Deaths from road traffic accidents in Scotland: 1979-1988. Does it matter where you live?

The purpose of this study was to calculate and compare the geographical distributions of male and female deaths from road traffic accidents in Scotland. A retrospective, nationwide study of deaths from road traffic accidents was undertaken; all road traffic deaths between 1979 and 1988 were included. Deaths were abstracted from the Annual Reports of the Registrar General for Scotland. Standardized mortality ratios (SMRs) for males and for females were calculated for 1979-83 and 1984-88. Maps showing the distributions of high SMRs (SMR greater than 135 or P less than 0.05) and low SMRs (SMR less than 65 or P less than 0.05) were prepared for males and females separately. The geographical distributions of deaths from road traffic accidents in Scotland were dissimilar to those of England and Wales. For both sexes, high mortality was predominantly in the sparsely populated regions of the north and south of Scotland; whereas low mortality was found in the cities and the populous central belt. Possible reasons for this pattern are discussed: speed, response time (both of notification of the accident and of arrival of the ambulance), distance to nearest hospital with suitable emergency facilities, and road conditions.