Global road deaths fell more than 30% between 1990 and 2023, yet low-income nations still account for 90% of fatalities, according to a study published in Lancet Public Health. While high-income countries like the U.S. see declines, safety systems remain unequal worldwide.
Global Progress Hides a Deep Inequality in Low-Income Countries
While worldwide rates of road injuries and deaths each dropped by more than 30% between 1990 and 2023, that progress bypassed a major share of the globe. Researchers from the University of Washington’s Institute for Health Metrics and Evaluation found that while injury rates remain higher in high-income regions, 90% of road deaths occur in low-income countries.
In many low-income countries, safety measures have not kept up with rapid growth in cities and use of motorized vehicles. Seat belt mandates and advanced cabin protections like air bags are more common in high-income countries, whereas poorer countries lack those baseline systems.
Conflicting Trends Shape Traffic Safety Across the United States
The United States presents a complex picture. Over the three decades studied, pedestrian and vehicle occupant deaths rose in just six countries worldwide, and the United States was among them. Motor vehicle traffic fatalities in the U.S. climbed steadily over the last decade, peaking at more than 43,000 in 2021 before turning downward, according to the National Highway Traffic Safety Administration.
U.S. officials attribute thousands of annual U.S. traffic deaths to distracted driving,
which includes motorists looking at their phones behind the wheel. Researchers also point to the growing proliferation of taller and larger passenger vehicles on American roads as another compounding risk factor.
Recent Drops Offer Encouraging Signs on American Roads
More recent administrative data shows that U.S. road deaths fell across 2024 and 2025. The National Highway Traffic Safety Administration estimated that annual traffic fatalities dropped to about 36,600 last year.
Pedestrian safety has also seen a welcome shift. The Governors Highway Safety Association reported that U.S. drivers hit and killed 7% fewer people walking on roads in 2025 compared to the previous year. That marked the largest annual reduction since pedestrian fatalities began dropping three years ago, though totals remain elevated above pre-pandemic COVID-19 levels.
The World Health Organization Highlights Ongoing Youth Risks
Parallel to the release of the Lancet study, the World Health Organization published figures showing that global road traffic deaths declined by 21% between 2011 and 2025. Even with those gains, traffic crashes claimed more than 1.1 million lives globally last year.
The WHO notes that traffic incidents remain the leading cause of death among children and youth aged 5 to 29 years old.
High-Level United Nations Discussions Target International Standards
Across the Atlantic, European Union lawmakers have pursued aggressive regulatory targets. In October 2021, the European Parliament adopted a resolution setting a goal of zero deaths on European roads by 2050, backed by mandatory advanced safety technologies like intelligent speed assistance and emergency braking systems designed to mitigate the human error involved in about 95% of all crashes.
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