Global road injury and death rates fell over 30% since 1990, but gains uneven and poorest countries lag

Global age-standardized rates of road injuries and deaths each declined by more than 30% between 1990 and 2023, according to a comprehensive analysis published in The Lancet Public Health. The study, based on Global Burden of Disease 2023 estimates from researchers at the University of Washington’s Institute for Health Metrics and Evaluation (IHME), found incidence rates dropped 38.3% and mortality rates 32.3% over the multi-decade period (healthdata.org).

Despite the overall progress, improvements were highly uneven. Low-income countries saw little measurable decline in mortality rates, while high-income countries recorded the sharpest reductions. In 2023, road injuries caused an estimated 50.9 million injuries, 1.34 million deaths, and 75.3 million disability-adjusted life years (DALYs) lost globally. More than 90% of those deaths occurred in low- and middle-income countries. Low-income countries had a mortality rate of 43.8 deaths per 100,000 people—nearly six times higher than the 7.5 per 100,000 in high-income countries—even though high-income nations recorded higher rates of non-fatal injuries (healthdata.org).

Road injuries ranked as the 11th leading cause of death overall and the leading cause among people aged 10–39. They were the second-leading cause among children aged 5–9. Males faced higher rates across nearly all age groups; among males aged 20–24, road injuries accounted for more than one in five deaths. Motor vehicle crashes were the largest contributor, responsible for 19.8 million injuries and 518,000 deaths in 2023. Pedestrians accounted for nearly one-third of road deaths, while motorcyclists represented 13% of cases but nearly 24% of fatalities (healthdata.org).

The Associated Press reported that pedestrian and vehicle occupant deaths rose between 1990 and 2023 in six countries, including the United States. More recent U.S. data, however, show declines: the National Highway Traffic Safety Administration estimated about 36,600 motor vehicle traffic fatalities in 2025, down from a peak above 43,000 in 2021 (apnews.com; nhtsa.gov).

On the same day, the World Health Organization updated its fact sheet, estimating approximately 1.16 million road traffic deaths annually. WHO figures indicate a 21% decline in deaths between 2011 and 2025, though crashes remain the leading cause of death for children and young people aged 5–29. About 92% of fatalities occur in low- and middle-income countries, which have roughly 60% of the world’s vehicles. Road crashes cost most countries about 3% of GDP (who.int).

IHME senior author Liane Ong noted that “road injury outcomes are shaped not only by crashes, but by the systems designed to prevent them and protect people when they occur.” Safety measures such as seat-belt laws and vehicle standards like airbags are more widespread in higher-income settings, while rapid motorization and urbanization in lower-income countries have often outpaced infrastructure and emergency care improvements. The study’s release coincides with a United Nations high-level meeting on global road safety in New York (healthdata.org; apnews.com).

Researchers emphasize that many deaths are preventable through safer roads and vehicles, stronger enforcement, and better post-crash care. Evidence cited in the analysis suggests enhanced trauma care coverage alone could save more than 200,000 lives annually in low- and middle-income countries. The findings align with the UN Sustainable Development Goal target of halving road traffic deaths and injuries by 2030.