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Injured by Design: A Global Perspective on Urban Design and Road Transport Injury

22 Pages Posted: 31 Jan 2019

See all articles by Jason Thompson

Jason Thompson

University of Melbourne - Transport, Health and Urban Design Research Hub

Mark Stevenson

University of Melbourne - Transport, Health and Urban Design Research Hub

Jasper S. Wijnands

University of Melbourne - Transport, Health and Urban Design Research Hub

Kerry Nice

University of Melbourne - Transport, Health and Urban Design Research Hub

Gideon Aschwanden

University of Melbourne - Transport, Health and Urban Design Research Hub

Jeremy Silver

University of Melbourne - School of Earth Sciences

Mark Nieuwenhuijsen

Barcelona Institute for Global Health (ISGlobal); Universitat Pompeu Fabra; Instituto de Salud Carlos III - CIBER de Epidemiología y Salud Pública (CIBERESP)

Peter Rayner

University of Melbourne - School of Earth Sciences

Robyn Schofield

University of Melbourne - School of Earth Sciences

Rohit Hariharan

University of Melbourne - Transport, Health and Urban Design Research Hub

Christopher N. Morrison

Columbia University - Mailman School of Public Health

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Abstract

Background: The design of cities has been heavily influenced by the needs of private motor vehicles, resulting in significant population and planetary health challenges. Death and injury due to motor vehicle crashes is now the world's 5th leading cause of mortality and morbidity and motor vehicle-related air pollution accounts for 4.2 million deaths per year. This study highlights the global importance of urban design as an approach to mitigating the challenges associated with rapid motorisation and road transport injury.

Methods: Urban characteristics were obtained from sample maps for 1692 cities capturing one third of the world's population. Applying a combined convolutional neural network and graph-based approach, cities were classified into unique groupings based on selected urban design characteristics represented in sample maps. Associations between identified city types and the burden of road transport injury were estimated using data from the most recent Global Burden of Disease (GBD) study.

Findings: For the first time, 9 city types (urban designs) have been identified that capture the diversity of land transport and are associated with the burden of road transport injury. The burden of road transport injury was 2-fold higher (RR=2.13) for the poorest performing city types as opposed to the best performing city type. A total of 9 million DALYs lost per year to road transport injury can be attributed to urban design/city types.

Interpretation: With more than a 2-fold difference observed in the total estimated burden of road transport injury between the best performing city type and the worst performing city types, prevention efforts need to be focused up-stream to deliver urban design that supports transport mode shift that places people within lower risk transport modes such as rail and advocates for increased safe active transport. Such an approach will reduce the considerable health burden associated with cities operating predominantly private motor vehicle-oriented transport systems.

Funding Statement: JT is supported by an Australian Research Council Discovery Early Career Research Award [Grant No. DE180101411]. MS is supported by a National Health and Medical Research Council (Australia) Fellowship [Grant No. APP1136250]. The work of JS was funded by a McKenzie Postdoctoral Fellowship from the University of Melbourne, Australia. CM is supported by the National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health under Award Number K01AA026327. RS work is supported by the Australian Research Council discovery DP160101598 grant, centre of excellence CE170100023 scheme and the National Environment Science Program Clean Air and Urban Landscape hub.

Declaration of Interests: Nothing to disclose.

Ethics Approval Statement: No human or animal participants were involved in the study. The study did not require approval from the University of Melbourne’s Human Research Ethics Committee.

Suggested Citation

Thompson, Jason and Stevenson, Mark and Wijnands, Jasper S. and Nice, Kerry and Aschwanden, Gideon and Silver, Jeremy and Nieuwenhuijsen, Mark and Rayner, Peter and Schofield, Robyn and Hariharan, Rohit and Morrison, Christopher N., Injured by Design: A Global Perspective on Urban Design and Road Transport Injury (December 29, 2018). Available at SSRN: https://ssrn.com/abstract=3307635

Jason Thompson (Contact Author)

University of Melbourne - Transport, Health and Urban Design Research Hub ( email )

Carlton, Victoria
Australia

Mark Stevenson

University of Melbourne - Transport, Health and Urban Design Research Hub

Carlton, Victoria
Australia

Jasper S. Wijnands

University of Melbourne - Transport, Health and Urban Design Research Hub

Carlton, Victoria
Australia

Kerry Nice

University of Melbourne - Transport, Health and Urban Design Research Hub

Carlton, Victoria
Australia

Gideon Aschwanden

University of Melbourne - Transport, Health and Urban Design Research Hub

Carlton, Victoria
Australia

Jeremy Silver

University of Melbourne - School of Earth Sciences

The University of Melbourne
Victoria, 3010
Australia

Mark Nieuwenhuijsen

Barcelona Institute for Global Health (ISGlobal) ( email )

Barcelona, 08003
Spain

Universitat Pompeu Fabra ( email )

Ramon Trias Fargas, 25-27
Barcelona, E-08005
Spain

Instituto de Salud Carlos III - CIBER de Epidemiología y Salud Pública (CIBERESP) ( email )

Monforte de Lemos 5
Madrid
Spain

Peter Rayner

University of Melbourne - School of Earth Sciences

The University of Melbourne
Victoria, 3010
Australia

Robyn Schofield

University of Melbourne - School of Earth Sciences

The University of Melbourne
Victoria, 3010
Australia

Rohit Hariharan

University of Melbourne - Transport, Health and Urban Design Research Hub

Carlton, Victoria
Australia

Christopher N. Morrison

Columbia University - Mailman School of Public Health

600 West 168th St., 6th Floor
New York, NY 10032
United States

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