Background Road traffic accident (RTA) is one of the major public health problems in the world, especially in developing countries. RTAs have become the first leading cause of burden of disease and the second leading cause of death in Iran. The epidemiological aspects of mortality from RTAs are explored in Iran but inequality in this problem and its trend has not been explored in this country. In as much as effective measures to reduce the negative influence of road crashes would require understanding of different contributing factors such as disparities, this article examines geographical inequality in mortality from RTAs over the last decade in Iran.

Methods We performed a cross-sectional analysis of RTAs registered in the legal medicine organization data bank between 2006 and 2015. We used theil index and index of disparity to estimate geographical inequality in mortality from RTA. Regression analysis was applied to investigate the linear or non-linear trend of geographical inequality in RTA deaths. Data were analyzed using Stata software and DASP statistical package.

Results Totally, 210582 RTA deaths occurred during the study period of which, 1 49 545 were happened in outside city roads and 61 128 happened in inside city roads. Age adjusted mortality rate due to RTAs in our study decreased from 41.50 per 1 00 000 in 2006 to 21.50 in 2015. The same decreasing trend was also observed when we analyzed RTAs mortality rates by inside and outside city roads. Although overall RTA death rates declined during this period, geographical inequality in mortality from RTA have worsened over time.

Conclusion The findings of this study indicate that there is a geographical inequality in mortality from RTAs in Iran. This implies that effective interventions in reducing the RTAs should be distributed equally among regions of the country. Further research should investigate the causes of this inequality