Spatial analysis of deaths due to traffic accidents, before and after the Brazilian Drinking and Driving Law, in micro-regions of the state of Sao Paulo, Brazil

Spatial analysis of deaths due to traffic accidents, before and after the Brazilian Drinking and Driving Law, in micro-regions of the state of Sao Paulo, Brazil Objective: To identify special micro-region clusters according to mortality rates resulting from traffic accident in the state of Sao Paulo, Brazil, during the period of one year before and one year after the enactment of the Brazilian Drinking and Driving Law. Methods: Ecological and exploratory study in the period of 2007 and 2009 in 63 micro-regions of the state of Sao Paulo. Geoprocessing tools were used with data from DATASUS (Database of the Brazilian Unified Health System), in order to analyze deaths resulting from traffic accidents at rates per 100,000 inhabitants and to build choropleth maps. New statistics were obtained by subtracting the 2009 rate from the 2007 rate, and regions with improvement or deterioration were observed. Results: In 2007, there were 5,204 deaths, averaging 83 deaths/micro-region, and ranging from 1 to 1,440. In 2009, there were 5,065 deaths, averaging 80 deaths/micro-region, and ranging from 1 to 1453. In 2007, the Moran's coefficient was I = 0.09 (p = 0.04), with positive spatial correlation; in 2009, the coeficient was I = 0.04 (p = 0.16), with no correlation. The difference between rates was I = 0.23 (p = 0.007), indicating spatial association. In 2007, Presidente Prudente, Rio Claro, Campinas, Braganca Paulista, Osasco, and Sao Paulo presented high mortality rates. Of these regions, only Osasco did not stand out in 2009. Ribeirao Preto, Ourinhos, and Avare deteriorated in 2009. The difference between the 2009 and 2007 rates showed that Amparo, Braganca Paulista, and Campinas improved, and that Presidente Prudente and Ourinhos deteriorated. Conclusion: It was possible to identify the places with higher mortality rates, pointing out locations where enforcement actions should be reviewed.