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Assessing discrepancies in estimates of road traffic deaths in Brazil
  1. Kavi Bhalla1,
  2. Soames Job2,
  3. Sudeshna Mitra2,
  4. James E Harrison3,
  5. Leah Watetu Mbugua2,
  6. Kazuyuki Neki2,
  7. Hialy Gutierrez1,
  8. Ramshankar Balasubramaniyan1,
  9. Mercer Winer1,
  10. Theo Vos4,
  11. Erin Hamilton4
  1. 1Public Health Sciences, University of Chicago, Chicago, Illinois, USA
  2. 2World Bank Global Road Safety Facility, World Bank, Washington, DC, USA
  3. 3Flinders University, Bedford Park, South Australia, Australia
  4. 4Institute for Health Metrics and Evaluation, Seattle, Washington, USA
  1. Correspondence to Dr Kavi Bhalla, Public Health Sciences, University of Chicago, Chicago, IL 60637, USA; kavibhalla{at}


Introduction The First UN Decade of Action for Road Safety (2011–2020) ended with most low/middle-income countries (LMICs) failing to reduce road traffic deaths. In contrast, Brazil reported a strong decline starting in 2012. However, comparisons with global health statistical estimates suggest that official statistics from Brazil under-report traffic deaths and overestimate declines. Therefore, we sought to assess the quality of official reporting in Brazil and explain discrepancies.

Methods We obtained national death registration data and classified deaths to road traffic deaths and partially specified causes that could include traffic deaths. We adjusted data for completeness and reattributed partially specified causes proportionately over specified causes. We compared our estimates with reported statistics and estimates from the Global Burden of Disease (GBD)-2019 study and other sources.

Results We estimate that road traffic deaths in 2019 exceeded the official figure by 31%, similar to traffic insurance claims (27.5%) but less than GBD-2019 estimates (46%). We estimate that traffic deaths have declined by 25% since 2012, close to the decline estimated by official statistics (27%) but much more than estimated by GBD-2019 (10%). We show that GBD-2019 underestimates the extent of recent improvements because GBD models do not track the trends evident in the underlying data.

Conclusion Brazil has made remarkable progress in reducing road traffic deaths in the last decade. A high-level evaluation of what has worked in Brazil could provide important guidance to other LMICs.

  • mortality
  • motorcycle
  • Motor vehicle occupant
  • public health

Data availability statement

Data are available in a public, open access repository. WHO Mortality Database is available to researchers from

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Data availability statement

Data are available in a public, open access repository. WHO Mortality Database is available to researchers from

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  • Contributors SM and KB contributed to the study design and jointly led all aspects of the study. SJ and SM initiated the research into the issue. KN, LWM, HG, MW, and RB searched for data sources, reviewed literature and conducted data analysis. KB wrote the first draft of the article. All authors contributed to the discussion and interpretation of the results and to the writing of the manuscript. All authors have read and approved the final manuscript. KB is the guarantor of the manuscript.

  • Funding This investigation was conducted by researchers from the University of Chicago and the World Bank Global Road Safety Facility and supported by funding from UKAID (Award/Grant Number: 7197082).

  • Disclaimer UKAID had no role in data analysis, data interpretation or writing of the article. The corresponding author had full access to all the data in the study and had the final responsibility for the decision to submit for publication.

  • 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.