Socio-Demographic Determinants of Road Traffic Fatalities in Women of Reproductive Age in the Republic of Georgia: Evidence from the National Reproductive Age Mortality Study (2014)

Abstract

Nino Lomia,1 Nino Berdzuli,1 Nino Sharashidze,2 Lela Sturua,3 Ekaterine Pestvenidze,1 Maia Kereselidze,4 Marina Topuridze,5 Babill Stray-Pedersen6,†, Arne Stray-Pedersen7 1Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; 2Department of Clinical and Research Skills, Faculty of Medicine, Iv. Javakhishvili Tbilisi State University, Tbilisi, Georgia; 3Department of Noncommunicable Diseases, National Center for Disease Control and Public Health, Tbilisi, Georgia; 4Department of Medical Statistics, National Center for Disease Control and Public Health, Tbilisi, Georgia; 5Health Promotion Division, Department of Noncommunicable Diseases, National Center for Disease Control and Public Health, Tbilisi, Georgia; 6Department of Obstetrics and Gynecology, Rikshospitalet, Oslo University Hospital, and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; 7Department of Forensic Sciences, Oslo University Hospital, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway†Dr Babill Stray Pedersen passed away on 24 April, 2019Correspondence: Nino Lomia Email [email protected]: Globally and in the European region, the road traffic injuries (RTI) have emerged as a major public health and development problem, killing the most productive adult members of a population, including women. This study aimed to identify the key socio-demographic determinants of premature and avoidable RTI mortality in reproductive-aged women (15– 49 years) in Georgia.Materials and Methods: The study employed verbal autopsy data from the second national reproductive age mortality survey (RAMOS 2014). Univariate and multivariate logistic regression models were fitted using the Firth method to assess the crude and adjusted effects of each individual level socio-demographic factor on the odds of RTI-attributed death, with corresponding 95% confidence intervals (COR and AOR, 95% CI).Results: Of 843 women aged 15– 49 years, 78 (9.3%) were the victims of fatal traffic crashes. After multivariate adjustment, the odds of dying from RTI were significantly higher in women aged 15– 29 years (AOR=7.73, 95% CI= 4.20 to 14.20), those being employed (AOR=2.11, 95% CI= 1.22 to 3.64) and the wealthiest (AOR=2.88, 95% CI= 1.44 to 5.77) compared, respectively, to their oldest (40– 49 years), unemployed and poorest counterparts. Conversely, there were no statistically significant ethnic, marital, rural/urban, and educational disparities in women’s RTI fatalities. Overall, motorized four-wheeler occupants (78.2%), particularly passengers (71.8%), appeared to be the most common victims of fatal road injuries than pedestrians (20.5%). Alarmingly, the vast majority (85.9%) of any type of road users died instantly at the scene of collision, as compared to deaths en route to hospital (1.3%) or in hospital (11.5%).Conclusion: Age, employment, and wealth status appeared to be the strong independent predictors of young women’s RTI mortality in Georgia. Future comprehensive research would be advantageous for further deciphering the differential impact of social determinants on traffic-induced fatalities, as a vital platform for evidence-based remedial actions on this predictable and preventable safety hazard.Keywords: women’s health, road traffic injuries, mortality, socioeconomic factors, employment, wealth status

Keywords

• women’s health
• road traffic injuries
• mortality
• socioeconomic factors
• employment
• wealth status