PT - JOURNAL ARTICLE AU - Katherine Harmon AU - Wesley Kumfer TI - 16 The burden of traffic crashes on appalachia: an overlooked health disparity in the region AID - 10.1136/injuryprev-2020-savir.1 DP - 2020 May 01 TA - Injury Prevention PG - A1--A1 VI - 26 IP - Suppl 1 4099 - http://injuryprevention.bmj.com/content/26/Suppl_1/A1.1.short 4100 - http://injuryprevention.bmj.com/content/26/Suppl_1/A1.1.full SO - Inj Prev2020 May 01; 26 AB - Statement of Purpose The Appalachian Region (AR) has a higher premature fatality rate than the rest of the United States (US). While disparities related to chronic disease and other health conditions in Appalachia are well-described, an overlooked contributor to premature mortality are traffic crashes. Therefore, there is a need to examine the epidemiology of traffic fatalities in Appalachia and compare to the non-Appalachian US.Methods/Approach We obtained 2013–2017 data from the Fatality Analysis Reporting System for the Appalachian and non-Appalachian US by county. To characterize differences between Appalachian and non-Appalachian counties, we calculated population-based fatality rates and rate ratios using multivariate Poisson regression. We also compared differences in crash characteristics using logistic regression.Results For the period 2013–2017, the traffic fatality rate was 22% higher in the AR than in the non-AR (aRR: 1.22, 95% CI: 1.21–1.24). Traffic fatality rates were higher across all age groups and genders. Compared to non-Appalachian counties, the AR had higher fatality rates among motor vehicle occupants (aRR: 1.36. 95% CI 1.33–1.38) and motorcyclists (aRR: 1.16, 95% CI: 1.11–1.21), but lower rates among non-motorists (aRR: 0.75, 95% CI: 0.72–0.79).Appalachian fatalities were more likely to have been in a vehicle >20 years old (OR: 1.28, 95% CI: 1.20–1.36) and to not have been wearing a seatbelt at the time of crash (OR: 1.31, 95% CI: 1.26–1.36); however, fatalities were less likely to have been in an alcohol-involved crash compared to non-Appalachian fatalities (OR: 0.66, 95% CI: 0.63–0.69).Conclusion Appalachia has a higher burden of traffic fatalities than the rest of the US. While more research is needed, potential explanatory factors include vehicle age and lack of seatbelt use.Significance/Contribution to Injury and Violence Prevention Science This is one of the first studies to perform an examination of the epidemiology of Appalachian traffic fatalities.