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Determination of Expected Frequency01:08

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Inverse Probability of Treatment Weighting (Propensity Score) using the Military Health System Data Repository and National Death Index
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Explaining regional disparities in traffic mortality by decomposing conditional probabilities.

Gregory P Goldstein1, David E Clark, Lori L Travis

  • 1Center for Outcomes Research and Evaluation, Maine Medical Center, Portland, Maine, USA.

Injury Prevention : Journal of the International Society for Child and Adolescent Injury Prevention
|January 8, 2011
PubMed
Summary

Traffic injury deaths are higher in rural and southern US areas. Rural disparities stem from increased deaths per injury, while southern disparities relate to more injuries per crash.

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Area of Science:

  • Public Health
  • Epidemiology
  • Injury Science

Background:

  • Traffic injury mortality rates in the USA are disproportionately higher in rural and southern regions.
  • The underlying factors contributing to these regional disparities remain unclear.

Purpose of the Study:

  • To investigate the determinants of traffic injury mortality disparities between rural/urban and southern/northern US counties.
  • To extend a decomposition method to analyze the contributions of various factors to traffic injury mortality.

Main Methods:

  • Utilized data from 1754 US counties, separating the deaths/population rate into deaths/injury, injuries/crash, crashes/exposure, and exposure/population.
  • Applied an extended decomposition method to assess the impact of rural and southern locations on these components, using vehicle miles traveled as a measure of exposure.

Main Results:

  • Deaths/injury was the primary driver of county-to-county variation in deaths/population and the largest contributor to rural/urban disparities.
  • After accounting for rural effects, injuries/crash emerged as the main factor explaining the southern/northern disparity.

Conclusions:

  • Increased traffic injury mortality in rural areas is linked to a higher probability of death following injury, potentially due to emergency medical response system challenges.
  • In southern regions, increased injury probability following a crash, possibly due to variations in vehicle, road, or driving conditions, contributes to higher mortality.