Disability related to road traffic crashes among adults in Spain.
BACKGROUND
Road traffic accidents cause substantial morbidity and disease burden; few studies have examined their impact on disability.


OBJECTIVE
To estimate the magnitude and distribution of disability due to road traffic accidents according to socio-demographic variables, and its main socioeconomic and health determinants.


METHODS
A cross-sectional study was conducted in community-dwelling participants in the "2008 Spanish National Disability Survey", a representative sample of 91,846 households with 20,425 disabled persons older than 15 years; 443 had disability due to road traffic accidents.


RESULTS
The prevalence was 2.1 per 1000 inhabitants (95% CI:1.8-2.3), with no differences by sex. Risk was highest among persons aged 31 to 64 years, and onset of disability showed a sharp inflection point at age 16 years in both sexes. Odds ratios (ORs) were higher (OR=1.3; 95% CI:1.1- 1.7) for participants with secondary education than for those with the lowest educational levels and were lower (OR: 0.5; 95% CI:0.3-0.8) for participants with the highest household income levels than for those with lowest. Only 24% of disabled participants were gainfully employed. As compared to other sources of disability, traffic crashes caused greater disability in terms of mobility (OR=3.1;p<0.001), a greater need for health/social services (OR=1.5;p=0.003), and more problems with private transportation (OR=1.6;p<0.001), moving around outside the home (OR=1.6;p<0.001) and changes in economic activity (OR=2.4;p<0.001).


CONCLUSIONS
The prevalence of disability due to road traffic accidents in Spain is lower than in other developed countries, with middle-aged and socio-economically underprivileged persons being the most affected. Disability due to road traffic accidents is related to a greater demand for social/health care support, problems of accessibility/commuting, and major changes in economic activity.
Area of epidemiological analysis and health situation, National Centre for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain; Research Centre Network for Epidemiology and Public Health (CIBERESP), National Centre for Epidemiology, Instituto de Salud Carlos III Madrid, Spain. Electronic address: p_rocio_del_pilar@hotmail.com.
Rocío
R
Palmera-Suárez
Area of epidemiological analysis and health situation, National Centre for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain; Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ, Madrid, Spain.
Teresa
T
López-Cuadrado
Area of applied epidemiology, National Centre for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain.
Javier
J
Almazán-Isla
Area of epidemiological analysis and health situation, National Centre for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain; Research Centre Network for Epidemiology and Public Health (CIBERESP), National Centre for Epidemiology, Instituto de Salud Carlos III Madrid, Spain.
Rafael
R
Fernández-Cuenca
Area of applied epidemiology, National Centre for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain.
Enrique
E
Alcalde-Cabero
Area of applied epidemiology, National Centre for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain; Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ, Madrid, Spain.
Iñaki
I
Galán
D000063:Accidents, Traffic / Q000191:economics / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D006233:Persons with Disabilities / Q000706:statistics & numerical data; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D064890:Social Determinants of Health; D012959:Socioeconomic Factors; D013030:Spain / Q000453:epidemiology; D011795:Surveys and Questionnaires; D055815:Young Adult
Accidentes de tráfico; Disability evaluation; Evaluación de la Discapacidad; Factores socio-económicos; Inequalities; Inequidades; Injuries; Lesiones externas; Socioeconomic factors; Traffic Accidents