Northern Ireland’s oldest road casualties stand out in hospital injury data

Northern Ireland's road-injury statistics tell a more troubling story for older people when the measure changes from a police assessment at the scene to a clinical injury scale used in hospitals. In the five years from 2020 to 2024, people aged 70 and over accounted for 25% of clinically seriously injured road casualties in the Department for Infrastructure's latest hospital-linked analysis. Their share of police-recorded serious injuries over the same period was 11%.

Both figures are official. They are not measures of the same set of injuries, and neither proves that an older person is more likely than a younger one to crash on any given journey. The contrast instead exposes why road safety cannot be understood solely from the most familiar police collision figures.

What a clinically serious injury means

The department's analysis uses the Maximum Abbreviated Injury Scale threshold of 3 or more, commonly written MAIS3+. It is derived from hospital admissions and grades injury severity using clinical information. A police classification of serious injury is based on a different recording system. Cases can be graded differently because the information available, injury definition and route into the statistics differ.

That distinction matters most when trying to compare trends or age groups. A reported police 'serious injury' is not synonymous with a hospital-coded MAIS3+ case. It is also wrong to subtract the two series and call the difference 'missed' victims for a particular year: the systems do not always contain precisely corresponding events and people.

One in four of the clinically serious group was 70 or older

According to the DfI report published on 18 June 2026, the 70-plus age group accounted for a quarter of MAIS3+ casualties during 2020–24. The equivalent shares were 14% of all hospital admissions for road-traffic collisions and 11% of police-reported serious injuries. Older people therefore form a much larger part of the most clinically severe hospital-coded category than they do of the police serious-injury category.

This is a comparison of the composition of three datasets, not a risk ratio adjusted for age, population or travel. We do not have the distance driven or walked by every age group here. Nor is the result proof that older drivers caused these injuries. Older casualties may be drivers, passengers, pedestrians or other road users; responsibility for a collision is a separate question.

The male share is also different

DfI reports that 70% of MAIS3+ casualties in the five-year period were male. Men accounted for 68% of hospital admissions and 62% of police serious-injury casualties in the corresponding comparisons. Again, these are proportions of recorded casualties, not injury rates per kilometre travelled. Exposure and road-user behaviour can differ widely between people and groups.

The department also found that 11% of hospital road-traffic admissions in 2020–24 were classed as MAIS3+. That share varied by road-user type: 8% among pedal cyclists, 12% among pedestrians and 11% among car users and motorcyclists. These percentages refer to hospital admissions within each mode, not the likelihood of being seriously hurt on a bicycle, on foot or in a car.

Why one recent annual number needs context

There were 50 MAIS3+ casualties in 2024, down 28% on the previous year, according to DfI. The count is 79% lower than the 2002 peak of 235. That long-term reduction is significant, but one year's improvement cannot erase the needs of the people sustaining severe injuries. The department notes indications of levelling-off in the long-run trend and more recent increases in the different police serious-injury measure.

DfI also says that, across the full historical period from 1999 to 2024, a substantial share of hospital-admission road casualties was not known to the police. Yet in every year since 2020, the police serious-injury count has exceeded the number of hospital admissions; across 2020–24, police serious injuries exceeded hospital admissions by 40%. This apparent reversal is another reason not to equate the datasets.

The policy question is bigger than older drivers

For older Northern Ireland residents, safe road design also concerns the journey to a bus stop, a hospital appointment, a town centre or a local shop. Crossing distances, lighting, footpath condition, junction visibility and opportunities to rest all deserve scrutiny. Those are relevant design questions; this particular statistical publication does not measure which road features caused individual injuries.

For motorists, the result also argues against reducing the issue to a debate about age-based driving tests. A person aged 75 travelling as a passenger or walking across a road is part of the human cost even when they have no driving licence. Better evidence would show MAIS3+ casualties by age, road-user type, location and travel exposure while protecting privacy.

What we can conclude — and what remains unknown

The established finding is clear: older people account for a substantially larger share of clinically serious injuries than of police-recorded serious injuries in the five-year dataset. That is important for how Northern Ireland measures and prioritises road harm. It does not establish an individual's chance of injury, the cause of a collision, whether medical treatment has changed survival outcomes or where a particular safety measure should be built.

PureCar's conclusion is that both measures belong in public reporting. A policy judged against police serious injuries alone risks missing information about the clinically gravest harm — particularly among older casualties.

Sources and method

The main source is DfI's June 2026 release on clinically seriously injured road casualties, based on hospital admissions and police records through 2024. The separate Northern Ireland Road Safety Strategy statistics provide context for the police-recorded series. Percentage comparisons are quoted as published and are not presented as causal findings or population-adjusted rates.