Article Text

Evaluation of road safety policies and their enforcement in Mexico City, 2015–2019: an interrupted time-series study
  1. Carolina Quintero Valverde1,
  2. Carolina Perez-Ferrer1,2,
  3. Luis Chías Becerril3,
  4. Armando Martínez Santiago3,
  5. Héctor Reséndiz Lopez3,
  6. Javier Prado Galbarro4,
  7. D. Alex Quistberg5,6,
  8. Ana V Diez Roux5,7,
  9. Tonatiuh Barrientos-Gutierrez4
  1. 1 Center for Research in Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
  2. 2 Programa Investigadores por México, National Council of Science and Technology (CONACYT), Mexico City, Mexico
  3. 3 Institute of Geography, National Autonomous University of Mexico (UNAM), Mexico City, Mexico
  4. 4 Center for Research in Population Health, National Institute of Public Health, Cuernavaca, Mexico
  5. 5 Urban Health Collaborative, Drexel University, Philadelphia, Pennsylvania, USA
  6. 6 Environmental & Occupational Health, Drexel University, Philadelphia, Pennsylvania, USA
  7. 7 Department of Epidemiology & Biostatistics, Drexel University, Philadelphia, Pennsylvania, USA
  1. Correspondence to Dr Carolina Perez-Ferrer, National Institute of Public Health, Cuernavaca 655, Mexico; carolina.perez{at}


Background Mexico City approved new road safety policies in 2015, which included lower speed limits and higher fines for traffic offences. In 2019, economic fines were replaced by a point penalty system among other changes. This study evaluates these policies on road traffic collisions, injuries and deaths.

Methods Collisions data came from insurance collision claims (January 2015 to December 2019) and road traffic deaths from vital registrations (January 2013 to December 2019). We conducted an interrupted time series analysis for each outcome using negative binomial regression models with an offset of insured vehicles (collisions) or total population (deaths). Then, we classified the 16 municipalities in the city into enforcement and no-enforcement groups based on presence or absence of automated traffic enforcement devices and conducted a controlled interrupted time series analysis.

Results The 2015 road safety policies had no effect on total collisions and collisions resulting in injury but were associated with a 0.2% (95% CI −0.3 to 0.0) decline in the mortality trend. The 2019 policies had no effect on total collisions but were associated with a 1.5% increase in the trend of collisions resulting in injuries and with a 2.7% (95% CI 1.0 to 4.5) increase in the mortality trend. Postpolicy trends in enforcement versus no-enforcement municipalities were not significantly different.

Conclusion Policies that included high economic penalties for speeding and dangerous behaviours were effective in decreasing traffic mortality while removing economic penalties and replacing them with a point penalty system were associated with an increase in collisions, resulting in injury and mortality.

  • Legislation
  • Public Health
  • Motor vehicle � Occupant
  • Epidemiology
  • Process/impact evaluation
  • Mortality

Data availability statement

Data are available in a public, open access repository. Stata do-files are available upon reasonable request.

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See:

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Data availability statement

Data are available in a public, open access repository. Stata do-files are available upon reasonable request.

View Full Text

Supplementary materials

  • Supplementary Data

    This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.


  • Twitter @carolinaperezf, @aquistbe

  • Contributors CQV: formal analysis, data curation, writing original draft. CP-F: conceptualisation, methodology, formal analysis, writing review and editing, supervision, project administration, funding acquisition and is responsible for the overall content as guarantor. LCB: validation, resources, data curation, writing—review. AM: validation, resources, data curation, writing—review. HRL: validation, resources, data curation, writing—review. JPG: methodology, formal analysis, writing—review. DAQ: methodology, software, resources, writing— reviewing and editing. AVDR: methodology, writing—review and editing, funding acquisition. TB-G: conceptualisation, methodology, writing— review and editing, funding acquisition.

  • Funding This work is part of the Salud Urbana en América Latina (SALURBAL)/ Urban Health in Latin America project funded by the Wellcome Trust [205177/Z/16/Z]. The authors acknowledge the contribution of all SALURBAL project team members. For more information on SALURBAL and to see a full list of investigators see SALURBAL acknowledges the contributions of many different agencies in generating, processing, facilitating access to data or assisting with other aspects of the project. Please visit for a complete list of data sources. The findings of this study and their interpretation are the responsibility of the authors and do not represent the views or interpretations of the institutions or groups that compiled, collected, or provided the data. The use of data from these institutions does not claim or imply that they have participated in, approved, endorsed, or otherwise supported the development of this publication. They are not liable for any errors, omissions or other defect or for any actions taken in reliance thereon. DAQ was partially supported by the Fogarty International Center of the National Institutes of Health under award number K01TW011782. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The funder had no role in the design, analysis or write up of this article. We also thank Olivia Olvera and Daniela Zepeda from AXA Mexico for their help with codebooks and other questions regarding the data and Luz Mery Cárdenas for her help with data cleaning.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.