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The Fatality Analysis Reporting System (FARS) was used to examine contributing factors pre-COVID-19 and in the COVID-19 era using the five pillars of the Safe System framework: (1) road users; (2) vehicles; (3) roadways; (4) speed; and (5) post-crash care. Two study time periods were matched to control for seasonality differences pre-COVID-19 (n = 1725, 1 April 2018\u201331 December 2019) and in the COVID-19 era (n = 2010, 1 April 2020\u201331 December 2021) with a three-month buffer period between the two time frames excluded. Four of the five pillars of the safe system had road safety indicators that worsened during the pandemic. Mortality was 19.7% higher for motor vehicle occupants and 45.1% higher for riders of motorized two-wheeled vehicles. In adjusted analyses, failure to use safety equipment (safety belts\/helmets) was associated with 44% higher mortality. Two road user groups, non-motorized bicyclists and pedestrians, did not contribute significantly to higher mortality. Urban roadway crashes were higher compared to rural crashes. Additional scientific inquiry into factors associated with COVID-19-era mortality using the Safe System framework yielded important scientific insights to inform prevention efforts. Motorized two-wheeled vehicles contribute disproportionately to pandemic-era higher mortality and constitute an emerging road safety issue that deserves further attention.<\/jats:p>","DOI":"10.3390\/ijerph22010061","type":"journal-article","created":{"date-parts":[[2025,1,3]],"date-time":"2025-01-03T11:50:10Z","timestamp":1735905010000},"page":"61","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Using a Safe System Framework to Examine the Roadway Mortality Increase Pre-COVID-19 and in the COVID-19 Era in New York State"],"prefix":"10.3390","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9039-9120","authenticated-orcid":false,"given":"Joyce C.","family":"Pressley","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Health Policy and Management and the Columbia Center for Injury Science and Prevention, Columbia University, New York, NY 10032, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zarah","family":"Aziz","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Columbia University, New York, NY 10032, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilia","family":"Pawlowski","sequence":"additional","affiliation":[{"name":"New York State, Bureau of Occupational Health and Injury Prevention, Albany, NY 12237, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0302-0421","authenticated-orcid":false,"given":"Leah","family":"Hines","sequence":"additional","affiliation":[{"name":"New York State, Bureau of Occupational Health and Injury Prevention, Albany, NY 12237, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aisha","family":"Roberts","sequence":"additional","affiliation":[{"name":"New York State, Bureau of Occupational Health and Injury Prevention, Albany, NY 12237, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jancarlos","family":"Guzman","sequence":"additional","affiliation":[{"name":"New York State, Bureau of Occupational Health and Injury Prevention, Albany, NY 12237, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Bauer","sequence":"additional","affiliation":[{"name":"New York State, Bureau of Occupational Health and Injury Prevention, Albany, NY 12237, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"865","DOI":"10.1177\/00031348211047466","article-title":"Increase in Motor Vehicle Crash Severity: An Unforeseen Consequence of COVID-19","volume":"89","author":"Kaufman","year":"2023","journal-title":"Am. 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