Objectives To evaluate preventive achievements and identify emerging trends and challenges regarding road traffic injuries (RTIs) in China from 1997 to 2023. Study Design Ecological trend study Methods Data on road traffic crashes, injuries, and deaths were extracted from China’s National Bureau of Statistics. Joinpoint regression analysis was employed to identify significant temporal trends and compute the annual percentage change (APC) and average annual percentage change (AAPC). All outcome variables were log-transformed prior to analysis due to skewed distributions, as determined by normality assessment. Results Over the 27-year period, the number of road traffic crashes and associated casualties showed three distinct phases: a rapid increase until 2001, a significant decline until around 2011, and a subsequent stabilization or slight rebound. While motor vehicle-related incidents initially drove these trends, injuries ( APC 2010-2023 =12.88, P <0.01); AAPC =6.54%, P <0.01) and deaths ( APC 2010-2019 =13.57%, P <0.01; APC 2019-2023 =5.06%, P <0.01) involving non-motor vehicles have risen sharply since around 2010. This surge has partially offset earlier gains in overall RTI prevention and now poses a substantial threat to national road safety. Notably, deaths exhibited a strong resurgence post-2011, exceeding 5,000 in 2023. Conclusions Despite commendable gains in reducing motor vehicle-related RTIs, China now faces the acute challenge of a rising injury burden involving non-motor vehicles. Consequently, future road safety initiatives must be formulated on a holistic approach that integrates enhanced vehicle safety, road infrastructure optimized for vulnerable users, and precise behavioral interventions targeting high-risk populations. The findings provide an evidence base for prioritizing non-motor vehicle safety in China’s next phase of road safety strategy and offer methodological insights for similar trend analyses in other low- and middle-income countries experiencing rapid e-bike adoption.
Deng et al. (Fri,) studied this question.