Date of Conferral

2015

Degree

Ph.D.

School

Public Health

Advisor

Bernice Kennedy

Abstract

Road traffic deaths, which affect people in their productive years, are projected to be the third leading cause of death by the year 2030. While most studies have focused on road infrastructure and vehicle safety, this study examined something new: the impact of prehospital response to road traffic accidents on the rate of death. Some countries send physicians to the scene of an accident; some send paramedics or registered nurses. The question this research sought to answer was whether the use of physician responders resulted in a lower rate of death compared to the use of nonphysician responders. The literature makes it clear that rate of road traffic death is related to country income and governance indicators, so first those variables needed to be equalized. My conceptual framework for this cross-sectional correlation study was the Haddon matrix, which organizes injuries by temporal (pre-event, event, and postevent) and epidemiological (host, agent, and environment) factors. Using World Health Organization data on road traffic injury and country income, World Bank data on governance indicators, and a literature search of 67 countries' prehospital response profiles, significant negative correlations (p > 0.001) were found for road traffic deaths and income, r (65) = -0.68, and governance indicators, r (65) = -0.646. No significant difference in the rate of road traffic death was found between physician and nonphysician prehospital staffing. Because increasing countries' income and improving governance are long-term, ambitious goals for developing countries, training nonphysician prehospital responders appears to be the most effective social change to decrease the burden of road traffic deaths.

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