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Clippings from Rural vs. Urban Motor Vehicle Crash Death Rates: 20 years of FARS data
Presented March 1998 at EMS Today Conference, 
published in Pre-hospital Emergency Care 2000;4;7-13   added 12/17/00

               Approximately 2X death rate for rural motor vehicles accidents

Abstract Results. A total of 875,405 crash deaths were included in the analysis. Both population-based and vehicle-miles-traveled-based motor vehicle crash deaths have decreased over the last 20 years, but rural rates remain significantly higher than urban rates. Dead-at-scene rates may be increasing, and the rural dead-at-scene rate is higher than the urban rate. 

DISCUSSION ITEMS

However, only about one- third of the vehicle miles traveled in the United States are on rural roads. 

The difference in rural and urban motor vehicle crash death rates is not unique to the United States. 

There are other possible factors. Discovery of the crash may be delayed in the rural setting, and notification of the EMS system may be hampered if one must travel some distance to find a telephone or emergency callbox. Both response and transport times are prolonged in rural areas, and pre-hospital care is often less sophisticated.  Hospital care can be a factor, too. Rural areas are less likely to have established trauma systems or trauma centers, and the medical professionals in rural areas are likely to have less experience in managing major trauma. 

The rural dead-at-scene rate is higher than the urban rate, and that, too, is consistently true over the 20 years of data. - - Perhaps some patients die as they await EMS, which is slowed by delayed access and prolonged response.

Here is the entire article {PDF file 129KBytes} 

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LifeWatch and Skyaid would reduce rural motor vehicle deaths by:
   1)  Eliminate crash discovery time
   2)  Eliminate delay to notify EMS system
   3)  Greatly reduce response and transport times
   4)  Transport victim to regional trauma center

see also Ambulance Scene Time and Ambulance Response time in Ireland