No effect of the Penalty Point System on road traffic accident mortality among men with a high socioeconomic status in Spain

• Published in: Accident analysis and prevention 2021-06, Vol.156, p.106154, Article 106154
• Main Authors: Pulido, J., Molist, G., Vallejo, F., Jiménez-Mejías, E., Hoyos, J., Regidor, E., Barrio, G.
• Format: Article
• Language: English
• Subjects: Educational status; Mortality; Occupational groups; Prospective studies; Socioeconomic factors; Traffic accidents
• ISSN: 0001-4575; 1879-2057
• DOI: 10.1016/j.aap.2021.106154

•A segmented regression analysis for all people residing in Spain (>40 million people).•Before the PPS, the magnitude of RTA mortality showed a downward trend in all socioeconomic groups.•A strong decrease of RTA mortality among men was observed immediately after the PPS in low-SEP groups.•In both males and females, the implementation of PPS did not result in a trend change on RTA mortality across different SEP groups. The purpose of this study was to assess the effect of the Penalty Point System (PPS) on road traffic accident mortality by gender and socioeconomic status. We conducted a nationwide prospective study covering adult people living in Spain on November 2001. They were followed up until 30 Nov 2007 to determine vital status and cause of death. An interrupted time-series analysis was used to assess whether PPS (explanatory variable) had both immediate and long-term effect on the rates of road traffic accident mortality (RTAMs) separately by gender. Subjects were classified by socioeconomic status (low and high) using two indicators: educational attainment (up to lower secondary education; upper secondary education or more) and occupation (manual and non-manual workers). We performed several segmented Poisson regression models, controlling for trend, seasonality, 2004 road safety measures and fuel consumption as proxy for traffic exposure. Among men, we found a decrease on the RTAMs immediately after PPS in those with low educational level (16.2 %, IC95 %: 6.1 %–25.2 %) and manual workers (16.3 %, IC95 %: 2.8 %–27.8 %), and a non-significant increase among those with high education level and non-manual workers (6.2 % and 1.8 %). Among women, there were no significant differences in the immediate effect of PPS by socioeconomic status. We did not identify significant trend changes between pre-PPS and post-PPS periods in any socioeconomic group. In a context of downward trend of traffic mortality, the PPS implementation led to an immediate reduction on death rates only among men with a low socioeconomic status.