title: 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 0-24 years. The BGV and RR of the rate of motorcycle helmet use decreased after passage of the law but increased from 2002 onwards.
  
  
  CONCLUSIONS
  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.
authors: NCKU Research Center for Health Data and Institute of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan. robertlu@mail.ncku.edu.tw
authors: Tsung-Hsueh
authors: TH
authors: Lu
authors: Ching-Huei
authors: CH
authors: Lai
authors: Tung-Liang
authors: TL
authors: Chiang
mesh_terms: D000063:Accidents, Traffic / Q000401:mortality* / Q000517:prevention & control; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002648:Child; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000401:mortality / Q000517:prevention & control*; D005260:Female; D006260:Head Protective Devices / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009049:Motorcycles / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012737:Sex Factors; D012959:Socioeconomic Factors; D013624:Taiwan / Q000453:epidemiology; D014947:Wounds and Injuries / Q000453:epidemiology / Q000209:etiology; D055815:Young Adult