Undercounts stemming from misclassification derived from fatal injuries in traffic crashes in Colombia, 2010 to 2021

Objectives: To identify and address potential misclassification of traffic fatalities in Colombia from 2010 to 2021. Methods: For an ecological study, we employed national records and databases. A database was consolidated to include information on the fatality occurrence site, area, place of death, year of occurrence, marital status, age, and enrollment in social security. Generalized linear regression models were used to detect and adjust possible errors in records due to misclassification starting from existing data, allowing reclassification with a high probability of specific garbage codes being valid, potentially associated with mortality caused by traffic. Results: In 2010; there was a mortality rate of 13.3 deaths per 100,000 population, while in 2021; it was 15.1/per 100,000 population. In 2020; from the effects of pandemic-related confinement, the risk came down to 11.5/100.000 population. With the imputation, these records increased from 14.9 (2010) to 16.4 (2021); the most notable rise was among motorcyclists, who contributed 62%, with a marked increase in 2021:13/100.000 population, while pedestrians contributed 27.2%, cyclists: 4% and vehicle occupants: 6.5%. Conclusions: Over the past decade, Colombia has stood out as one of the few countries worldwide that have been unable to reduce traffic-related mortality. The potential underestimation of the problem likely exacerbates this challenge due to record misclassification or measurement errors, which may be as high as 10%. Motorcyclists are particularly vulnerable, facing a significantly increased risk of death. To address this critical issue, cross-sectoral and inter-institutional policies, and plans are urgently needed to mitigate the high incidence of motorcycle fatalities and break the cycles of poverty and orphanhood they can cause.