Temporal trends in the incidence and mortality of road injuries in China: Current trends and future predictions

Background: China has the highest number of road injury deaths in the world. The aim of this study was to determine the long-term incidence and mortality trends of road injuries in China between 1990 and 2019 and to make projections up to 2030.Methods: Incident and death data were extracted from the Global Burden of Disease (GBD) 2019 study and population data were extracted from the GBD 2019 and World Population Prospects 2019 studies. An age-periodcohort framework was used for the analysis. Results: In 2019, 16.1 million road injuries (age-standardized incidence rate [ASIR]: 991.3/100,000) occurred in China. Between 1990 and 2019, the ASIR of road injuries in China increased by 87.4 %. In 2019, there are 250.0 thousand road deaths (age-standardized mortality rate [ASMR]: 14.79/100,000), and the ASMR decreased by 27.0 % between 1990 and 2019. Period and cohort risks for the incidence of road injuries were increased for both sexes. Period and cohort risks for road injury mortality appeared to increase in recent period and birth cohorts. The ASIR of road injuries was projected to increase in the future, and the ASMR was projected to decrease; however, the ASIR of cyclist road injuries in females was projected to increase in the future. Among road injuries, elderly individuals were projected to have an increasing proportion of occurrence and death. Although the proportion is decreasing, pedestrian road injuries were projected to still account for more than half of road injury deaths in China up to 2030.Conclusions: The incidence of road injuries in China has increased overall, while the overall mortality rate has decreased over the past 30 years, and this trend is expected to continue in the future. Effective effort is needed to improve road safety, especially for elderly individuals and female cyclists. In addition, pedestrian road safety also needs to be improved.