A County-Level/Ecological Approach to Analyzing the Impact of the COVID-19 Pandemic on Fatal Motor Vehicle Crashes’ Socioeconomic Predictors in Georgia Restricted; Files Only

Abstract

Objective. The COVID-19 pandemic response impacted roadway behavior, paired with an observed outcome of increases in Motor Vehicle Crash (MVC) fatalities. Prior research suggests differences in driving behavior and hospital capacity as explanations for this increase, but not differences in socioeconomic predictors. This study investigated socioeconomic determinants’ associations with MVC-related fatalities, in Georgia at the county-level, before and after the beginning of the COVID-19 pandemic.

Methods. Data from the National Highway Safety Administration's Fatality Analysis Reporting System (FARS) and census data from the State of Georgia and United States Census Bureau’s American Community Survey were used for MVC-related fatality outcomes and socioeconomic predictors. County-level observations from 2019 and 2021 were treated as control and case groups, with the year following COVID-19 pandemic onset as the primary exposure. Univariate and multivariate Poisson regression was used to estimate incidence rate ratios (IRRs) and 95% confidence intervals (CI) of MVC-related fatalities as affected by the COVID-19 pandemic. Analysis was stratified by Georgia’s rural and urban counties. 

Results. The study analyzed a total of 82 urban counties and 236 rural counties between 2019 and 2021. Urban counties with lower median incomes (IRR=1.96, 95%CI=1.42, 2.70) and medium median incomes (IRR=1.24, 95% CI=1.01,1.52) were found to experience significant harmful effects due to COVID-19 pandemic exposure. No socioeconomic predictors were found to have significant COVID-19 pandemic-related effects for rural counties.

Conclusions. Socioeconomic predictors were associated with the increase in MVC-related fatalities as hypothesized, although only for Georgia’s urban counties. Additional investigation must consider the temporal effects the COVID-19 pandemic has had on MVC-related fatalities and socioeconomic predictors, particularly as MVC-related fatalities start to decline but COVID-19 pandemic-related economic trends persist.

Table of Contents

INTRODUCTION.. 4

Definition of Terms. 5

REVIEW OF LITERATURE.. 6

Introduction.. 6

Literature. 8

Georgia. 13

Summary.. 14

METHODOLOGY.. 14

Research Design.. 14

Population.. 15

Data Sources. 15

Variable Definitions. 17

Independent Variables. 17

Exposure Variable. 18

Dependent Variable. 18

Table 1: Variable Definitions and Data Sources. 19

Procedures. 23

Data Preparation. 23

Missing Data. 24

FARS Missing Values. 24

Missing Counties. 26

Data Analysis Methodology.. 26

Descriptive Analysis and Instruments. 26

Inferential Analysis and Instruments. 27

RESULTS.. 29

Key Findings. 29

Table 2a: Descriptive Statistics of Georgia Counties by Year, State. 29

Table 2b: Descriptive Statistics of Georgia Counties by Year, Rural. 30

Table 2c: Descriptive Statistics of Georgia Counties by Year, Urban. 31

Table 2d: Differences in Mean by Year, by Urban and Rural by Year 32

Predictors’ Means. 33

Fatality Rates. 33

Table 2e: Descriptive Statistics of Georgia MVC-Related Fatality Rates. 35

Groups Tables. 36

Table 2f: Grouped Variable Summary Statistics, Rural Counties. 36

Table 2g: Grouped Variable Summary Statistics, Urban Counties. 38

Univariate Analysis. 40

Table 3a: Univariate Poisson Regression IRRs Before/After COVID-19 Pandemic Onset, Rural Counties. 40

Table 3b: Univariate Poisson Regression IRRs Before/After COVID-19 Pandemic Onset, Rural Counties, Significant Variables. 42

Figure 1a: Univariate Poisson Regression IRRs Before/After COVID-19 Pandemic Onset, Rural Counties. 43

Table 3c: Univariate Poisson Regression IRRs Before/After COVID-19 Pandemic Onset in Urban Counties. 44

Table 3d: Univariate Poisson Regression IRRs Before/After COVID-19 Pandemic Onset, Urban Counties, Significant Variables. 46

Figure 1b: Univariate Poisson Regression IRRs Before/After COVID-19 Pandemic Onset, Urban Counties. 46

Multivariate Analysis. 47

Table 3e: Multivariate Poisson Regression IRRs Before/After COVID-19 Pandemic Onset, Rural Counties. 47

Figure 2a: Multivariate Poisson Regression IRRs Before/After COVID-19 Pandemic Onset, Rural Counties. 48

Table 3f: Multivariate Poisson Regression IRRs Before/After COVID-19 Pandemic Onset, Urban Counties. 49

Figure 2b: Multivariate Poisson Regression IRRs Before/After COVID-19 Pandemic Onset, Urban Counties. 50

Other Findings. 50

Summary.. 51

CONCLUSIONS, IMPLICATIONS, AND RECOMMENDATIONS.. 52

Summary of Study.. 52

Discussion of Key Results. 53

Limitations and Strengths. 55

Implications. 57

Recommendations. 58

Conclusion.. 59

WORKS CITED.. 60

Table A.1: Georgia County MVC-Related Fatalities and Fatality Rates by Year.. 65

Table A.2: Rural Georgia County MVC-Related Fatalities and Fatality Rates by Year.. 73

Table A.3: Urban Georgia County MVC-Related Fatalities and Fatality Rates by Year.. 80

 

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School	Rollins School of Public Health
Department	Executive Masters of Public Health - MPH
Subfield / Discipline	Applied Epidemiology
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Epidemiology Health Sciences, Public Health Health Sciences, General
Parola chiave	COVID-19 Socioeconomics Economics Crash Georgia Transportation Ecology Pandemic Motor Vehicle Crash
Committee Chair / Thesis Advisor	Jose Binongo, Emory University
Committee Members	Denise Yeager , Georgia Department of Public Health Mick Ballesteros, Centers for Disease Control and Prevention

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