The percentage of people killed or seriously injured on Manx roads is near double that of in England.
It comes follow statistics published by Public Health Isle of Man.
It shows around 81.2 people per 100,000 residents die, or are severely hurt in crashes on the Island - in comparison to just 40.8 suffering the same fate across the water.
The figures were published in the second edition of the Public Health Outcomes Framework.
The document provides information and indicators on health and wellbeing across the Island.
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