SECTION: CAPITOL HILL HEARING TESTIMONY

LENGTH: 3621 words

COMMITTEE: HOUSE TRANSPORTATION AND INFRASTRUCTURE

SUBCOMMITTEE: HIGHWAYS AND TRANSIT

HEADLINE: IMPROVING HIGHWAY SAFETY

TESTIMONY-BY: BELLA DINH-ZARR, PH.D., M.P.H., DIRECTOR, TRAFFIC SAFETY POLICY

BODY:
STATEMENT OF BELLA DINH-ZARR, Ph.D., M.P.H. DIRECTOR, TRAFFIC SAFETY POLICY AAA

Before the House Subcommittee on Highways and Transit Committee on House Transportation and Infrastructure

June 27, 2002

Mr. Chairman, Members of the Committee, and Staff, I am honored to be here today. My name is Bella Dinh-Zarr and I represent AAA. With over 45 million members, we represent many diverse interests, but consistently, our members have expressed that their greatest concerns are Safety and Mobility.

The Transportation Equity Act for the 21st Century (TEA-21) was an historic achievement thanks to the unwavering commitment of those who served on this subcommittee, as well as the vast majority of Members of Congress, and the organizations here today. It represented an impressive decision on the part of Congress to improve safety on our highways. AAA was proud to lend its support to your efforts and looks forward to working with you again to craft the next federal transportation bill. As you prepare for next year's reauthorization of TEA-21, we in the traffic safety community welcome the opportunity to provide input into the legislative process at this early stage. AAA celebrates its 100th anniversary this year. For a century, we have retained our commitment to ensuring the safety, security and peace of mind of our members and the entire traveling public. We were founded as an advocacy organization to improve the quality of our roadways and we continually strive to improve safety for the motoring public. That is the history that guides our work today as we prepare our safety program for the TEA-21 reauthorization.

Thank you for bringing us together today to explore solutions to this important national problem.

The Public Health Perspective

Mr. Chairman and Members of the Committee, I am a public health scientist, and I view traffic safety as the ultimate public health challenge of the 21st Century. Traffic deaths are consistently one of the top 10 causes of death for all ages, rivaling cancer, heart disease, and HIV. For children, it is the leading cause of death and, for seniors, motor vehicle death rates are rising with alarming speed despite declines in other age groups. Motor vehicle crashes affect all of us--no matter where we live or how old we are. We must view them as an epidemic as serious as any deadly disease. Although we have made great gains in annual death rates (an all-time low of 1.5 deaths per 100 million vehicle miles traveled compared to 1.9 in 1991), the total number of deaths remains far too high. From a public health perspective, this is a "disease "that kills more than 41,000 people and injures more than 5 million people every year.

In recent years, we have begun to battle this epidemic on our roads in the same way we have fought in the past against devastating diseases such as polio. Just as we have beaten polio through vaccinations, we must "vaccinate" our nation against crashes. Just as we have saved thousands of Americans from the devastating effects of polio, and continue to prevent needless suffering, through public health efforts, we can now save thousands of lives on our roads by using a public health strategy.

It is from this public health perspective that we at AAA are preparing our safety recommendations for the next reauthorization. In public health, prevention is key. Therefore, we offer recommendations for a safety strategy based on 3 cornerstones of public health:

I. PREVENTION--We should prevent injuries and deaths due to crashes, but most importantly, we should strive to prevent crashes before they occur;

II. IMPACT--We should target the key areas that will have the greatest public health impact; and

III. COLLABORATION and EVALUATION--We should increase coordination and reduce duplication of efforts. In addition, we should include an evaluation component in all projects to determine what works so that the results can benefit others.

I. PREVENTION: Pre-Crash, Crash, and Post-Crash

In traffic safety research, we characterize the prevention of injuries into three stages: Pre-Crash, Crash, and Post-Crash. Prevention in the Pre-Crash stage consists of preventing crashes altogether through interventions such as reducing high risk driving and improving dangerous roads. This is Primary Prevention.

In the Crash Stage, we can mitigate the injuries and deaths resulting from the impact of the crash through the use of safety belts, secondary restraint systems, and child safety seats.

Finally, in the Post-Crash Stage, the key factor is prompt medical treatment for the injured. All three stages are important, but ideally, injury experts attempt to intervene in the Pre-Crash stage before any collision has taken place. This is the most effective time to intervene.

Ironically, the most effective Pre-Crash interventions are also often the most neglected. Of course, we support strong funding of important Crash and Post-Crash interventions that reduce injuries incurred in a crash--AAA is well-known for its emphasis on seat belt and child safety seat use as well as our roadside assistance after a crash. Nevertheless, we propose that the TEA-21 reauthorization re-emphasize the importance of interventions that will prevent crashes before they occur. Many of these types of Pre-Crash interventions are outlined in our Four Key Areas below.

II. IMPACT: Four Key Areas

Because resources are always limited, we must focus our efforts where we can have the greatest impact. In public health, we know that epidemics have "Tipping Points"which either tip in favor of the disease (leading to rapidly increasing numbers of victims) or in favor of the people (leading to the rapid decline of the disease). Scientists who fight against diseases must determine the best points to attack a disease in order to "tip it"in favor of people. Likewise, we can "tip"the epidemic of traffic crashes in our favor (and save the most lives) by focusing on Four Key Areas:

1. Improving Our Roads

2. Reducing High Risk Driving

3. Collecting Real Crash Causation Data

4. Protecting Vulnerable Road Users

1. Improving Our Roads: Intersection Safety, Safety Audits, and Safety Planning

Historically, AAA has been an advocate for better, safer roads. We have a long and proud tradition of supporting road and safety improvements. Today, I would like to discuss some innovative ways of improving roads and the planning process that will assist in the primary prevention effort I mentioned earlier.

First, AAA recommends funding demonstration projects on intersection safety to promote cost-effective interventions that reduce crashes and save lives. Intersection safety affects all of us, but children and seniors are especially vulnerable. In addition, we are all pedestrians at times and intersection safety benefits those outside and well as inside vehicles. Each year, there are more than 2.8 million crashes in intersections with a toll of over 9,000 lives lost.

Demonstration projects that target intersections should be funded and evaluated. A model of this type of program is the Michigan Road Improvement Program, sponsored by AAA Michigan, which facilitates road improvements at targeted high-crash locations in Detroit and Grand Rapids. These improvements include well-placed traffic signals with larger heads for visibility, improved signage, pavement markings, left-turn lanes with left-turn phases, and adjustments in signal timing.

The project is still under evaluation, but initial results show large crash and injury reductions following the improvements. A relatively small investment of money resulted in tremendous gains in the reduction of crashes--truly cost-effective primary prevention. These impressive results are available due to an extensive and systematic evaluation that was integral to the project. Demonstration projects were historically developed to expedite innovation. Therefore, by funding the implementation and evaluation of safety projects in the reauthorization, the results could be used to provide safety benefits to the entire nation. We would be happy to provide more information on the Michigan Road Improvement Project.

Second, road safety audits should be encouraged in each state. Road safety audits consist of independent, multidisciplinary teams trained to review all road construction for safety concerns. The premise is to make safety improvements BEFORE the concrete is poured, which is both more effective and efficient (cost-effective). Currently, approximately 10 state transportation agencies are implementing road safety audit pilot projects, with initial anecdotal evidence demonstrating large safety benefits. These safety audits should be more widely implemented and evaluated so that we can know the true safety benefits of this primary prevention of crashes.

Third, in order to make safety a priority, we should continue to support efforts to integrate safety as an explicit criterion in statewide and metropolitan planning. This vital link between safety and planning was recognized in TEA-21. The effort is already underway, but much work still needs to be done.

While safety and planning integration may seem self-evident, forums conducted by the Transportation Research Board (TRB) in 2001 showed that transportation planners did not always have sufficient safety information and would have welcomed input from safety experts, researchers, and public partners. TRB uses the term "safety conscious planning"to describe a situation in which (1) all planning organizations routinely consider safety as a priority in all elements of all projects; (2) there is access to safety planning experts and tools; and (3) decision-makers are informed and base their decisions in part on the quantitative safety implications.

2. Reducing High Risk Driving

The most commonly known type of high risk driving is drunk driving. We should focus on interventions targeting this group that is overly represented in crashes. Drunk driving has decreased substantially in the past 25 years, but alcohol is still a factor in 40% of highway deaths or over 16,000 fatalities each year. About one-third of all drivers arrested or convicted of DWI are repeat offenders. Of all drivers in fatal crashes, more than 10,000 had a blood alcohol content (BAC) of 0.10 or higher. Almost two-thirds of drunk drivers who died had a BAC of greater than 0.15, or the equivalent of a 180-pound man drinking seven beers in an hour.

More than 20% of drinking drivers are problem drinkers, but they contribute to over 40% of drunk driving trips. We need practical solutions that can be implemented in every state to address the problem of drunk drivers, especially repeat offenders and high BAC offenders.

The AAA Foundation for Traffic Safety recently published a report entitled Drunk Driving: Seeking Additional Solutions (Hedlund & McCartt, May 2002). This report offers 3 practical recommendations:

-Establish drunk driving control system monitoring programs--to determine what is working well and not working (evaluation).

-Reinvigorate state drunk driving task forces--to ensure coordination of efforts so that drunk drivers do not fall through the gaps (collaboration).

-Improve state drunk driving grant reauthorization--to simplify the process and allow each state to do what is most effective for that state with performance-based criteria.

Additional details are available in the report. We have provided copies of this report with our written testimony and would be happy to provide additional copies to the committee.

3. Collect real crash causation data

Why should we collect crash causation data? Although it may seem that we already know the cause of many crashes, we do not have enough details for PREVENTION. The details are needed so that we can develop innovative solutions for the primary prevention of crashes. It is difficult to decide how best to reduce crashes if we don't have up-to-date information.

Isn't crash data already being collected? All of our current interventions are based on old data about crash causation--the most recent information is 25 years old. We are collecting some crash data but these data are most useful for crashworthiness (preventing injuries once you are in the crash), rather than preventing the crash itself. We need data that is collected within 5 minutes of the crash, rather than 5 days after the crash. Much of the useful information is lost when so much time elapses.

How can we get the data? In the short-term, we can use the established infrastructure of the Truck Crash Causation study, which this committee authorized as part of the Motor Carrier Safety Improvement Act (P.L. 105-159). This comprehensive study was designed to determine the causes of and contributing factors to crashes involving commercial motor vehicles. Teams of crash investigators from the National Highway Traffic Safety Administration's National Automotive Sampling System (NASS) and state truck inspectors are investigating fatal and injury crashes of large trucks in 24 locations in 17 states. Crash details are being collected at the scene on involved drivers, vehicles, the roadway and environment at the time of the crash.

Instead of dismantling a system that cost millions of dollars to set up, we could build on an established program, which would save time and money. In addition to utilizing an existing system, which could easily be translated to collect car crash causation data, the investigators conducting the study have developed an invaluable rapport with the police departments, enabling them to arrive at crash scenes within minutes. Building a car crash causation study upon this framework would provide us with "at- the-scene"information that would teach us more about how to prevent all crashes and to target our actions where we will have the greatest impact.

In the long-term, funding the development of the Future Strategic Highway Research Program (F-SHRP) safety plan developed by the Transportation Research Board would allow collection of "Before- During-and After"data.

A combination of the Car Crash Causation study and the F-SHRP proposal being currently developed would provide both immediate and long-term useful information. This is the information that we will need to make even greater strides in the reduction of motor vehicle crashes.

4. Protecting Vulnerable Road Users

Certain road users are at greater risk than others. We at AAA feel that it is important to protect the most vulnerable members of our population. We encourage funding for activities that will most benefit those who are at greatest risk, as well as activities that benefit the greatest number of people. Children, teenagers, and seniors each face special dangers on our roads.

This theme of protecting vulnerable road users also recurs as we look at the previous three key target areas:

Reducing High Risk Driving (Protecting Children and Others): The most commonly known type of high risk driving is drunk driving. Drunk driving is especially harmful to our children. Alcohol is still a factor in one in five traffic deaths of children under age 15. When you consider all children killed in car crashes involving a drunk driver, nearly two-thirds of the time it's the driver of the child's car that is drunk. The stereotype that drunk drivers kill people in other cars is a myth. Sixty percent of the children who died in alcohol-related motor-vehicle accidents were riding in the same vehicle as the drunken driver. Only 16 percent of them were using proper restraints such as safety belts or child safety seats. The more a driver has been drinking, the less likely the kids in the car are in car seats or seat belts. By targeting high risk driving, especially drunk driving, we protect our children and help keep our roadways safe.

Improving Our Roads (Protecting Seniors and Others): Intersection safety will benefit everyone, but will have particular benefit to senior drivers and pedestrians. The over 65 age group is the fastest growing population in the United States. By 2020, there will be over 40 million licensed drivers over 65 years of age. Older drivers are often wiser drivers: they are less likely to speed, more likely to wear their seat belts, and less likely to drink and drive. Yet, they are some of our most vulnerable road users with the highest crash death rate per mile of everyone except teenagers. Senior road fatality rates have climbed while overall fatality rates have remained stable since 1991. Senior drivers are over-represented in intersection crashes (in part because they do more city driving) and senior pedestrians are up to 5 times more likely to die than any other age group (in part because of increased physical frailty). By targeting road improvements such as intersection safety, we can protect our seniors and keep them safely mobile.

Collecting Real Crash Causation Data (Protecting Teens and Others): Collecting crash causation data will provide insight into all types of crashes, including those of the highest risk driving population: teenage drivers. AAA clubs were instrumental in the passage of Graduated Driver License laws in 39 states and the District of Columbia. GDL has been shown to reduce teen driving crashes, likely through reducing exposure to dangerous situations and delaying the age of solo driving. But very little is known about the teenage driver. By targeting research to find better information about the cause of crashes, before, during, and immediately after they occur, we can design better interventions to protect young drivers.

III. COLLABORATION AND EVALUATION

Throughout the four key areas, a need for collaboration and evaluation emerges as a common theme. These two vital components will strengthen all safety efforts within the reauthorization.

Collaboration

Collaboration is essential in public health. Without help from field workers and the community at large, public health practitioners would not have been able to defeat diseases such as polio. Likewise, collaboration, in the form of greater coordination of efforts, is needed in the traffic safety field. Traffic safety efforts are disjointed leading to duplication of efforts in one area and lack of activity in others. This is due in part to the many types of expertise that are required in traffic safety: medical, engineering, public health, statistics, behavioral science, legislative, education, and others. The multidisciplinary nature of traffic safety, coupled with the various types of institutions that are involved in safety activities (federal, private, university, non-profit, others), make coordination difficult. Nevertheless, greater coordination is essential in order to increase the impact of interventions to reduce motor vehicle crashes. An effort to increase collaboration between disciplines as well as across organizations would make safety efforts more effective overall. Collaboration is important in each of the 4 key target areas I have discussed. For example:

Improving Our Roads: Integrating safety and planning efforts, as recognized in TEA-21, is an important collaboration between two disciplines that contribute to the safety of our roads.

Reducing High Risk Driving: Increasing coordination through state drunk driving task forces would improve enforcement and adjudication so that fewer repeat and high BAC offenders fall through the cracks. Collecting Real Crash Causation Data: Rather than discarding established systems, we should attempt to build on them. The Truck Crash Causation study infrastructure would be a good framework to quickly begin collecting broader crash causation data. In addition, coordination with the F-SHRP proposal should be established so that the data are complementary rather than competitive.

Evaluation

Public health is grounded in the science of evaluation. Evaluation saves time and money in the long run. Many projects are conducted under the assumption that they are improving safety, but evidence is needed. We need to know whether something works. Rigorous evaluation should be incorporated in the beginning stages of all interventions to ensure that they are accomplishing their goals. Demonstration projects, for example, should include evaluation components based on strong evaluation criteria, so that the benefits can be measured and the intervention applied in other locations.

CONCLUSION

Traffic safety is one of the greatest public health challenges of the 21st Century. TEA-21 reauthorization presents us with an opportunity to reevaluate where we've been and where we need to go in terms of safety. Through this process, we have the potential to greatly impact the health and safety of our nation.

To put this whole issue in perspective, we need to recognize deaths and injuries on our roads as a staggering national loss. As a Vietnamese American who fled the Communist Regime in 1975, I am humbled by the loss of 50,000 Americans who gave their lives in the Vietnam War. Yet, I cannot forget that another, insidious enemy is taking 41,000 Americans every year on our own soil--and that every two years the deaths on our roads far surpass the number of lives lost during the Vietnam War. We are losing Americans at the rate of one life every 13 minutes. This is a war we must also fight.

At AAA we are dedicated to the fight to prevent motor vehicle crashes and I thank you for the opportunity to testify at this important hearing. As we continue to fine-tune our reauthorization proposals and consider additional ideas, we look forward to working with you to make our transportation system as safe as possible.



LOAD-DATE: July 1, 2002