The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #71953

Amy E. Donaldson, MS¹, Lawrence J. Cook, MStat², and Caroline B Hutchings, MStat². (1) Intermountain Injury Control Research Center, University of Utah School of Medicine, 615 Arapeen Drive, Suite 202, Salt Lake City, UT 84108, 8015855962, amy.donaldson@hsc.utah.edu, (2) Intermountain Injury Control Research Center, University of Utah, 615 Arapeen Dr, Suite 202, Salt Lake City, UT 84108

Introduction: Many studies have demonstrated that the fatality rate for motor vehicle crashes is significantly higher in rural than urban areas. The purpose of this study is to quantify the risk of a fatal outcome associated with a motor vehicle crash by the urban/rural classification of county of residence and county of crash before and after adjusting for potentially confounding factors. Methods: County of crash and driver's county of residence were classified as urban or rural for 456,069 Utah crash participants. Chi-square analysis was used to investigate the association between county of residence and certain behavioral and crash characteristics. Logistic regression was used to model the outcome of fatality (yes/no) in four models constructed in a step-wise fashion to assess the change in estimates as additional information was added to each model. Results: Rural residency is associated with a number of factors that increase the risk of a fatality. The highest number of fatal crash outcomes involve rural residents in rural areas. Before adjusting for confounding factors the relative risk of fatality in a rural crash was 9.4 for urban residents compared to 3.3 for rural residents. After adjustment risk estimates were reduced to 2.8 (urban) versus 1.8 (rural). Conclusion: There is a need for improved education in the areas of safety belt use, adherence to speed limits and alcohol use, particularly in rural areas where these factors are more prevalent. Urban residents may benefit from programs designed to educate them about driving in rural areas.

Learning Objectives:

At the conclusion of the session, the participant (learner) in this session will be able to:
• Identify specific behavioral, road and crash characteristics that are associated with MVC fatality and their influence on the difference between urban and rural crash fatality rates.
• Assess the importance of considering county of driver's residence in models examining crash outcomes.
• Discuss potential implications for future MVC research.

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.