Highway Administration Finds Women Nearly Twice as Likely to Suffer Fatal or Serious Injuries in Crashes

A major federal safety study has revealed a troubling reality about modern vehicle crashes: women are significantly more likely than men to suffer serious injuries, even when driving similar vehicles and experiencing comparable crashes. The findings come from a comprehensive National Highway Traffic Safety Administration analysis that examined more than two decades of detailed crash investigations across the United States.

Using nationally representative crash data from 2000 to 2022, researchers analyzed real-world collisions involving passenger cars, SUVs, vans, and light trucks. The study did not rely on simulations or lab testing alone. Instead, it examined actual crashes investigated by federal crash teams, covering frontal impacts, side impacts, rear-end crashes, and rollovers. The results consistently showed that women face higher odds of injury across most crash types and injury categories.

The analysis focused on 25 different injury outcomes, ranging from moderate injuries to fatalities, and examined how those injuries differed by crash type and body region. Overall, women were more likely than men to experience moderate and serious injuries, particularly those classified as MAIS 2+ and MAIS 3+, which include injuries serious enough to require medical treatment and often hospitalization. In several crash scenarios, including frontal crashes and rollovers, women were found to have up to 1.6 times higher odds of sustaining these injuries.

Frontal crashes stood out as especially dangerous for women. These collisions accounted for the largest share of serious injuries overall, and women consistently showed higher injury odds even after researchers controlled for speed, vehicle type, seat belt use, airbag deployment, vehicle age, and crash severity. Rollovers, while less common, produced some of the starkest differences, with women more likely to be injured across every major severity category when a rollover was the most severe event.

The study also examined where injuries occurred on the body, and the differences were striking. Women were far more likely to suffer injuries to the arms, legs, hips, and lower extremities across nearly all crash types. Lower-extremity injuries alone accounted for more than 1.5 million moderate-or-worse injuries nationwide. Serious injuries to the chest, abdomen, and spine were also common, particularly in frontal and rollover crashes. While head injuries affected both sexes, women still showed higher odds in several crash scenarios, including frontal crashes and rollovers.

One of the most important aspects of this study is what it did differently from earlier research. Instead of limiting analysis to belted drivers or front-seat occupants, researchers included all seating positions and both belted and unbelted occupants. Rather than excluding complex crashes, they controlled for those factors statistically. This approach reflects how crashes actually happen in the real world and strengthens the relevance of the findings for everyday drivers.

To address gaps in crash data, the researchers used advanced statistical techniques to handle missing information, allowing them to include far more cases than traditional methods. This ensured the findings were not driven by a small or biased subset of crashes. In total, the study built 150 separate statistical models, each tailored to a specific injury type and crash scenario, making it one of the most detailed examinations of sex-based injury risk ever conducted.

Perhaps most notably, the study found no crash scenario in which men had statistically higher odds of injury than women once all factors were considered. While men sometimes showed higher rates of fatal injuries, those differences were not statistically significant. Women, on the other hand, consistently showed higher odds for a wide range of non-fatal but life-altering injuries.

These findings raise serious questions about how vehicles are designed and tested. For decades, crash test standards and safety systems have been based largely on male body models, with less consideration given to differences in body size, muscle distribution, bone density, and seating posture. The results suggest that current safety systems may not protect women as effectively as men in many common crash scenarios.

NHTSA studied six crash types for this report: frontal, near-side, far-side and rear crashes; one combining all four of those crash types; and one for rollover crashes. Unlike other recent studies, NHTSA’s study covered a broader range of crash types, occupant restraint conditions, and seating positions. 

Findings related to moderate and higher injuries include: 

• 46% higher injury risk in frontal crashes.
• 55% higher injury risk in rollover crashes.
• 62% higher risk for lower extremity injuries in frontal crashes (including knee, thigh, hip, leg, foot and ankle).
• 128% higher risk of injuries to the foot and ankle in frontal crashes. 

This new injury report’s results suggest the following for both men and women: 

• Injury risk increases with a person’s age. When compared to the youngest age group (13 to 24 year olds), each subsequent age group (25-34, 35-44, 45-54, 55-64, and 65 and up) had higher moderate-to-severe and fatal injury risk in all but rollover crashes.
• Having a body mass index of 30 or higher was frequently associated with significantly higher injury risk, especially in frontal crashes.
• Occupant height was not significantly associated with injury risk in 86% of injuries studied. 

A previous NHTSA report assessed the difference in fatality risk between men and women, finding this difference was reduced significantly in newer vehicles. The report found that the newer the vehicle, the smaller the disparity. The overall fatality gap between women and men drops from 18% to 6.3% for 2010-2020 vehicles and to 2.9% for 2015-20 vehicles.  

The takeaway is clear and unsettling. Even in modern vehicles equipped with advanced safety features, women face a higher risk of serious injury in crashes that millions of Americans experience every year. As regulators, automakers, and safety engineers look toward the next generation of vehicle safety standards, this research underscores the urgent need to ensure that protection truly works for everyone on the road.

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