The following is from DR1.com and while it is specific to the capital of Santo Domingo; I think it is probably true of the DR in general. FYI Santo Domingo is a metropolitain city of approximately 2.5 million.
[b]#1 cause of deaths in Santo Domingo
Traffic accidents, not cancer, neither heart problems, are the number one cause of deaths in the National District (Santo Domingo). These accidents are also responsible for most of the emergencies arriving to public hospitals. Last year, according to Hoy newspaper, there were 4,601 deaths attributed to traffic accidents. The numbers were reported by INSTRAT, a local institute that tries to follow traffic patterns and prevent accidents. An INSTRAT report says that traffic accidents are the first cause of death among the economically active population and the third cause of death among the general population. Last year there were 52 traffic deaths for every 100,000 population, the highest ever.
What is worse, according to INSTRAT, is that the numbers would be higher if accident victims taken to private clinics were recorded.
A dramatic detail contained in the story, is that of the 53,000 wounded accident victims, 14,000 were left with permanent injuries or are now invalids.
The study attributes the huge increase in traffic fatalities and injuries to the increase in motor vehicles in the country. It cites the fact that between 1995 and 1996 there were more than 50,000 accidents and 2,000 people lost their lives. In 1997, the vehicular fleet increased by 200,000 units. In 1997 there were 699,000 vehicles registered in the DR, in 1998 there were 737,000 and in 1999 the number was 1,605,000. By 2002 there were 3,800 traffic deaths and in 2003 there were 4,300 deaths reported.
The report points out that the numbers are not accurate because private clinics do not report traffic-related patients.