Objectives: To explore the differential impact of urban and rural areas on motor vehicle accidents (MVA) and life expectancy in Taiwan. Methods: Data for population, death registration, income, and motor vehicle registration were acquired from the government. Life expectancy (LX) and its gains after MVA deaths were eliminated were calculated for Taiwan as a whole and for each city and county. Stepwise Regression Models were used to examine the association of MVA with the gap in LX. Results: Residents in most of the rural areas had a shorter LX, ranging from 71.6 to 77.6 years, than did urban residents whose LX ranged from 76.9 to 80.8 years. MVA mortality contributed 4.0% to 16.2% of the gaps in LX between Taipei City and each of the counties or cities. The impact of MVA on LX ranged from 0.6 to 1.1 years in rural areas and from 0.2 to 0.5 years in urban areas. MVA mortality was significantly negatively correlated with life expectancy (r=-0.87, p<0.01) and influenced the gaps in LX (Partial R <sup>2</sup>=0.75, p<0.0001). Urbanization was the most important factor in reducing MVA mortality (Partial R<sup>2</sup>=0.66, p<0.0001) and heavy motorcycle was the only significantly influential motor vehicle on MVA mortality (Partial R<sup>2</sup>=0.03, p<0.0001). Conclusions: Motor vehicle accidents were responsible for the worsening health disparity between urban and rural areas in Taiwan. The rural suffered a higher impact from motor vehicle density and its associated accidents on life expectancy than their urban counterparts. Reducing motor vehicle accidents would most benefit the life expectancy of populations in rural areas.
Date:
2010-06
Relation:
Taiwan Journal of Public Health. 2010 Jun;29(3):261-272.
