Ecological analysis of behavioural and policy correlates of road traffic accidents in India

India faces a severe road safety crisis, accounting for approximately 11% of global road traffic deaths despite possessing only 1% of the world’s motor vehicles. A cross-sectional ecological analysis of 34 Indian states and Union Territories was conducted using 2022 data. Negative binomial regression with population as an exposure offsets was used to examine associations between total road crashes and behavioural factors (overspeeding, drunken driving), policy context (alcohol prohibition), infrastructure (road length), and contextual factors. Data were obtained from the Ministry of Road Transport and Highways, Census of India, and India Meteorological Department. India reported 461,312 road crashes, 168,491 fatalities, and 443,366 injuries in 2022. National highways, comprising only 2% of road length, accounted for 32.9% of crashes. Overspeeding (β = 5.34, p = 0.011) and total road length (β = 5.12, p = 0.015) were significant predictors of crash counts. Alcohol prohibition status and per-capita alcohol consumption were not significantly associated with crashes. No multicollinearity was detected (mean VIF = 1.81). At the state level, speeding-related crash counts and road length were strongly associated with total reported road crashes in 2022. Because behavioural variables were derived from cause-specific crash counts, these findings should be interpreted as descriptive correlates within the crash dataset rather than independent causal or predictive effects. Alcohol prohibition status was not statistically associated with crash counts in this ecological analysis; this does not establish that prohibition is ineffective, as the binary policy indicator did not capture enforcement intensity, compliance, or informal alcohol access. Integrated strategies combining speed management, impaired-driving enforcement, infrastructure safety, and behaviour-change interventions remain essential.