Monday, December 20, 2004

Country Roads, Take Me (to the funeral) Home.....
No wonder I stay so busy:Country roads can be deadly
The South's beautiful tree-lined roadways may be to blame for the region having the highest number of vehicle deaths in the country, according to a Georgia Institute of Technology study.

More than a quarter of U.S. vehicle deaths between 1996 and 2000 happened in just eight Southeast states - Georgia, South Carolina, North Carolina, Alabama, Mississippi, Kentucky, Florida and Tennessee. It's the largest proportion of deaths in any region of the country, according to the study.

The reason for the higher number of crashes is that the Southeast has a higher density of rural roads than any other part of the country. Driving on those roads has been dangerous for drivers. Sixty-four percent of the fatal crashes in the Southeast were on rural roads.

"The most frequent crashes in the Southeast occurred on rural roads in wooded areas where people ran off the road and hit a tree," said Karen Dixon, associate professor of civil and environmental engineering at Georgia Tech......
.....A lack of road maintenance funding in rural areas may mean country roads are loaded with driving hazards, such as trees that stand too close to the roadway, a lack of paved shoulders and devices such as rumble strips, Dixon said.

There were more than 49,000 fatal crashes in the Southeast out of nearly 186,600 fatalities on the road in the United States during the time period of the study.

Based on this research from Georgia Tech. Some of the reasons given in the report:
On rural roads, the most common contributing factor to traffic fatalities was late-night driving by tired or apparently intoxicated motorists, especially on weekends, Dixon noted. Many of these victims were males between ages 16 and 25.

The study also found that 48.6 percent of the region’s fatal crashes involved drivers who did not wear seatbelts, she added. In a related finding in Georgia’s report, Dixon discovered a disproportionate number of pickup trucks involved in fatal crashes.....
Another of the study’s findings lays potential blame for fatal crashes on the 2.5- to 5-inch pavement drop-offs often found on rural highway edges.

"Almost half of the non-state maintained roadway crashes we looked at had an edge drop-off issue,” she noted. “We don’t know if this caused all of these crashes, but nonetheless, the potential exists for it to be a serious problem.”

Drop-offs develop as roads are repaved and/or soil erodes along the shoulder. And roadside ruts are caused by rural mail carriers who drive with one side of their vehicles on the road and the other on the unpaved shoulder, she added.

They are examining the number of deaths, not of total crashes. The proposed theories have to do more with crash causation than deaths. Certainly if more crashes occur, more victims are expected to succumb to their injuries.
I think another reason could contribute, the lack of a well-developed trauma/EMS system in the rural southeast, especially in rural south Georgia. As seen in this article from the Atlanta Journal-Constitution I posted on in January, Georgia has a lot of work to do:
Lurking under Georgia's radar screen is a public health care crisis that costs hundreds of people their lives each year.

"If Georgia did nothing but become average, we'd save more than 600 lives a year," said Dr. James Patrick O'Neal, state Emergency Medical Services medical director. "If we had a statewide trauma network, we'd save more lives than that."

Vast chunks of Georgia remain unserved by a trauma center, hospitals qualified, equipped and staffed to treat people severely injured in car crashes or other mishaps. Only 14 of the state's hospitals meet the criteria to be designated as trauma centers, and only four, including Atlanta's Grady Memorial Hospital, are designated as Level 1, qualified to give the most extensive level of care.

South of Macon, there is only one Level 1 center, Savannah's Memorial Health University Medical Center.

A large group of Georgia lawmakers heard a heartfelt plea from health care professionals and safety advocates at a Thursday breakfast gathering to do more to address the lack of quality trauma care.

"It is costing more and more to provide this service," said Dr. M. Gage Ochsner, the Savannah facililty's director of trauma services. "Most of our trauma centers have provided it as a community service, but when it starts driving them into the ground, they have to look at [eliminating] it."

O'Neal said two-thirds of Georgia's hospitals are operating in the red, making it more difficult to justify providing expensive trauma coverage.

Complicating the issue even further, said Ken Beverly, chairman of the board for the Georgia Hospital Association, is Georgia's lack of a Good Samaritan law shielding physicians from many of the liabilities involved in emergency room work.

"Doctors don't want to go into emergency rooms," he said.

Injury is the leading cause of death for all Georgians aged 1 to 45, and ranks fourth among Georgians of all ages. It costs us 4,500 lives a year, hundreds of which could be saved if they could be reached, taken to a trauma center and treated within the famous "golden hour."

Yet many Georgians are critically injured on roads hundreds of miles from a trauma center.

"If you are in some of these areas, you can expect to get the same care you got 40 years ago if you're in a motor vehicle crash," said Ochsner.

Lives that can be saved are only part of the story, said Dr. Arthur Kellermann, chairman of Emory University's Department of Emergency Medicine.

"Disabilities can be averted if we do the right things on the front end," he said.

Political leaders who addressed the gathering could do little more than express concern as the state battles a budgetary crisis. "We know there's a problem there, and we're looking for solutions," said House Speaker Terry Coleman (D-Eastman).

Senate President Pro Tempore Eric Johnson (R-Savannah) urged health care officials to "bring your legislators into your emergency rooms and show them how many physicians are needed."

"This is a basic quality-of-life issue," said Lt. Gov. Mark Taylor. "This is a life-and-death situation for our citizens."

So are the deaths due to bad roads, or bad medical infrastructure?
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