on driving behavior could reduce the risk of traffic injuries remarkably. We aimed to investigate the role of non-punitive performance feedback on drivers' behavior and evaluate the persistence of the al...
Introduction:
There is considerable uncertainty in estimates of traffic deaths in many sub-Saharan African countries, with the Global Burden of Disease (GBD) and the Global Status Report on Road Safety (GSRRS) reporting widely differing estimates. As a case study, we reviewed and compared estimates for Tanzania.
Methods:
We estimated the inciden...
Introduction:
Road traffic crashes involving vertical curbs are commonly reported to occur on highways and expressways in India. We found a gap in terms of systematically assessing the evidence of the impact of curbs on road safety outcomes in the real world.
Method:
We conducted a systematic review and meta-analysis of the impact of curbs on th...
Introduction
Timely, accurate and detailed information about traffic injuries are essential for managing national road safety programmes. However, there is considerable under-reporting in official statistics of many low and middle-income countries (LMICs) and large discrepancies between estimates from the Global Burden of Disease (GBD) study and WH...
Annual report published by TRIP Centre on road safety statistics of India at the city, state and national level. Includes age- and gender-specific death rates, underreporting and misreporting in official statistics, types of road users involved as victims, trends in death rates across cities and states, and interventions to improve road safety.
Introduction
Tracking progress towards Sustainable Development Goal (SDG) 3·6 of reducing traffic deaths and serious injuries poses a measurement challenge in most low-income and middle-income countries (LMICs) due to large discrepancies between reported official statistics and estimates from global health measurement studies. We assess the extent...
International standards recommend provision of one ambulance for every 50,000 people to fulfill demand for transporting patients to definitive care facilities in low and middle income countries (LMICs). Governments’ consistent attempt to build capacity of emergency medical services (EMS) in LMICs has been financially demanding. This study is an att...
Background
The Sustainable Development Goals (SDGs), which aim to halve global traffic deaths by 2020, will not be met by most low-income and middle-income countries (LMICs). In Latin America and the Caribbean (LAC) region, traffic deaths have remained stable at a high-level despite strong progress in other health domains. We evaluated the effects...
The Decade of Action for Road Safety 2011–2020, officially proclaimed by the UN General Assembly in March 2010, sought to reduce morbidity and mortality due to road traffic injuries (RTI) significantly. While there is reasonable agreement internationally on safer designs of motor vehicles (except locally produced vehicles like three‐wheeled scooter...
Despite strong advocacy, the UN Decade of Action for Road Safety (2011–2020) is ending with most low- and middle-income countries (LMICs) no closer to the Sustainable Development Goals target of reducing traffic mortality by half. In contrast, most high-income countries (HICs) have seen large benefits in recent decades from large-scale safety inter...
Road traffic deaths in high-income countries (HICs) have been steadily declining for five decades, but are rising or stable in low- and middle-income countries (LMICs). We use time-series cross-sectional methods to assess how age- and sex- specific death rates evolved in 20 HICs during 1955–2015, controlling for income, population density and urban...
Introduction
Ambulance-based emergency medical systems (EMS) are expensive and remain rare in low- and middle-income countries, where trauma victims are usually transported to hospital by passing vehicles. Recent developments in transportation network technologies could potentially disrupt this status quo by allowing coordinated emergency response...
Background: Time to hospital after a road traffic crash (RTC) plays a vital role in determining the outcome for crash victims. In Delhi, there are seven designated trauma centres where crash victims are typically taken, which may not be nearest hospital. We compare the transport time access (crash to hospital) depending on whether the victim is tra...
Traffic injuries remain a leading health concern in most low- and middle-income countries (LMICs). However, most LMICs have not established institutions that have the legislative mandate and financial resources necessary to coordinate large-scale interventions. Argentina provides a counterexample. Argentina is a federal country where the decentrali...
Objective:
Deaths due to road traffic accidents (RTAs) are a major public health concern around the world. Developing countries are over-represented in these statistics. Punitive measures are traditionally employed to lower RTA related behavioural risk factors. These are, however, resource intensive and require infrastructure development. This is...
Background:
Street imagery is a promising and growing big data source providing current and historical images in more than 100 countries. Studies have reported using this data to audit road infrastructure and other built environment features. Here we explore a novel application, using Google Street View (GSV) to predict travel patterns at the city...
Further details on methods and results.
(DOCX)
Dataset.
This file contains tabulation of city-level census-reported commute mode shares, APS-reported past-month walking and cycling variables and GSV counts of road users and monthly distribution of images.
(CSV)
The interest in bicycling and its determining factors is growing within the public health, transportation and geography communities. Ownership is one factor affecting bicycle usage, but work is still ongoing to not only quantify its effects but also to understand patterns in its growth and influence. In recent work, we mined and discovered patterns...
Street imagery is a promising big data source providing current and historical images in more than 100 countries. Previous studies used this data to audit built environment features. Here we explore a novel application, using Google Street View (GSV) to predict travel patterns at the city level. We sampled 34 cities in Great Britain. In each city,...
Objective:
European car design regulations and New Car Assessment Program (NCAP) ratings have led to reductions in pedestrian injuries. The aim of this study was to evaluate the impact of improving vehicle front design on mortality and morbidity due to pedestrian injuries in a European country (Germany) and two countries, (USA, and India) that do...
Background
Sudan has been undergoing demographic and social changes that could have a tangible impact on population injury rates. However, reliable estimates of injury epidemiology are lacking. We aimed to estimate injury incidence and mortality in urban and rural Sudan, using existing data sources.
Methods
We used the 2008 national census mortali...
Background:
Reliable data on traffic deaths are important for planning road safety programmes and evaluating progress. Although pedestrians comprise approximately 40% of traffic deaths in low-income and middle-income countries, official government statistics in India suggest that pedestrians comprise less than 10% of deaths.
Objective:
To assess...
Background Sudan has been undergoing demographic and social changes that could have a tangible impact on population injury rates. However, reliable estimates of injury epidemiology are lacking. We aimed to estimate injury incidence and mortality in urban and rural Sudan, using existing data sources. Methods We used the 2008 national census mortalit...
Background Burden of disease and injury methods can be used to summarise and compare the effects of conditions in terms of disability-adjusted life years (DALYs). Burden estimation methods are not inherently complex. However, as commonly implemented, the methods include complex modelling and estimation.
Objectives To provide a simple and open-sourc...
We assessed the quality of Global Burden of Disease-2010 (GBD-2010) estimates of road injury deaths by comparing with government statistics for Organisation for Economic Co-operation and Development (OECD) countries that report to the International Road Traffic Accident Database (IRTAD).
We obtained tabulated data for 25 OECD countries that report...
The safety of children younger than 10 years on motorized two-wheeled vehicles (MTWs) in low- and middle-income countries receives substantial attention from global road safety advocates. However, there is little empirical evidence available to describe the magnitude of the problem. Therefore, we constructed a population-level database of road traf...
In settings with low seatbelt use prevalence, self-reported seatbelt use estimates often lack validity, and routine observational studies are scarce. In this paper, we aim to describe the prevalence of seatbelt use and associated factors in drivers and front-seat passengers across eight sites in four countries (Egypt, Mexico, Russia, Turkey) using...
Reducing vehicle speed is among the most effective road safety strategies. We assess how a new policy in Russia that eliminates fines for driving up to 20 km/h above the speed limit has affected the prevalence of speeding. We measured speeds periodically in 13 districts of two Russian regions during 2011-2013 and analysed the effect of the policy u...
Recall bias is a well-documented limitation of population-based cross-sectional injury surveys. To fill some gaps in this area, we investigated the extent and nature of recall bias in Sudan Household Health Survey (SHHS 2010) injury data. The extent of incomplete recall was measured by comparing the total reported injuries over 12 months with the a...
The UN Decade of Action for Road Safety 2011-2020 calls on national governments in sub-Saharan Africa and worldwide to direct substantial resources to stem the increasing burden of road traffic injuries. Bringing such attention to road safety requires demonstrating the importance of the problem relative to other major threats that currently confront...
Background:
Measurement of the global burden of disease with disability-adjusted life-years (DALYs) requires disability weights that quantify health losses for all non-fatal consequences of disease and injury. There has been extensive debate about a range of conceptual and methodological issues concerning the definition and measurement of these we...
Road traffic crashes in China kill in excess of 250,000 people annually, more than any other country in the world. They are the fourth leading cause of premature death in the country and are responsible for 2.4% of the burden of non-fatal health loss in the country. Interventions to curb speeding and drink driving are being implemented in the citie...
BACKGROUND Road traffic crashes kill 1.3 million people annually. Enforcing compliance with highway design speeds is a primary road safety concern in most countries. We evaluated the performance of a new speed enforcement system introduced by the traffic police in Dalian, China.
METHODS Donglian is an urban, limited-access, 11.3 km long, elevated...
Importance: Understanding the major health problems in the United States and how they are changing over time is critical for informing national health policy.
Objectives: To measure the burden of diseases, injuries, and leading risk factors in the United States from 1990 to 2010 and to compare these measurements with those of the 34 countries in th...
Kavi Bhalla provides a perspective on new research by Christopher Millett and colleagues that reports rural dwellers who migrate to cities have worse cardiovascular outcomes, partly due to a shift to private motor vehicles and reduced physical activity.
Please see later in the article for the Editors' Summary
The Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010) constitutes an unprecedented collaboration of 488 scientists from 303 institutions in 50 countries, focusing on describing the state of health around the world using a uniform method. Results for the world and 21 regions for 1990 and 2010 have been reported for 291 dise...
Background Measuring disease and injury burden in populations requires a composite metric that captures both premature mortality and the prevalence and severity of ill-health. The 1990 Global Burden of Disease study proposed disability-adjusted life years (DALYs) to measure disease burden. No comprehensive update of disease burden worldwide incorpo...
Background Measurement of the global burden of disease with disability-adjusted life-years (DALYs) requires disability weights that quantify health losses for all non-fatal consequences of disease and injury. There has been extensive debate about a range of conceptual and methodological issues concerning the defi nition and measurement of these wei...
Background Measurement of the global burden of disease with disability-adjusted life-years (DALYs) requires disability weights that quantify health losses for all non-fatal consequences of disease and injury. There has been extensive debate about a range of conceptual and methodological issues concerning the defi nition and measurement of these wei...
Background: Measuring disease and injury burden in populations requires a composite metric that captures both premature mortality and the prevalence and severity of ill-health. The 1990 Global Burden of Disease study proposed disability-adjusted life years (DALYs) to measure disease burden. No comprehensive update of disease burden worldwide incorp...
Background: Reliable and timely information on the leading causes of death in populations, and how these are changing, is a crucial input into health policy debates. In the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010), we aimed to estimate annual deaths for the world and 21 regions between 1980 and 2010 for 235 causes...
Background Measurement of the global burden of disease with disability-adjusted life-years (DALYs) requires disability weights that quantify health losses for all non-fatal consequences of disease and injury. There has been extensive debate about a range of conceptual and methodological issues concerning the defi nition and measurement of these wei...
Background: Non-fatal health outcomes from diseases and injuries are a crucial consideration in the promotion and monitoring of individual and population health. The Global Burden of Disease (GBD) studies done in 1990 and 2000 have been the only studies to quantify non-fatal health outcomes across an exhaustive set of disorders at the global and re...
Background Measurement of the global burden of disease with disability-adjusted life-years (DALYs) requires disability weights that quantify health losses for all non-fatal consequences of disease and injury. There has been extensive debate about a range of conceptual and methodological issues concerning the defi nition and measurement of these wei...
Background Measurement of the global burden of disease with disability-adjusted life-years (DALYs) requires disability weights that quantify health losses for all non-fatal consequences of disease and injury. There has been extensive debate about a range of conceptual and methodological issues concerning the definition and measurement of these weig...
Objective To test the predictive ability of multinomial regression method in obtaining category of death distribution for cases with unknown/ill-defined mortality codes.
Methods The authors evaluated the performance of the multinomial regression model by fitting the model to trial datasets from 2004 Mexican vital registration data. To predict categ...
More than 1.2 million people die and as many as 50 million people are injured or disabled due to road traffic injuries (RTIs) every year worldwide. The lack of reliable data hinders efforts to describe the characteristics of the issue and prioritise prevention activities. The objective was to provide a snapshot of fatal and non-fatal RTI in Argenti...
We used data from multiple sources to estimate the incidence of fatal and non-fatal road traffic injuries in Sri Lanka in 2005. We validated the accuracy of the data from the national traffic police by comparing with estimates based on national death registration. For estimating the incidence and patterns of non-fatal injuries, we used a nationally...
OBJECTIVE: To assess the availability and quality of global death registration data used for estimating injury mortality. METHODS: The completeness and coverage of recent national death registration data from the World Health Organization mortality database were assessed. The quality of data on a specific cause of injury death was judged high if fe...
To assess the availability and quality of global death registration data used for estimating injury mortality.
The completeness and coverage of recent national death registration data from the World Health Organization mortality database were assessed. The quality of data on a specific cause of injury death was judged high if fewer than 20% of deat...
Background
Estimating injury burden in low income countries is hampered by lack of structured nationally representative data collection systems.Objective
To demonstrate the construction of estimates of the national burden of injuries using a systematic assessment of multiple data sources. The approach harnesses the strength of each source and accou...
National vital registration systems that record causes of death do not exist in most African countries. This makes estimating incidence of mortality from injuries in African regions particularly challenging. We discuss the viability of using retrospective and prospective data gathered from death registration sites that issue death certificates for...
Estimating fatal injuries:
Estimating non-fatal injuries:
Building estimates The data were mapped to corresponding GBD external cause and nature groupings. When applicable, the data were disaggregated to compute age-sex-injury rates. The rates were then applied to urban and rural population estimates, respectively. Demographic and health surveys da...
Reliable estimates of the burden of injuries are essential inputs for prioritising prevention strategies. While population-based injury surveillance is the best source for such information, it is recognised that these systems do not exist in many countries. Thus, we conducted an environmental scan of data sources that can be used to estimate the in...
Introduction Reliable estimates of burden of injuries in Ethiopia are needed for planning national health priorities. Such estimates should be developed using all available information sources in the country.
Materials and Methodology We conducted an environmental scan of all available data sources that can inform estimates of the burden of injury...
We used data from various sources to triangulate to a national snapshot of the incidence of fatal and non-fatal road traffic injuries in Mexico in 2005. Data sources used include national death registration data, national hospital discharge data and a nationally representative health survey. We estimate that in 2005, 19,389 people died due to injur...
Recent studies have made it clear that Iran has too many road traffic injuries (RTI). This paper explains the reasons for high traffic injury rates and points to solutions. It also provides detailed data on the burden of traffic injury in Iran in 2005. Traffic injury rates have rapidly risen out of control because for a variety of possible reasons...
The estimates of the incidence of deaths and non-fatal injuries from road traffic crashes are essential inputs for prioritising national health and transport policies. This article sketches a methodology for assembling such estimates at the country level by piecing together data from a wide array of sources that include death registers, hospital re...
To use a range of existing information sources to develop a national snapshot of the burden of road traffic injuries in one developing country-Iran.
The distribution of deaths was estimated by using data from the national death registration system, hospital admissions and outpatient visits from a time-limited hospital registry in 12 of 30 provinces...
