Road safety issues in China: Understanding key risk
factors to improve public health and safety
Dr Judy Fleiter
Postdoctoral Research Fellow
Australia China Centre for Public Health, SYSU visit, May 11, 2015
Overview
• Global road safety
• Road safety in China
• Behavioural research conducted by CARRS-Q in
China
• Future research priorities
Acknowledgements
•
Partner Institutions:
– Institute of Psychology, Chinese Academy of Science, Beijing (5 months)
– Zhejiang Police College, Hangzhou, China (2 years)
– Guangdong Institute of Public Health, Guangdong Province Centre for Disease
Control and Prevention (4 months)
– Yinchuan City Centre for Disease Control and Prevention (4 months)
•
Colleagues:
– Dr Barry Watson, Dr Mark King, Emeritus Professor Mary Sheehan, Dr George
Jia, Dr Alexia Lennon - CARRS-Q (QUT)
– Professor Shi Kan, - Chinese Academy of Sciences
– Professor Guan Manquan, Ding Jingyan, Xu Cheng – Zhejiang Police College
– Professor Ma Wenjun – Guangdong Institute of Public Health
– Dr Jing Lei - Yinchuan City Centre for Disease Control and Prevention
Acknowledgements
Funding
•
Australia’s National Health & Medical Research Council
– Postdoctoral Research Fellowship (Australia-China Exchange)
– Promote Australia-China road safety research & capacity building (2011-2015)
•
Endeavour Australia Awards
– Cheung Kong Postgraduate Award – 2008 (Fleiter)
– Prime Minister’s Australia Asia Postgraduate Award – 2012 (Jia)
United Nations
Decade of Action for Road Safety
(2011-2020)
• Every year, globally, road crashes:
– kill 1.3 million people
– injure 20 – 50 million people
• Aim to reduce road-related trauma
– save 5 million lives in 10 years
– by sharing experiences, and introducing effective legislation,
enforcement and education
World Health Organization, 2009; 2013
United Nations
Decade of Action for Road Safety
(2011-2020)
Globally,
• Road traffic injuries 8th leading cause of death
• Leading cause of death of young people 15-29
• 90% of road deaths & injuries occur in low- & middleincome countries
• 46% of global road deaths are ‘vulnerable road users’
– pedestrians, cyclists, motorcyclists
World Health Organization, 2013
In China
• Scale of road trauma problem difficult to determine:
– Unlinked reporting systems (police, hospital datasets)
– Reporting mechanisms vary (e.g., death within 7 days of crash in police records,
doesn’t follow ICD10 classification)
– Under-reporting likely
• Police records indicate ~70,000 fatalities/year with sharp
decrease since 2002
– Examination of 210 military hospitals shows slow increase since 2002
– Analysis of city level data indicates 3 times as many fatalities and up to 5 times
as many injuries as reported in official data (Qui et al., 2015)
– These data similar to WHO estimates
In China
• Road fatalities = leading cause of injury deaths
– ahead of all natural disasters (including fire, earthquake, and flood) (Ma, et al;, 2012).
– 25% of total productive years lost from all injuries (Zhou et al., 2003)
• Road fatalities
–
–
–
–
Males = 76%
Majority of road traffic injuries (RTI) occur among young males
RTI = one of the top 3 causes of death in people aged 60+ (Zhou et al., 2014)
Vulnerable road users = 70 %
Vulnerable Road Users, China
% of Fatalities
35%
70%
25%
17%
10%
6%
5%
2%
Source: 2010 PRC Road Traffic Accident Annual Statistic Report, Traffic Management Bureau of Ministry of Public Security,
cited in WHO, 2103 Global Road Safety Status Report.
Large population, unprecedented economic growth, rapid
motorisation, large number of novice drivers
Mixed traffic fleet: pedestrians, non-motorised vehicles,
increase in e-bikes (banned in some places), heavy vehicles
Large rural > urban migration = unfamiliarity with traffic and
traffic rules
In Transition
Enforcement & Education
– Road safety legislation relatively new (2004) and still in formative stage
– Traffic police not well respected & responsible for public education with
limited resources
– Varying levels of traffic law enforcement
– Traffic laws not well understood by general community
– Road safety awareness relatively low
– Non-compliance with traffic laws evident
Fleiter et al., 2009; 2011; 2013a,b,c; Jia et al., 2013; Senserrick et al., 2011
Behavioural factors
• Illegal/risky on-road behaviours common & appear
normalised
–
–
–
–
–
Non-use of helmets & seat belts
Phone use while driving/riding
Over-crowded & overloaded vehicles
Drink driving
Speeding (main reported cause of crashes in China - estimates of
between 50-90% of all crashes
Du et al., 2013; Fleiter et al., 2009; Fleiter et al., 2013a,b,c; Jia et al., 2013a,b; Routley et al., 2008
Behavioural factors
• Illegal/risky on-road behaviours common & appear
normalised
–
–
–
–
–
Non-use of helmets & seat belts
Phone use while driving/riding
Over-crowded & overloaded vehicles
Drink driving
Speeding
• 2 risk factors identified by Bloomberg-funded Global Road
Safety Program (2010-2014)
– Dalian & Suzhou
• Bloomberg Initiative for Global Road Safety (BIGRS) 20152019
– Shanghai, legislative focus
Du et al., 2013; Fleiter et al., 2009; Fleiter et al., 2013a,b,c; Jia et al., 2013a,b; Routley et al., 2008
CARRS-Q Behavioural Research
Speeding
CRICOS No. 00213J
Beijing & Hangzhou
Speeding
•
Qualitative & quantitative research with car drivers:
– Speeding viewed as common, normal, necessary, safe
– Self-reported ‘usual’ speeds up to 50% above posted speed limits (link to
enforcement tolerance in legislation)
– ‘Safe speeds’ reported as up to 20 km/h above posted speed limits
– ‘Preferred speeds’ significantly faster than ‘safe speeds’
– Penalties not certain and can be avoided (use of ‘guanxi’/networks; arguing with
police, convincing police not to issue infringement)
– Experiences of avoiding detection & punishment encourage future offending
Fleiter et al., 2009; Fleiter et al., 2013a,b,c; Fleiter & Watson, 2015
CARRS-Q Behavioural Research
Speeding
Drivers attending re-training program after losing licence
– Significantly more crashes among newly licensed drivers
– Mean of 4.6 infringements in previous year (range 2-18, SD=3.8)
– 62% drink driving offence; 48% speeding offence
– Identification of ‘most dangerous’ on-road behaviours by drivers
•
•
•
•
•
Speeding
Drink driving
...
Phone use while driving, fatigue, non-use of seat belts nominated by very few
Reflects enforcement practices by police?
Fleiter & Watson, 2015
CARRS-Q Behavioural
Research
Drink Driving
Guangzhou & Yinchuan
Drink Driving
• Legislative change in May 2011, Drunk driving criminalised
• 2 legal blood alcohol concentration limits
– Drink driving = 20mg-80mg/100 ml
– Drunk driving = >80mg/100ml
• Qualitative & quantitative research
– General drivers
– Convicted drunk driving offenders in detention
– Traffic police
Jia, 2015; Jia et al., 2013a,b, c
CARRS-Q Behavioural Research
Drink Driving
• High awareness in both cities that Drunk driving now a criminal
offence
• Low awareness of legal BAC levels in all samples
– Only 16 – 40% reported correct knowledge of legal BACs
• Knowledge of how to keep BAC below legal limit was extremely low
for all, including traffic police
Jia, 2015; Jia et al., 2013a,b, c
CARRS-Q Behavioural Research
Drink Driving
• Evidence of limited police roadside testing and lack of adequate
police resourcing
• Drivers use many strategies to avoid detection, some endangering
police safety
• AUDIT scores used to assess problematic drinking
– Higher level of alcohol misuse among convicted drunk driving offenders (both
cities). Higher among Yinchuan than Guangzhou offenders
– 1st time vs Repeat offenders: significant difference in AUDIT scores in both cities.
1st time offenders had a significant lower AUDIT scores than recidivists.
– Indicates problematic alcohol use levels among repeat drink drivers
Jia, 2015; Jia et al., 2013a,b, c
Future Research
• Legislation in formative stage
– penalties not necessarily a deterrent
– low levels of awareness (e.g. BAC levels)
– low levels of perceived risk associated with high risk behaviours (e.g.
speeding, phone use while driving)
• Evidence needed to reduce harm
– Enhance data quality
– Inform policy development
– Inform public education campaigns
– Raise awareness about high risk behaviours
– Consider culturally-specific issues when introducing countermeasures
Thank you for your attention today.
j.fleiter@qut.edu.au
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