As an emergency physician in New York, I have seen, as we struggle every day with the pandemic, how public policy can play a crucial role in hospital admissions.
Even before COVID-19, there was a less widely recognized preventable plague — traffic-related injuries and fatalities. In the trauma bays of America’s hospitals, we too often see the result of poor street design, inadequate investment and failed leadership.
My colleagues and I serve victims of traffic crashes every day and witness firsthand the traumatic brain injuries, lost limbs, crushed bones, and damaged organs. We are the doctors who have had to tell families that their son will never walk again or that their grandmother, who was coming home from the grocery store, has died after being hit by a motorist while on a sidewalk. We are among the first witnesses to preventable tragedies that, even with a death, are only beginning to unfold.
New data suggests pedestrian deaths increased dramatically during the pandemic and we have seen enough.
Trauma care hospitals are required to combat the causes of our most common injuries — including roadway collisions. Rather than just treating the aftermath, my colleagues and I want to see solutions that prevent these hospital visits altogether. That is why I join Families for Safe Streets, the Road to Zero, the Vision Zero Network, and towards Zero Deaths to urge the Biden administration to undertake bold leadership to address this crisis and to commit to reduce traffic fatalities to zero by 2050.
Our nation’s priorities must seek to advance street safety, public health, and health equity. Particularly in this time of hospital bed shortages, we must do all we can to save our limited resources. Evidence-based strategies to make streets safe for motorists, bicyclists and pedestrians should be a top priority of President Biden and Secretary Buttigieg’s Department of Transportation.
The same kind of systemic failures we’ve seen with coronavirus are apparent in America’s traffic safety policies as well. The United States is an international outlier among developed countries with respect to roadway safety. The traffic-related death rate in the United States is more than twice that in our neighbor Canada. All European countries, excluding Albania and Armenia, Belarus, Bosnia, Moldova and Ukraine, have fewer traffic deaths per capita than the US. The rate in Germany is 70% less than that of the United States.
The US needs to transform our culture of safety around driving, systematically eliminating distracted driving, and improving infrastructure in a way that supports safety. Examples of infrastructure strategies include incentivising safe biking in cities with dedicated bike and micro-mobility lanes and lower speed limits in residential and urban shopping areas. We can also insist on higher vehicle safety standards for our cars adopting and mandating lifesaving new features like automatic emergency braking and pedestrian detection.
Twenty percent of the people killed in this country from crashes were simply walking to their job, school or other destination. Communities of color, in particular, are far more likely to die while walking. This speaks to a systematic lack of investment and improper design of streets in communities of color. Addressing this inequity will advance the administration’s stated goal of health equity. Specific strategies such as limiting right or left turns where appropriate, deployment of speed safety cameras and increased frequency of accessible crossings all are proven to save lives.
But it is important that our policies to prevent crashes do not inadvertently harm communities of color. Studies also show that communities of color are disproportionately burdened by some programs and policies intended to support traffic safety, such as those around jaywalking and other enforcement strategies that do not address underlying needs for safe built environments and equitable policies. Work towards #ZeroTrafficDeaths must not further exacerbate harm to these communities, but rather elevate equity and justice in traffic safety strategies.
In addition to the vast personal toll, the financial cost of traffic crashes in the United States is enormous. According to the National Safety Council, the annual cost of traffic crashes is $463 billion. These costs include wage and productivity losses, medical and administrative expenses, property damage and employer costs.
Lastly, the Biden administration should be investing in an analytics infrastructure to support learning systems in states and communities to improve street safety. To this end, there should be systematized crash data collection on highways and improved coordination between state and local public health and transportation agencies on motor vehicle-related injury data. In addition, there should be an effort to link health system data with transportation data. Injury severity and health outcomes should be guiding interventions.
As President Biden aims to Build Back Better, addressing traffic crashes and its intersection with healthcare must be a part of it. Doctors want to be partners with traffic safety agencies and the government not just in treating the aftermath of these collisions, but in helping develop the will and prescription to prevent them from occurring. The cost to individuals, families and communities is too high not to act.
Nicholas Gavin is an associate professor of emergency medicine at Columbia University.