Inequalities in the risk of disability due to traffic injuries in the Spanish adult population, 2009–2010 Rocío Palmera-Suárez a,b, *, Teresa López-Cuadrado a,d , Rafael Fernández-Cuenca a,b , Enrique Alcalde-Cabero c , Iñaki Galán c,d a Department of Epidemiological Analysis and Health Status, National Centre for Epidemiology, Carlos III Institute of Health, Calle Monforte de Lemos 5, Pabellón 12, PC 28029, Madrid, Spain b Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública – CIBERESP), National Centre for Epidemiology, Carlos III Institute of Health, Calle Monforte de Lemos 5, Pabellón 12, PC 28029, Madrid, Spain c Department of Applied Epidemiology, National Centre for Epidemiology, Carlos III Institute of Health, Calle Monforte de Lemos 5, Pabellón 12, PC 28029, Madrid, Spain d Department of Preventive Medicine and Public Health, School of Medicine, Autonomous University of Madrid/IdiPAZ (Instituto de Investigación del Hospital Universitario La Paz/La Paz University Teaching Hospital Research Institute), Calle del Arzobispo Morcillo 4, PC 28029, Madrid, Spain A R T I C L E I N F O Article history: Accepted 6 February 2018 Keywords: Disability Road traffic injuries Inequality Social determinants of health A B S T R A C T Background: Although traffic injuries (TIs) are an important cause of disability the related factors are little known. We aimed to estimate the differences in risk of TI-related disability according to individual characteristics that might generate health inequalities. Methods: Cross-sectional study using a representative Spanish population sample drawn from the European Health Interview Survey 2009/2010. We calculated traffic crashes in the preceding year which resulted in injuries. Disability was measured using the Global Activity Limitation Indicator and four indicators of limitations (sensory, physical functional, self-care and domestic activities). Principal socio- demographic and behavioural/lifestyle variables were studied. We used multivariate logistic regression to estimate the risk (ORs) of TI-related disability in the sample as whole and disability-related factors in persons who had experienced TIs. Results: Persons with TIs had a higher risk of global disability (OR = 1.61; 95%CI:1.17–2.20), physical functional limitations (OR = 1.96; 95%CI:1.33–2.89) and self-care limitations (OR = 1.73; 95%CI:0.98– 3.05). Among persons with TIs, GALI-related risk was higher in women (OR = 3.06, p = 0.002) and persons aged over 30 years (OR 31–45years = 6.81, p < 0.001; OR 46–64years = 5.96, p = 0.011; OR >64years = 4.54, p = 0.047). Lower risk was observed among persons with a higher educational level (OR = 0.22, p = 0.003). The risk of disability among persons with TIs who consumed illegal drugs was OR = 3.9 (p = 0.023). Conclusions: Traffic injuries in the preceding year are associated with higher risk of disability, which is unevenly distributed. Individual (women and persons over 30 years), socio-economic (lower educational level) and behavioural (illegal drug use) factors are involved. Actions aimed at changing the unequal risk among vulnerable subgroups and providing health, social and protective services should be implemented. © 2018 Elsevier Ltd. All rights reserved. Introduction Traffic injuries (TIs) are an important public health problem worldwide, due to their high morbidity and mortality burden and high social and economic cost [1]. It is estimated that for every death, there are 20 injured persons, and that approximately 50 million persons suffer a considerable impact on their health and quality of life [1]. In Spain, despite the reduction in TIs seen in recent years, the number of non-fatal victims generated by this cause continues to be high, and is estimated to be over 130,000 * Corresponding author at: Department of Epidemiological Analysis and Health Status, National Centre for Epidemiology, Carlos III Institute of Health, Calle Monforte de Lemos 5, Pabellón 12, PC 28029, Madrid, Spain. E-mail addresses: rpalmera@externos.msssi.es (R. Palmera-Suárez), teresalc@isciii.es (T. López-Cuadrado), rfcuenca@isciii.es (R. Fernández-Cuenca), ealcalde@isciii.es (E. Alcalde-Cabero), igalan@isciii.es (I. Galán). https://doi.org/10.1016/j.injury.2018.02.006 0020-1383/© 2018 Elsevier Ltd. All rights reserved. Injury, Int. J. Care Injured xxx (2018) xxx–xxx G Model JINJ 7583 No. of Pages 7 Please cite this article in press as: R. Palmera-Suárez, et al., Inequalities in the risk of disability due to traffic injuries in the Spanish adult population, 2009–2010, Injury (2018), https://doi.org/10.1016/j.injury.2018.02.006 Contents lists available at ScienceDirect Injury journal homepa ge: www.elsev ier.com/locate /injury