Road fatalities are dropping in the United States and across the globe — but the gains are largely bypassing poorer nations, according to a new study released Monday.
Between 1990 and 2023, global rates of road injuries and deaths each dropped by more than 30%, according to research published in Lancet Public Health. However, the study noted that progress varied widely from one country to the next.
In fact, deaths among pedestrians and vehicle occupants actually increased over that period in six countries — and the United States was among them. That said, newer data indicates U.S. road fatalities have been trending downward in both 2024 and 2025.
The World Health Organization also released figures Monday, showing road traffic deaths fell 21% between 2011 and 2025. Even so, crashes still took more than 1.1 million lives last year, and they continue to be the number one cause of death among children and young people between the ages of 5 and 29, according to the WHO.
Road deaths include fatal injuries suffered by pedestrians, cyclists, and people riding in cars, trucks, and other vehicles. Because complete data isn’t available in every country, researchers made estimates based on whatever information was accessible.
The research team, based at the University of Washington’s Institute for Health Metrics and Evaluation, found that while road injury rates are higher in wealthier nations, a staggering 90% of all road deaths happen in low-income countries.
In many of those lower-income nations, safety infrastructure has failed to keep pace with rapid urban growth and a surge in motorized vehicle use. Seat belt requirements, for instance, are far more common in higher-income countries, as are vehicle safety features like air bags.
Senior author Liane Ong put it this way in a statement: “Road injury outcomes are shaped not only by crashes, but by the systems designed to prevent them and protect people when they occur.”
In the U.S., the picture has been complicated by several competing trends — including the growing size and height of passenger vehicles on American roads. Federal officials have also pointed out that thousands of deaths each year are linked to “distracted driving,” such as drivers using their phones behind the wheel.
According to the National Highway Traffic Safety Administration, motor vehicle fatalities in the U.S. climbed over the past decade, peaking at more than 43,000 in 2021 before starting to come down. The agency estimates that figure dropped to around 36,600 last year.
Separately, the Governors Highway Safety Association recently reported that drivers struck and killed 7% fewer pedestrians on U.S. roads in 2025 compared to the previous year — the largest single-year drop since pedestrian deaths began declining three years ago. Still, the number remains higher than pre-COVID-19 pandemic levels.
The WHO first identified road safety as a global public health priority more than two decades ago. The release of the Lancet study coincides with the opening of a two-day United Nations high-level meeting focused on improving road safety worldwide, being held in New York City.
