title: Regional disparities in road traffic injuries and their determinants in Brazil, 2013.
abstract: In recent decades middle-income countries have experienced a rapid increase in the number of cars and motorcycles. Increased deaths and hospitalizations due to road traffic injuries (RTI) has been observed in several countries as a result. In this study we assessed the determinants of RTIs in Brazil by mode of transportation and compared differences in RTI rates among macro-regions.
  
  
  
  We used data from the National Health Survey (NHS) conducted in 2013 by the Brazilian Institute of Geography and Statistics and the Ministry of Health. NHS is a comprehensive household survey which includes a representative sample (N = 60,198) of individuals aged 18 years or older. The prevalence and determinants of RTI were estimated according to different modes of transport (car/van, motorcycle, and other) and regions of the country. Bivariate and multivariable logistic regression models were applied to assess crude and adjusted odds ratios, respectively, and their 95 % CI for RTI determinants.
  
  
  
  The prevalence of RTI for the Southeast, South, Central-West, Northeast and North regions of Brazil was 2.4 %, 2.9 %, 4.4 %, 3.4 % and 4.8 %, respectively, pointing to important differences among regions. High percentages of motorcyclists were observed in the Northeast and North regions. For motorcyclists, factors associated with RTIs were being male (OR = 2.6;95 % CI:2.3;3.0), aged 18-29 (OR = 3.2; 95 % CI:2.7;3.8) and 30-39 years (OR = 2.0;95 % CI:1.7;2.5), black (OR = 1.4;95 % CI:1.1;1.7), having elementary educational (OR = 1.5;95 % CI:1.1;1.9), reporting binge drinking behavior (OR = 1.3;95 % CI:1.1;1.5), and living in the Central-West (OR = 2.0;95 % CI:1.6;2.5), Northeast (OR = 1.8;95 % CI:1.5;2.1) and North (OR = 2.0;95 % CI:1.6; 2.5) regions of the country. The independent variables associated with RTI for car/van occupants were being male (OR = 1.7;95 % CI:1.4;2.1), aged 18-29 (OR = 1.5;95 % CI:1.1;2.0) and 30-39 years (OR = 2.5;95 % CI:1.9;3.2), reporting binge drinking behavior (OR = 2.0;95 % CI:1.6;2.5) and living in the South region (OR = 1.6;95 % CI:1.3;2.1).
  
  
  
  There were considerable regional disparities in RTI rates across Brazil's regions. Motorcyclists contributed to the high RTI rates in these regions as did demographic factors and behaviors such as alcohol use. These findings can help guide interventions to reduce the burden of RTIs in Brazil.
authors.affiliation: Departamento de Saúde Coletiva. Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, Rua 235, S/N, Setor Universitário, Goiânia, Goiás, Cep: 74605-050, Brazil. otaliba.libanio@gmail.com.
authors.forename: Otaliba Libanio
authors.initials: OL
authors.lastname: Morais Neto
authors.affiliation: Departamento de Saúde Coletiva. Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, Rua 235, S/N, Setor Universitário, Goiânia, Goiás, Cep: 74605-050, Brazil.
authors.forename: Ana Lúcia
authors.initials: AL
authors.lastname: Andrade
authors.affiliation: Mestrado do Programa de Pós-Graduação em Enfermagem, Universidade Federal de Goiás, Rua 227 Qd 68, S/N - Setor Leste Universitário, Goiânia, Goiás, CEP: 74605-080, Brazil.
authors.forename: Rafael Alves
authors.initials: RA
authors.lastname: Guimarães
authors.affiliation: Centro de Excelência em Ensino, Pesquisa e Projetos - Leide das Neves Ferreira, Rua 26, 521 - Jardim Santo Antônio, Goiânia, GO, 74853-070, Brazil.|Programa de Pós-Graduação em Medicina Tropical e Saúde Pública, Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, Rua 235, S/N, Setor Universitário, Goiânia, Goiás, Cep: 74605-050, Brazil.
authors.forename: Polyana Maria Pimenta
authors.initials: PM
authors.lastname: Mandacarú
authors.affiliation: Programa de Pós-Graduação em Medicina Tropical e Saúde Pública, Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, Rua 235, S/N, Setor Universitário, Goiânia, Goiás, Cep: 74605-050, Brazil.|Secretaria Municipal de Saúde de Senador Canedo, Av. Dom Manoel - Res. Boa Vista, Sen. Canedo, GO, 75250-000, Brazil.
authors.forename: Gabriela Camargo
authors.initials: GC
authors.lastname: Tobias
mesh_terms: D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D000368:Aged; D000428:Alcohol Drinking; D001336:Automobiles; D001938:Brazil / Q000453:epidemiology; D005260:Female; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009049:Motorcycles; D016017:Odds Ratio; D012111:Residence Characteristics; D014947:Wounds and Injuries / Q000453:epidemiology / Q000209:etiology*; D055815:Young Adult
keywords: Epidemiologic determinants; Health disparities; Traffic accidents