Citation

Edmonston C, Siskind V, Sheehan M. Int. J. Environ. Res. Public Health 2020; 17(5): e1467.

Affiliation

Centre for Accident Research & Road Safety-Queensland, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia.

Copyright

(Copyright © 2020, MDPI: Multidisciplinary Digital Publishing Institute)

DOI

10.3390/ijerph17051467

PMID

32106471

Abstract

Road trauma is a significant health problem in rural and remote regions of Australia, particularly for Indigenous communities. This study aims to identify and compare the circumstances leading to (proximal causation) and social determinants of (distal causation) crashes of Indigenous and non-Indigenous people in these regions and their relation to remoteness. This is a topic seriously under-researched in Australia. Modelled on an earlier study, 229 persons injured in crashes were recruited from local health facilities in rural and remote North Queensland and interviewed, mainly by telephone, according to a fixed protocol which included a detailed narrative of the circumstances of the crash. A qualitative analysis of these narratives identified several core themes, further explored statistically in this sample, supplemented by participants in the earlier study with compatible questionnaire data, designed to determine which factors were more closely associated with Indigenous status and which with remoteness. Indigenous participants were less often vehicle controllers, more likely to have recently been a drink driver or passenger thereof; to be unemployed, unlicensed, distracted or fatigued before the crash, alcohol dependent and have lower perceived social, but not personal, locus of control in a traffic crash than non-Indigenous persons. Differences between Indigenous and non-Indigenous participants are largely ascribable to hardship and transport disadvantage due to lack of access to licensing and associated limitations on employment opportunities. Based on these findings, a number of policy recommendations relating to educational, enforcement and engineering issues have been made.

Language: en

Keywords

Indigenous; distal causation; proximal causation; road safety; rural and remote crashes; transport disadvantage