Deprived neighborhoods and risk of road trauma (incidence and severity) among under 25year-olds in the Rhône Département (France).

INTRODUCTION Previous research has shown that there are inequalities with regard to traffic accident risk between different social categories. This study describes the influence of the type of residential municipality (with or without deprived urban areas, "ZUS, zones urbaines sensibles"), used as an indicator of contextual deprivation, on the incidence and severity of road trauma involving people of under 25years of age in the Rhône. METHOD Injury data were taken from The Rhône Road Trauma Registry. The study covers the 2004-2007 period, with 13,589 young casualties. The incidence of traffic injury of all severities were computed according to the type of municipality and the age, gender, and type of road user. The ratios of the incidences of deprived municipalities, compared with others were calculated. Subsequently the severity factors and incidences according to the severity level (ISS 1-8, ISS 9+) were studied. RESULTS For the main types of road users except motorized two-wheeler users, the incidences were higher in the deprived municipalities: the greatest difference was for pedestrians, where the incidences were almost twice those of other municipalities. This excess risk, constituting a health inequality topic rarely considered, was even greater in municipalities with two or three ZUSs. It was essentially observed for minor injuries among motorists, cyclists, and pedestrians. CONCLUSIONS While the incidence increased among people less than 25years of age, the severity of road injuries was lower in deprived neighborhoods, contrary to what is suggested by other studies. This lower severity disappeared when taking into account the crash characteristics. IMPACT ON INDUSTRY The incidence of injuries as a pedestrian, cyclist or motorist is higher among young people living in deprived municipalities. These areas should therefore be the targets of dedicated education programs, as well as further investigations about urban planning.