SEATTLE, Wash. – July 20, 2026 – In 2023, nearly 51 million people were injured and 1.34 million died from road injuries, making road injuries one of the leading global causes of premature death and disability, according to a new study published today in The Lancet Public Health . While age-standardized rates of road injury incidence and mortality have declined over the past three decades, progress has been highly uneven, with the greatest burden continuing to fall on low- and middle-income countries.
Around the globe, road injuries ranked as the 11th cause of death and accounted for 75.3 million disability-adjusted life years (DALYs), a measure of total health loss that combines years of life lost to early death and years lived with disability. Low-income countries had nearly six times the rate of years lost to premature death as high-income countries.
Based on the Global Burden of Disease (GBD) 2023 study, the research analyzed road injury trends across 204 countries and territories between 1990 and 2023. It provides the most comprehensive and up-to-date assessment of road injury burden worldwide, examining incidence, mortality, years of life lost, years lived with disability, and DALYs by age, sex, income group, road-user type, and injury severity.
Low- and middle-income countries continue to bear the greatest burden.
Between 1990 and 2023, global age-standardized rates of new road injury cases and deaths declined by 38.3% and 32.3%, respectively, but these gains were uneven across income groups. Mortality rates fell most sharply in high-income countries, while low-income countries saw little measurable improvement.
More than 90% of road injury deaths continued to occur in low- and middle-income countries. While low-income countries had substantially fewer new road injury cases than high-income countries, they registered the highest mortality rate, at 43.8 deaths per 100,000 people. By contrast, high-income countries had the highest rate of new road injury cases, at 858.1 cases per 100,000, but the lowest mortality rate, at 7.5 deaths per 100,000.
Progress also varied widely by country. While many countries achieved meaningful reductions in road injury mortality over the past decade, the United States experienced one of the largest increases. Overall, road injury mortality increased significantly in six countries between 2010 and 2023: Ghana, Jamaica, the Dominican Republic, Armenia, Costa Rica, and the US, with increases ranging from 13.2% in the US to 48.5% in Ghana.
"Road injury outcomes are shaped not only by crashes, but by the systems designed to prevent them and protect people when they occur," said Dr. Liane Ong, Senior Research Scientist at the Institute for Health Metrics and Evaluation (IHME) and senior author of the study. "Road deaths are largely preventable, but progress requires sustained investment. Reducing them requires safer infrastructure, stronger safety policies, and better emergency care."
Young people and adult males face the greatest risks.
Road injuries were the leading cause of death among young people ages 10 to 39 globally and the second-leading cause of death among children ages 5 to 9. Among males ages 20 to 24, road injuries accounted for over one in every five deaths. Across nearly every age group, males experienced higher road injury incidence rates than females.
Burden also varied by road-user type, reflecting who is most exposed and vulnerable on the road. Motor vehicle crashes accounted for the largest share of both road injuries and deaths worldwide, causing 19.8 million injuries and 518,000 deaths in 2023. Pedestrian injuries caused nearly one-third of road injury deaths, while motorcyclist injuries represented just 13% of cases but nearly 24% of deaths.
The study also found substantial differences in injury severity. Fractures were the most common non-fatal injury, accounting for more than 38% of cases, while head injuries occurred in roughly one in ten cases. Motorcyclists experienced the highest proportion of head injuries, most of which were moderate or severe traumatic brain injuries. These more severe injuries were also disproportionately concentrated in low- and middle-income countries.
Road injuries place major strain on health and economic systems.
Beyond the physical toll on individuals and families, road injuries carry major social and economic costs worldwide. The global economic cost of road injuries is projected to reach US$1.8 trillion over the 2015-2030 period. Road injuries also place long-term strain on health systems, workforces, and economies. Evidence suggests that more than 200,000 lives could be saved each year through enhanced trauma care coverage in low- and middle-income countries.
"Road safety should be treated as a public health priority, not just a transportation issue," said Dr. Marie Ng, Affiliate Associate Professor at IHME and Associate Professor at the National University of Singapore. "Reducing deaths and injuries requires moving beyond individual driver behavior and investing in systems that prevent crashes, strengthen trauma care, and implement evidence-based interventions tailored to the needs of each community."
As countries work toward the UN Sustainable Development Goal of halving road traffic deaths and injuries by 2030, stronger surveillance systems, safer road and vehicle standards, and expanded access to emergency care will be critical to closing persistent global disparities. Reducing deaths and disability will require coordinated action across society, including transportation, urban planning, engineering, law enforcement, and health care, to build safer systems that protect communities worldwide.
About IHME
An independent population health research organization based at the University of Washington School of Medicine, the Institute for Health Metrics and Evaluation (IHME) works with collaborators around the world to develop timely, relevant, and scientifically valid evidence that illuminates the state of health everywhere. In making our research available and approachable, we aim to inform health policy and practice in pursuit of our vision: all people living long lives in full health.
