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Journals / ESTÜDAM Halk Sağlığı Dergisi / 2026 / Cilt: 11 Sayı: 2

Traffic accidents and public health: Preventable mortality estimates from interrupted time series and panel evidence in Türkiye, 2009–2023

Trafik kazaları ve halk sağlığı: 2009–2023 yılları kesintili zaman serisi ve panel bulgularına dayalı önlenebilir ölüm tahminleri

Canan Bulut(İSTANBUL KÜLTÜR ÜNİVERSİTESİ)0000-0001-5092-5261
Pages
141–158
Publication Date
2026-05-15
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Findings indicate a significant upward level shift in 2015 (+0.89 log-DPM, p<0.001), a downward shock in 2020 (−0.30, p<0.001), and a post-2020 positive slope change (+0.17 per year, p<0.001).

📌 3 Key Takeaways

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Objective & Hypothesis:This study aims to quantify the public health burden of road traffic fatalities and injuries in Türkiye between 2009 and 2023, with particular attention to the definitional change in 2015 (30-day rule) and the COVID-19 shock in 2020.
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Key Findings & Data:Counterfactual deaths for 2020–2023 were generated from the 2012–2019 trend.
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Conclusion & Impact:Findings indicate a significant upward level shift in 2015 (+0.89 log-DPM, p<0.001), a downward shock in 2020 (−0.30, p<0.001), and a post-2020 positive slope change (+0.17 per year, p<0.001).
🔬Design:Modeling & Simulation
📍Scope:2009 Verileri
⚙️Variables:Trafik kazaları · halk sağlığı · kesintili zaman serisi (ITS)

Abstract

This study aims to quantify the public health burden of road traffic fatalities and injuries in Türkiye between 2009 and 2023, with particular attention to the definitional change in 2015 (30-day rule) and the COVID-19 shock in 2020. Using an interrupted time-series (ITS) design, annual deaths per million population (DPM, log-transformed) were modeled through segmented OLS with Newey–West standard errors, incorporating level and slope changes. Diagnostics included ACF/PACF and Ljung–Box tests. Counterfactual deaths for 2020–2023 were generated from the 2012–2019 trend. Findings indicate a significant upward level shift in 2015 (+0.89 log-DPM, p<0.001), a downward shock in 2020 (−0.30, p<0.001), and a post-2020 positive slope change (+0.17 per year, p<0.001). Observed DPM consistently remained below counterfactual expectations during 2020–2023 (e.g., 58 vs. 97 in 2020). Case fatality ratio (CFR) rose from 1.38% in 2012 to 1.83% in 2023, with peaks in summer and marked regional heterogeneity. The results demonstrate that measurement standardization and exposure shocks strongly influence mortality trends, whereas the increasing post-pandemic slope indicates a renewed escalation of traffic-related risks. These findings highlight the need for targeted policy packages integrating speed management, behavioral adaptation strategies, and comprehensive trauma care systems.

Özet

Bu çalışma, 2009–2023 döneminde Türkiye’de karayolu trafik kazalarına bağlı ölümlerin ve yaralanmaların halk sağlığı yükünü nicel olarak ortaya koymayı amaçlamaktadır. Özellikle 2015 yılındaki tanımsal değişiklik (30-gün standardı) ve 2020’deki COVID-19 pandemisi şoku, kesintili zaman serisi (KZS) yaklaşımıyla incelenmiştir. Bağımlı değişken olarak milyon nüfus başına ölüm (DPM, log-dönüşümlü) kullanılmış; Newey–West standart hatalarıyla tahmin edilen segmentli OLS modeline seviye ve eğim kırılmaları dahil edilmiştir. Artık yapısı ACF/PACF ve Ljung–Box testleriyle değerlendirilmiş; karşı-olgusal ölümler 2012–2019 eğiliminden türetilmiştir. Bulgular, 2015’te anlamlı bir düzey artışı (+0.89 log-DPM, p<0,001), 2020’de düzey düşüşü (−0.30, p<0,001) ve 2020 sonrasında pozitif eğim değişimi (+0.17/yıl, p<0,001) olduğunu göstermektedir. 2020–2023’te gözlenen DPM, beklenen değerlerin altında kalmıştır (örn. 2020’de 58 gözlenen vs 97 beklenen). Olgu-ölüm oranı (CFR) 2012’de %1,38’den 2023’te %1,83’e yükselmiş; yaz aylarında zirve yapan mevsimsel desenler ve iller arasında belirgin farklılıklar saptanmıştır. Sonuçlar, ölçüm standardizasyonu ve maruziyet şoklarının eğilimleri güçlü biçimde etkilediğini, pandemi sonrası eğim artışının ise risklerin yeniden yükseldiğine işaret ettiğini göstermektedir. Bulgular, hız yönetimi, davranışsal uyum ve travma bakım zincirini bütünleyen hedefli politika paketlerinin gerekliliğini ortaya koymaktadır.

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Cite This Article

Bulut, C. (2026). Traffic accidents and public health: Preventable mortality estimates from interrupted time series and panel evidence in Türkiye, 2009–2023. ESTÜDAM Halk Sağlığı Dergisi, Cilt: 11 Sayı: 2, 141–158. https://doi.org/10.35232/estudamhsd.1858281

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References (26)

  1. World Health Organization. Global status report on road safety 2023. Geneva: World Health Organization; 2023.
  2. World Health Organization. Global plan for the decade of action for road safety 2021–2030. Geneva: World Health Organization; 2021.
  3. European Commission. 2023 road safety statistics: 20,400 lives lost on EU roads. Brussels: European Commission; 2024.
  4. European Commission. Provisional road safety statistics 2024. Brussels: European Commission; 2025.
  5. Türkiye İstatistik Kurumu (TÜİK). Karayolu trafik kaza istatistikleri 2023. Ankara: TÜİK; 2024.
  6. Türkiye İstatistik Kurumu (TÜİK). Karayolu trafik kaza istatistikleri 2015. Ankara: TÜİK; 2015.
  7. UNECE, WHO, ITF, Eurostat. Glossary for transport statistics. 5th ed. Geneva: United Nations Economic Commission for Europe; 2020.
  8. Aarts L, Van Schagen I. Driving speed and the risk of road crashes: a review. Accid Anal Prev. 2006;38(2):215-24. DOI:10.1016/j.aap.2005.07.004.
  9. Elvik R, Vadeby A, Hels T, Van Schagen I. Updated estimates of the relationship between speed and road safety at the aggregate and individual levels. Accid Anal Prev. 2019;123:114-22. DOI:10.1016/j. aap.2018.11.014.
  10. International Transport Forum, OECD. Speed and crash risk. Paris: OECD Publishing; 2018.
  11. Høye A. How would increasing seat belt use affect the number of killed or seriously injured light vehicle occupants? Accid Anal Prev. 2016;88:175-86. DOI:10.1016/j.aap.2015.12.022.
  12. Liu BC, Ivers R, Norton R, Boufous S, Blows S, Lo SK. Helmets for preventing injury in motorcycle riders. Cochrane Database Syst Rev. 2008;(1):CD004333. DOI:10.1002/14651858.CD004333.pub3.
  13. Simmons SM, Hicks A, Caird JK. Safety-critical event risk associated with cell phone tasks as measured in naturalistic driving studies: a systematic review and meta-analysis. Accid Anal Prev. 2016;87:161-9. DOI:10.1016/j.aap.2015.11.015.
  14. Fell JC, Voas RB. The effectiveness of a 0.05 blood alcohol concentration (BAC) limit for driving in the United States. Addiction. 2014;109(6):869-74. DOI:10.1111/add.12365.
  15. MacKenzie EJ, Rivara FP, Jurkovich GJ, Nathens AB, Frey KP, Egleston BL, et al. A national evaluation of the effect of trauma-center care on mortality. N Engl J Med. 2006;354(4):366-78. DOI:10.1056/NEJMsa052049
  16. Bernal JL, Cummins S, Gasparrini A. Interrupted time series regression for the evaluation of public health interventions: a tutorial. Int J Epidemiol. 2017;46(1):348-55. DOI:10.1093/ije/dyw098.
  17. Newey WK, West KD. A simple, positive semi-definite, heteroskedasticity and autocorrelation consistent covariance matrix. Econometrica. 1986;55(3):703–8.
  18. Pei X, Wong SC, Sze NN. The roles of exposure and speed in road safety analysis. Accid Anal Prev. 2012;48:464–471. DOI:10.1016/j.aap.2012.03.005.
  19. Shilling F, Waetjen D. Special report: impact of COVID-19 on California traffic crashes. Davis (CA): Road Ecology Center, University of California Davis; 2020. Erişim adresi: https://roadecology.ucdavis. edu
  20. Kabiri N, Abbasi A, Pashazadeh F, Hajebrahimi S, Soleimanpour H. The impact of the COVID-19 pandemic on hospital admissions due to road traffic crashes: a systematic review and meta-analysis. Arch Acad Emerg Med. 2023;12(1):e12. DOI:10.22037/aaem.v12i1.2157.
  21. Ahmed SS, Alnawmasi N, Anastasopoulos PC, Mannering F. The effect of higher speed limits on crash-injury severity rates: a correlated random parameters bivariate Tobit approach. Anal Methods Accid Res. 2022;34:100213. DOI:10.1016/j. amar.2022.100213.
  22. Alshibani A, Banerjee J, Lecky F, Coats TJ, Prest R, Mitchell A, et al. A consensus building exercise to determine research priorities for silver trauma. BMC Emerg Med. 2020;20(1):63. DOI:10.1186/s12873-020-00357-4.
  23. Haddon W Jr. Advances in the epidemiology of injuries as a basis for public policy. Public Health Rep. 1980;95(5):411-21.
  24. National Highway Traffic Safety Administration (NHTSA). Critical reasons for crashes investigated in the National Motor Vehicle Crash Causation Survey. US Department of Transportation; 2015. Erişim adresi: https://crashstats.nhtsa.dot.gov/Api/Public/ViewPublication/812115
  25. OECD, International Transport Forum. Zero road deaths and serious injuries: leading a paradigm shift to a Safe System [Internet]. Paris: OECD Publishing; 2016 [Erişim tarihi 24 Ağustos 2025]. Erişim adresi: https://www.itf-oecd.org/zero-road-deaths
  26. Chung Y. Injury severity analysis in taxi-pedestrian crashes: an application of reconstructed crash data using a vehicle black box. Accid Anal Prev. 2018;111:345-53. DOI:10.1016/j.aap.2017.10.016.