title: Temporal trends in motor vehicle fatalities in the United States, 1968 to 2010 - a joinpoint regression analysis.
abstract: BACKGROUND
  In the past 40 years, a variety of factors might have impacted motor vehicle (MV) fatality trends in the US, including public health policies, engineering innovations, trauma care improvements, etc. These factors varied in their timing across states/localities, and many were targeted at particular population subgroups. In order to identify and quantify differential rates of change over time and differences in trend patterns between population subgroups, this study employed a novel analytic method to assess temporal trends in MV fatalities between 1968 and 2010, by age group and sex.
  
  
  METHODS
  Cause-specific MV fatality data from traffic injuries between 1968 and 2010, based on death certificates filed in the 50 states, and DC were obtained from Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER). Long-term (1968 to 2010) and short-term (log-linear piecewise segments) trends in fatality rates were compared for males and females overall and in four separate age groups using joinpoint regression.
  
  
  RESULTS
  MV fatalities declined on average by 2.4% per year in males and 2.2% per year in females between 1968 and 2010, with significant declines observed in all age groups and in both sexes. In males overall and those 25 to 64 years, sharp declines between 1968 and mid-to-late 1990s were followed by a stalling until the mid-2000s, but rates in females experienced a long-term steady decline of a lesser magnitude than males during this time. Trends in those aged <1 to 14 years and 15 to 24 years were mostly steady over time, but males had a larger decline than females in the latter age group between 1968 and the mid-2000s. In ages 65+, short-term trends were similar between sexes.
  
  
  CONCLUSIONS
  Despite significant long-term declines in MV fatalities, the application of Joinpoint Regression found that progress in young adult and middle-aged adult males stalled in recent decades and rates in males declined relatively more than in females in certain age groups. Future research is needed to establish the causes of these observed trends, including the potential role of contemporaneous MV-related policies and their repeal. Such research is needed in order to better inform the design and evaluation of future population interventions addressing MV fatalities nationally.
authors.affiliation: Department of Nutrition, Food Studies, and Public Health, Steinhardt School of Culture, Education and Human Development, New York University, 411 Lafayette St, 5th Floor, New York, NY, 10003, USA. pb1349@nyu.edu.
authors.forename: Priti
authors.initials: P
authors.lastname: Bandi
authors.affiliation: Department of Nutrition, Food Studies, and Public Health, Steinhardt School of Culture, Education and Human Development, New York University, 411 Lafayette St, 5th Floor, New York, NY, 10003, USA.
authors.forename: Diana
authors.initials: D
authors.lastname: Silver
authors.affiliation: Department of Nutrition, Food Studies, and Public Health, Steinhardt School of Culture, Education and Human Development, New York University, 411 Lafayette St, 5th Floor, New York, NY, 10003, USA.
authors.forename: Tod
authors.initials: T
authors.lastname: Mijanovich
authors.affiliation: Department of Nutrition, Food Studies, and Public Health, Steinhardt School of Culture, Education and Human Development, New York University, 411 Lafayette St, 5th Floor, New York, NY, 10003, USA.
authors.forename: James
authors.initials: J
authors.lastname: Macinko