Background Road traffic deaths (RTDs) are a leading cause of death throughout the world.

Methods To gauge progress in reducing RTDs, we used data from the International Road Traffic and Accident Database to calculate population-based death rates (per 100,000 population), distance-based death rates (per billion vehicle kilometers traveled), and vehicle-based death rates (per 10,000 registered vehicles), as well as average rates and average percent changes from 2015 to 2019 for 29 high-income countries with populations >1,000,000 residents and for which data were available.

Results In 2019, the U.S. had the highest population-based RTD rate (11.1) compared with 28 other high-income countries; the U.S. rate was 2.3 times higher than the average rate (4.8). The U.S. also had a higher distance-based death rate (6.9) than the average rate for 20 other high-income countries (5.7) and a higher vehicle-based death rate (1.21) than the average rate for 27 other high-income countries (0.78). From 2015 to 2019, Switzerland had the largest percent decrease (-28.7%) in population-based RTD rates, whereas Denmark had the largest percent increase (9.0%). The U.S. remained relatively stable with a 0.1% percent increase.

Conclusion Many high-income countries with low RTD rates and large reductions have implemented effective strategies (e.g., lower blood alcohol concentration limits and speed reduction strategies). Emphasizing a Safe System approach—which accounts for human error and helps protect all road users—and implementing proven strategies can help reduce RTDs in the U.S. and other countries.

Learning Outcomes Learn about road safety progress in 29 high-income countries.