eprintid: 10206226 rev_number: 7 eprint_status: archive userid: 699 dir: disk0/10/20/62/26 datestamp: 2025-03-18 11:32:04 lastmod: 2025-03-18 11:32:04 status_changed: 2025-03-18 11:32:04 type: article metadata_visibility: show sword_depositor: 699 creators_name: Christie, Nicola creators_name: Jones, Sarah creators_name: O'Toole, Sarah E title: Systemic inequalities in road safety outcomes across high income countries and lessons from intervention approaches ispublished: pub divisions: UCL divisions: B04 divisions: F44 keywords: Road safety inequality, Socioeconomic disparities, Road casualties, Killed or seriously injured (KSI), System interventions note: © 2025 The Authors. Published by Elsevier Ltd. under a Creative Commons license (http://creativecommons.org/licenses/by/4.0/). abstract: BACKGROUND: Road safety inequality refers to the systematic and avoidable differences in road safety exposures and health outcomes among various demographic groups, influenced by social, economic, environmental, and structural factors. METHOD: A narrative review approach was employed, integrating a systems perspective to examine the interplay of social, economic and environmental factors. Literature searches were conducted across academic databases and grey literature, over the last 15 years yielding 42 sources after applying exclusion criteria. The review was guided by research questions focusing on demographic and geographic disparities, the underlying risk factors, and the effectiveness of interventions. RESULTS: Findings highlight that most studies concentrate on risk factors rather than interventions. Key risk factors, especially for the young as pedestrians and cyclists, included living in hazardous built environments with high traffic levels and being more exposed to antisocial and illegal driving behaviour. For interventions the evidence suggests the need for multifaceted interventions supported by multi-agency efforts. Effective communication, community engagement, and recognition of broader systemic issues were critical for intervention success. CONCLUSIONS: The review underscores the importance of integrating road safety within wider social and environmental strategies to maximize co-benefits. System-wide interventions targeting young pedestrians and cyclists, are recommended. Future research should address gaps in understanding the multifaceted nature of road safety inequalities and develop comprehensive, scalable interventions. date: 2025-03 date_type: published publisher: ELSEVIER SCI LTD official_url: https://doi.org/10.1016/j.jth.2025.102006 oa_status: green full_text_type: pub language: eng primo: open primo_central: open_green verified: verified_manual elements_id: 2363604 doi: 10.1016/j.jth.2025.102006 lyricists_name: Christie, Nicola lyricists_id: NCHRI60 actors_name: Christie, Nicola actors_id: NCHRI60 actors_role: owner funding_acknowledgements: [Road Safety Trust] full_text_status: public publication: Journal of Transport & Health volume: 41 article_number: 102006 pages: 13 citation: Christie, Nicola; Jones, Sarah; O'Toole, Sarah E; (2025) Systemic inequalities in road safety outcomes across high income countries and lessons from intervention approaches. Journal of Transport & Health , 41 , Article 102006. 10.1016/j.jth.2025.102006 <https://doi.org/10.1016/j.jth.2025.102006>. Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10206226/1/Inequalities%20in%20road%20safety%20outcomes%20Christie.pdf