class: center, inverse # [Socioeconomic inequalities in cycling safety](https://www.sciencedirect.com/science/article/abs/pii/S2214140521003212) .ref[<br>An analysis of cycling injury risk by residential<br> deprivation level in England] <!-- --> <!-- <img src="Images_paper3/leicester2.jpg" --> <!-- width="500" --> <!-- height="325" /> --> <img src="Images_paper3/IMG_20180509_Eugeni-ref.jpg" width="575" height="325" /> [Eugeni Vidal Tortosa](https://environment.leeds.ac.uk/transport/staff/9633/eugeni-vidal-tortosa), Robin Lovelace, Eva Heinen, and Richard P. Mann --- ## Introduction <!-- - There is evidence that road injury risk is higher for deprived groups than for non- deprived populations. --> - **Previous research** has found that people living in deprived areas are at a higher risk of injury when cycling, than people living in non-deprived areas .ref2[(Edwards et al., 2008; O’Toole and Christie, 2018; Feleke et al., 2018)]. - These studies focused on serious and fatal injuries, children, and a specific point in time. - This paper **aims** to explore: + i) inequalities in cycling injury risk by residential deprivation for *all recorded casualties*, + ii) whether these inequalities vary by *sex and age*, and + iii) how these inequalities have *changed over time*. <!-- - Better understanding inequalities in cycling safety can support evidence-based policies to make cycling safer for all and more diverse. --> --- ## Data and methods #### Data - Three datasets (for the six-year period 2014–2019) were used: + [STATS19 database of road traffic casualties in Britain](https://data.gov.uk/dataset/cb7ae6f0-4be6-4935-9277-47e5ce24a11f/road-safety-data) + [English National Travel Survey](https://www.gov.uk/government/collections/national-travel-survey-statistics) + [population estimates for England](https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationestimates/datasets/populationestimatesforukenglandandwalesscotlandandnorthernireland) #### Methods - We estimated the ratio of slight, serious, and fatal cycling casualties per billion kilometres (Bkm) cycled in England by: + residential deprivation quintile, + residential deprivation quintile and sex, + residential deprivation quintile and age group, and + residential deprivation quintile and year. - 95% CIs using exact Poisson confidence limits were computed. --- ## Results #### Cycling injury rates by residential deprivation quintile <img src="./Images_paper3/figimd-1-0.jpg" width="80%" style="display: block; margin: auto;" /> --- ## Results #### Cycling injury rates by residential deprivation quintile <img src="./Images_paper3/figimd-1-1.jpg" width="80%" style="display: block; margin: auto;" /> --- ## Results #### Cycling injury rates by residential deprivation quintile <img src="./Images_paper3/figimd-1-2.jpg" width="80%" style="display: block; margin: auto;" /> --- ## Results #### Cycling injury rates by residential deprivation quintile <img src="./Images_paper3/figimd-1-3.jpg" width="80%" style="display: block; margin: auto;" /> --- ## Results #### Cycling injury rates by residential deprivation quintile and sex <img src="./Images_paper3/figsex-1-0.jpg" width="80%" style="display: block; margin: auto;" /> --- ## Results #### Cycling injury rates by residential deprivation quintile and sex <img src="./Images_paper3/figsex-1-1.jpg" width="80%" style="display: block; margin: auto;" /> --- ## Results #### Cycling injury rates by residential deprivation quintile and sex <img src="./Images_paper3/figsex-1-2.jpg" width="80%" style="display: block; margin: auto;" /> --- ## Results #### Cycling injury rates by residential deprivation quintile and sex <img src="./Images_paper3/figsex-1-3.jpg" width="80%" style="display: block; margin: auto;" /> --- ## Results #### Cycling injury rates by residential deprivation quintile and age group <img src="./Images_paper3/figage-1-0.jpg" width="80%" style="display: block; margin: auto;" /> --- ## Results #### Cycling injury rates by residential deprivation quintile and age group <img src="./Images_paper3/figage-1-1.jpg" width="80%" style="display: block; margin: auto;" /> --- ## Results #### Cycling injury rates by residential deprivation quintile and age group <img src="./Images_paper3/figage-1-2.jpg" width="80%" style="display: block; margin: auto;" /> --- ## Results #### Cycling injury rates by residential deprivation quintile and age group <img src="./Images_paper3/figage-1-3.jpg" width="80%" style="display: block; margin: auto;" /> --- ## Results #### Cycling injury rates by residential deprivation quintile and year <img src="./Images_paper3/figyear-1-0.jpg" width="80%" style="display: block; margin: auto;" /> --- ## Results #### Cycling injury rates by residential deprivation quintile and year <img src="./Images_paper3/figyear-1-1.jpg" width="80%" style="display: block; margin: auto;" /> --- ## Results #### Cycling injury rates by residential deprivation quintile and year <img src="./Images_paper3/figyear-1-2.jpg" width="80%" style="display: block; margin: auto;" /> --- ## Results #### Cycling injury rates by residential deprivation quintile and year <img src="./Images_paper3/figyear-1-3.jpg" width="80%" style="display: block; margin: auto;" /> --- ## Discussion and conclusions #### i) The higher the level of residential deprivation, the greater the risk of minor and serious cycling injuries - More road density, traffic volume, and aggressive driving behaviour associated with higher road injury in deprived areas .ref2[(Morency et al., 2012; Hasselberg et al., 2005)]. - Disadvantaged groups may be more likely to own bicycles of poor quality and have less access to safety equipment. #### ii) These inequalities were particularly large for children - There may be more urban environment particularly dangerous for children in deprived areas. - Children in deprived areas may have fewer opportunities to ride safely. #### iii) These inequalities may have grown between 2014 and 2019 - There may have been higher investment in least deprived areas. - Cycling infrastructure in deprived areas may not be the most suitable for cyclists from these areas .ref2[(Vidal-Tortosa et al., 2021)]. --- ## Discussion and conclusions #### Further research - Why do socioeconomic inequalities in cycling injury risk exist? - Why are they particularly large for children? - Why may they have increased in recent years? <!-- -- --> <!-- #### Limitations --> <!-- - The number of cycling casualties is under-reported. --> <!-- - The postcode in 12% of casualties was missing. --> --- ## References .ref2[ Edwards, P., Green, J., Lachowycz, K., Grundy, C., Roberts, I., 2008. Serious injuries in children: Variation by area deprivation and settlement type. Archives of Disease in Childhood 93, 485–489. https://doi.org/10.1136/adc.2007.116541 Feleke, R., Scholes, S., Wardlaw, M., Mindell, J.S., 2018. Comparative fatality risk for different travel modes by age, sex, and deprivation. Journal of Transport & Health 8, 307–320. https://doi.org/10.1016/j.jth.2017.08.007 Hasselberg, M., Vaez, M., Laflamme, Lucie, 2005. Socioeconomic aspects of the circumstances and consequences of car crashes among young adults. Soc. Sci. Med. 60 (2), 287–295. https://doi.org/10.1016/j.socscimed.2004.05.006 Morency, P., Gauvin, L., Plante, C., Fournier, M., Morency, C., 2012. Neighborhood social inequalities in road traffic injuries: the influence of traffic volume and road design Am, J. Public Health 102 (6), 1112–1119. https://doi.org/10.2105/AJPH.2011.300528 O’Toole, S.E., Christie, N., 2018. Deprivation and road traffic injury comparisons for 4–10 and 11–15 year-olds. Journal of Transport & Health 11, 221–229. https://doi.org/10.1016/j.jth.2018.08.003 Vidal Tortosa, E., Lovelace, R., Heinen, E., Mann, R.P., 2021. Cycling behaviour and socioeconomic disadvantage: an investigation based on the English National Travel Survey. Transport. Res. Pol. Pract. 152, 173–185. https://doi.org/10.1016/j.tra.2021.08.004 <!-- Parkin, J., Wardman, M., Page, M., 2008. Estimation of the determinants of bicycle mode share for the --> <!-- journey to work using census data. Transportation 35, 93–109. https://doi.org/10.1007/s11116-007-9137-5 --> <!-- Vidal Tortosa, E., Lovelace, R., Heinen, E., Mann, R.P., 2021. Infrastructure is not enough: Interactions --> <!-- between the environment, socioeconomic disadvantage and cycling participation in England. Journal of --> <!-- Transport and Land Use. --> <!-- https://doi.org/10.5198/jtlu.2021.1781 --> ] --- background-size: cover class: inverse, center, middle, Slides available in https://eugenividal.github.io/slides/Presentation_paper3.html The paper was published in the Journal of Transport & Health https://www.sciencedirect.com/science/article/abs/pii/S2214140521003212 # Thanks! --- ## Update #### Cycling injuries by residential deprivation quintile and year (2014 - 2021) <img src="./Images_paper3/plot2.jpg" width="80%" style="display: block; margin: auto;" /> <!-- For further information visit https://eugenividal.github.io -->