Background/Objective Road traffic injuries (RTIs) pose a significant public health problem, especially in low- and middle-income countries, where most injuries occur. Speeding, helmet use, and seat-belt and child restraint use are three major risk factors for RTIs. This study aims to characterize these factors in Latin America, provide further insight to the road safety context, and generate data to support evidence-based interventions and policies in the region. From this, we deduce potential causes of advancements in road safety and propose interventions applicable in other low-resource settings. After discussing our findings with partners and key stakeholders, we provided recommendations to support actions to protect vulnerable road users. To our knowledge, this study is the first to characterize these risk factors in Latin America and synthesize data to support interventions to increase equity in this space.

Methods Observations were conducted in each respective city between 2020 and 2023. Information was collected on three primary risk factors in randomly selected observation sites. A standardized protocol for data collection was implemented for each risk factor. The data management team at Johns Hopkins International Injury Research Unit reviewed and cleaned the data to produce the analyses. Summary measures were generated using univariate analysis and a p-value cutoff of p=0.05.

Results Among all cities, speeding was a predominant issue. Among the four million observations collected, motorcycle drivers almost always had higher or equivalent percentages of correct helmet use compared with passengers. Correct helmet use was lower than 80% in four cities (range:44%-99%). Seat-belt and child restraint use was lower than 80% in six cities (range:54%-86%). In the last round of observations, vehicles observed speeding were higher than 10% in almost every city (range:2%-51%). Of all motorcycles observed, speeding ranged from 2%-55%.

Conclusions Vulnerable road users, oftentimes low-income road users such as pedestrians and motorcyclists, account for a substantial number of road traffic mortalities. Our analyses indicate speeding was the primary driver of RTIs. Moreover, a concerning number of motorcyclists continue to travel at unsafe speeds, despite their susceptibility to injuries. Implementation of recommendations based on findings from this study should be applied to reduce RTIs globally.