An automobile accident is defined as a crash that occurs between an automobile and another automobile, human, animal, or fixed object. Automobile accidents are also commonly called traffic collisions, traffic crashes, motor vehicle collisions, and motor vehicle crashes. Among the professionals who aim to reduce the number of traffic crashes and related injuries, use of the word accident is often debated as the term suggests that such events are unexpected and unpreventable.
Traffic crashes are a major public safety problem; overall, they are the leading cause of death by injury in the United States. The National Highway Traffic Safety Administration (NHTSA) reports that in 2005, there were almost 6.16 million police-reported crashes, 2.7 million injuries, and 43,443 deaths. Injuries that result from traffic crashes are the leading cause of death to individuals ages 1 through 34 and are the leading contributor to years of life lost due to premature death, surpassing heart disease, cancer, AIDS, and stroke. A 2000 NHTSA report estimated the cost of U.S. traffic crashes at over $230.6 billion annually.
Globally, traffic safety is a rising concern. The World Health Organization projects that by 2020, road traffic injuries and deaths will be the third most important contributor to global health problems, up from ninth in 2000. Eighty-five percent of the traffic deaths around the world occur to pedestrians, bicyclists, and motorcyclists in low- and middle-income countries. More than half of these fatalities occur among younger, able-bodied adults; the economic cost of these fatalities to these countries is estimated at $65 billion each year.
Who Is at Risk?
Some populations may be overrepresented in the crash data because of behaviors associated with greater risks or may be overrepresented in injury data because they are less protected in some way. Such vulnerable populations include children, teenagers, older adults, communities of color, and nonmotorized road users (pedestrians and bicyclists).
Child passenger safety seats are key to protecting infants and children from motor vehicle injury. Because of their size and level of physical development, children are extremely vulnerable to injury and fatality as unrestrained passengers. Infants and toddlers are 4 times more likely to be unrestrained with an unrestrained driver than with a restrained driver. Even with the increase in car and booster seat use, many child safety seats are not installed properly.
Per population, the crash involvement rate of teen drivers is higher than that of any other age group. Issues related to human development, personality, peer influence, driving experience, and demographics all contribute to risk. New research in brain development shows that development of the prefrontal cortex, responsible for executive decision making, is not complete until the early 20s. Graduated driver licensing shows promise in reducing the teen crash rate, as do laws targeting underage drinking and driving and enforcing restricted alcohol sales to minors.
Although injury and fatality rates decline dramatically after young adulthood, they begin to rise again in older adulthood. Older adults face more severe injury risk in traffic crashes and are more likely to die from injuries. Some skills (vision, cognition, and sensory motor skills) important for safe driving may decline with the aging process, although age is not a predictor of driving skills and not all older adults experience a decline in skills that affect safe driving. As a percentage of the population, older drivers are least likely to be involved in motor vehicle crashes. However, per mile driven, older drivers have a higher rate of crash involvement. This is an increasing problem, as older adults comprise the fastest-growing age group in the United States. The National Center for Injury Prevention and Control reports that by 2020, there will be more than 40 million older licensed drivers.
In addition to varying across age groups, collision involvement differs by ethnicity. Collision rates are higher among Latinos/as, African Americans, and Native Americans than among whites and Asians.
Safety belt compliance, higher rates of impaired driving, and higher rates of pedestrian injury and fatality have been found to occur disproportionately among communities of color. These racial disparities are partially correlated with lower socioeconomic status and may be partially due to the confluence of many factors, including language and culture barriers, mistrust of law enforcement, insufficient knowledge of relevant laws, and the increased likelihood of rural residence. Focus groups and other research have identified culturally appropriate and sensitive educational materials geared toward special populations. This will be integral in reducing racial disparities in traffic safety.
Pedestrians and bicyclists, in particular, face hazards on the streets. Pedestrian deaths account for just over 11 percent of the country’s traffic fatalities. Walking or riding a bicycle reduces road congestion, air pollution, and global climate change and offers other health benefits. However, pedestrians and cyclists frequently encounter problems with a road infrastructure designed primarily for motor vehicles, thereby creating greater risks. Unfortunately, creating reliable estimates of pedestrian accident rates is impossible without adequate information about pedestrian exposure (e.g., how many people walk, how many miles people walk). Currently, no widespread systematic and accessible method exists to estimate pedestrian exposure.
Addressing the Problem
Many traffic crashes result from poor driver behavior. Driving while distracted, driving while under the influence, and speeding are among the leading driver behaviors contributing to traffic crashes. In recent years, alcohol involvement was a factor in about 40 percent of fatal motor vehicle crashes and driver inattention in at least 25 percent of police-reported crashes. In 2004, speeding was a contributing factor in 30 percent of fatal crashes.
Effective in reducing alcohol-related crashes are policies addressing drinking and driving, such as legal blood alcohol content limits set at .08 percent, license suspension laws, minimum drinking age laws, monitoring retail compliance with regard to sales to minors, vehicle impounding, and ignition interlock systems. Besides interventions to prevent crashes by targeting driving behavior, other efforts seek to reduce the effects of traffic crashes through safety devices. One of the most common devices, the seat belt, has a substantial effect on survivability in a crash. The NHTSA reported in 2004 that seat belts saved 15,434 lives. Rates of seat belt use vary among states but climbed between 1975 and 2004 in every state, most dramatically in states with laws requiring seat belt use.
At the national level, the NHTSA has led a sustained effort over the past few decades to reduce traffic crashes and subsequent injuries and death, resulting in greatly increased use of occupant restraints, decreased alcohol-related injuries and fatalities, and a reduction in the death rate per million miles traveled.
Need for a Systematic Approach
Expertise in transportation engineering, enforcement, city planning, public health, policy, and other relevant professions is critical to meeting the nation’s complex traffic safety challenges. Reducing the toll that traffic injury takes on society requires a committed and comprehensive approach that covers education, engineering, enforcement, and environmental modifications. A critical element of injury prevention is to reach out to vulnerable populations by tailoring messages and programs to fit specific groups and their cultural norms, backgrounds, and experiences.
A systematic approach to traffic safety that addresses human behavior, vehicle design, and roadway design as interacting approaches to preventing traffic crashes and injury is needed. Cross-training and interdisciplinary work is central. For example, law enforcement must understand how data related to injuries and fatalities can inform formation and enforcement of traffic safety laws. Engineers must understand where and how injuries occur so that they can design roadways that are safe for drivers, passengers, pedestrians, and bicyclists. Planners must understand the traffic safety issues in land use decisions. Teachers and social service professionals need to know how alcohol and other drugs affect driving behavior.
One way of organizing the diverse approaches to traffic safety is in terms of the Haddon matrix, developed by William Haddon, the first director of the NHTSA. The matrix is a tool for describing opportunities for where and when to conduct traffic safety interventions. The Haddon matrix looks at injuries in terms of causal and contributing factors by examining the factors of the driver, the vehicle, and the highway, as well as time phases before a potential vehicle collision (“pre-crash”), during the vehicle collision (“crash”), and after the collision (“post-crash”).
The value of the Haddon matrix is that each cell illustrates a different area in which to mount interventions to improve traffic safety. Intervention designs that apply to the pre-crash phase can reduce the number of collisions. Interventions that apply to the crash phase do not stop the crash, but they reduce the number or severity of injuries that occur as a result. Interventions that apply to the post-crash phase do not stop the initial crash or the injury from occurring, but they optimize the outcome for people with injuries.
- AAA Foundation for Traffic Safety. 2001. “The Role of Driver Distraction in Traffic Crashes.” Washington, DC: AAA Foundation for Traffic Safety. Retrieved March 29, 2017 (https://www.aaafoundation.org/role-driver-distraction-traffic-crashes).
- National Highway Traffic Safety Administration. 2002. “The Economic Impact of Motor Vehicle Crashes, 2000.” Retrieved March 29, 2017 (https://www.google.com.ua/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&ved=0ahUKEwj7n-SHwvvSAhXEK5oKHbvrBu0QFggpMAA&url=https%3A%2F%2Fcrashstats.nhtsa.dot.gov%2FApi%2FPublic%2FPublication%2F809446&usg=AFQjCNG3bbW7usRGsw6A2wCjObhuHhB1pg).
- National Highway Traffic Safety Administration. 2004. “Traffic Safety Facts.” Retrieved March 29, 2017 (https://crashstats.nhtsa.dot.gov/Api/Public/ViewPublication/810809).
- Pedestrian and Bicycle Information Center. 2014. “Pedestrian Crash Facts.” Chapel Hill, NC: Pedestrian and Bicycle Information Center. Retrieved March 29, 2017 (http://www.pedbikeinfo.org/pbcat_nc/pdf/summary_ped_facts08-12.pdf).
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