Under-reporting of road traffic injuries to the police: results from two data sources in urban India

Dandona, Rakhi; Kumar, G Anil; Ameer, Mohammed Abdul; Reddy, Gopinath; Dandona, Lalit · 2008 · OpenAlex-citations

DOI: 10.1136/ip.2008.019638

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Summary

This study investigates the magnitude and patterns of underreporting road traffic injuries (RTI) to the police in Hyderabad, India, addressing a critical gap in public health data. Since road safety policies in India rely heavily on police records collected by the National Crimes Record Bureau, accurate data is essential for effective intervention. The authors aimed to quantify the discrepancy between actual RTI occurrences and those officially reported, using two complementary data sources to provide a comprehensive view of the issue. The research employed a cross-sectional design involving two distinct studies conducted between 2005 and 2006. First, a population-based survey utilized three-stage systematic cluster sampling to interview 10,459 participants aged 5–49 years (94.3% participation rate). Participants recalled non-fatal RTI in the preceding 12 months and fatal RTI in the preceding three years. Second, a hospital-based study recruited 781 consecutive RTI cases from the emergency departments of two public and three private hospitals. Data were collected via structured interviews with injured individuals or their caregivers, documenting whether a First Information Report (FIR) was filed with the police and the reasons for non-reporting. Statistical analyses included univariate and multivariate logistic regression to identify factors associated with reporting behavior. The findings revealed severe underreporting of non-fatal RTI. In the population-based study, only 2.3% of those seeking outpatient care and 17.2% of those requiring inpatient care reported their injuries to the police. The hospital-based study showed a slightly higher but still low reporting rate of 24.6% for non-fatal cases. Fatal RTI were reported more frequently but still suffered from significant underreporting: 77.8% in the population study and 98.1% in the hospital study. Reporting was selective; crashes involving cars, heavy vehicles, multiple injuries, or high medical expenditures (>5,000 Indian Rupees) were significantly more likely to be reported. Conversely, pedestrians, cyclists, and motorized two-wheeler users were underreported. The primary reasons for non-reporting were the perception that reporting was unnecessary, hit-and-run incidents where the other party fled, and private settlements between involved parties. The study concludes that police data in India significantly underestimate the true burden of RTI, particularly for vulnerable road users like pedestrians and cyclists. This underreporting compromises the validity of road safety policies derived from such data. The authors attribute the gap to public reluctance due to bureaucratic hurdles, lack of awareness regarding the importance of reporting, and systemic failures in hospital-to-police information transfer. They recommend improving reporting mechanisms in emergency departments, enhancing public awareness, and establishing better linkages between police, hospital, and vehicle registration databases to ensure accurate surveillance and effective policy formulation.

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• incidence prevalence

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• Empirical Findings: crash risk outcomes