Nearly 51 million people were injured and 1.34 million died from road injuries in 2023, making road injuries one of the leading global causes of premature death and disability, according to a new study published in The Lancet Public Health on Jul. 20. The research found that while age-standardized rates of road injury incidence and mortality have declined over the past three decades, progress has been uneven, with low- and middle-income countries bearing the greatest burden.
The study reported that globally, road injuries ranked as the 11th cause of death and accounted for 75.3 million disability-adjusted life years (DALYs), a measure combining years lost to early death and years lived with disability. Low-income countries had nearly six times the rate of years lost to premature death compared to high-income countries.
Based on data from the Global Burden of Disease (GBD) 2023 study, researchers analyzed trends across 204 countries between 1990 and 2023. They found that global age-standardized rates for new cases declined by 38.3% and deaths by 32.3%, but improvements were most significant in high-income nations while low-income regions saw little measurable change. More than ninety percent of deaths occurred in low- or middle-income areas; these regions also had higher mortality rates despite fewer total injury cases compared to wealthier countries.
Progress varied widely among individual nations: while many achieved reductions in mortality over the past decade, six—including Ghana, Jamaica, Dominican Republic, Armenia, Costa Rica, and the United States—experienced increases ranging from a rise of over thirteen percent in the U.S. up to nearly fifty percent in Ghana.
"Road injury outcomes are shaped not only by crashes, but by the systems designed to prevent them and protect people when they occur," said Dr. Liane Ong, Senior Research Scientist at the Institute for Health Metrics and Evaluation (IHME) and senior author of the study. "Road deaths are largely preventable, but progress requires sustained investment. Reducing them requires safer infrastructure, stronger safety policies, and better emergency care." Road injuries were identified as the leading cause of death among young people ages ten to thirty-nine worldwide.
Dr. Marie Ng, Affiliate Associate Professor at IHME and Associate Professor at National University of Singapore, said: "Road safety should be treated as a public health priority, not just a transportation issue... Reducing deaths and injuries requires moving beyond individual driver behavior and investing in systems that prevent crashes... tailored to each community." The authors concluded that meeting UN Sustainable Development Goals will require coordinated action across sectors such as transportation planning—and improved trauma care—to reduce disparities.
