Fatal motor vehicle crashes in rural and urban areas: decomposing rates into contributing factors.

OBJECTIVES Motor vehicle crash fatality rates have been consistently higher in rural areas than in urban areas. However, the explanations for these differences are less clear. In this study the decomposition method was used to explore the factors associated with increased fatal crash involvement rates in rural communities. DESIGN Using national databases, the fatal crash incidence density was decomposed into the product of three factors: the injury fatality rate, the crash injury rate, and the crash incidence density. RESULTS As expected, the fatal crash incidence density was more than two times higher in rural than in urban areas. This was driven primarily by the injury fatality rate, which was almost three times higher in rural areas. CONCLUSIONS Further research should examine the relative roles of crash severity and the timely receipt of definitive medical care after a crash.