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With the number of individuals driving in the United States having increased by a massive six fold since 1925, it is not a wonder then that the number of motor vehicle accidents have also drastically increased, to now stand at 215 million vehicles. This represents an 11-fold increase for a similar period too (National Safety Council 1998).
Moreover, the distance that is today covered by motorist has also drastically increased by about 10 times what it was during the mid-1920s. From the 1960s onwards, efforts to institute systematic motor-vehicle safety in the United States were implemented.
By about 1960, 93,803 deaths were being attributed to unintentional injuries. Of these 41 percent were attributed to crashes that involved motor vehicles. The rise in the death rate increased for the next five years and in 1966, the federal government received authorisation from the Highway Safety Act to not only set, but also regulate highways and motor vehicles standards. This is a mechanism that seeks to offer an effective prevention of motor vehicle related accidents (Transportation Research Board 1990).
High-Risk Populations to motor vehicle accidents
Drivers under the influence of alcohol
The numbers of motor vehicle crashes that are attributable to alcohol-induced driving have been shown to have decreased steadily over the years to about 16,000 deaths now on an annual basis. This represents a massive 39 percent reduction n the fatalities since 1982. Nevertheless, Alcohol-induced motor vehicle accidents accounts for about 38.6 percent of all the traffic-related deaths in the United States (CDC 1996-97; National Highway Traffic safety Administration 1998).
Some of the factors that have been attributed to this observable decline in the number of deaths includes among others tougher new state laws, an increased awareness to the members of the public on the dangers that accompanies the behaviors of drinking and driving, more stringent enforcement of the traffic laws, a rise in the drinking age that is legally recognized, advocacy for the implementation of preventative programs which seeks to offers alternatives to drivers who wishes to get drunk (for instance, public transportation, and taxicabs), practices of serving alcohol in a responsible manner, designated drivers, and a reduction in the per capita consumption levels of alcohol (CDC 1992; Graham 1993).
Drivers and passengers of a younger age
From 1975, the number of fatality rates associated with motor vehicles has witnessed a 27 percent reduction, with regard to the young occupants of such motor vehicles between the ages of 16 and 20 years. On the other hand, the recorded death rate amongst this population, and which was attributed to motor vehicle fatalities stood at 28.3 for every 100,000 individuals in the population.
Clearly, this was more than double the death rate in the entire United States population, which stands at 13.3 percent for every 100,000 persons (National Highway Traffic Safety Administration 1998). Statistics shows that teenage drivers have a higher likelihood to drive under the influence of either drugs or alcohol, or even to over-speed.
Furthermore, this group of youngsters in their teenage years has also been shown to ride with drivers who are quite intoxicated, and even go to the extent of urinating out of the window (Hingson & Howland 1993). These are some of the behaviors that the elderly population are not likely to engage in, and this could thus explain why the fatality cases appears to be extremely high fro the teenage population, more than in any other age group in the United States.
Some of the strategies that have facilitated in an enhanced safety if the motor vehicles amongst the drivers who are young consist of the institution of laws that prohibits the purchase of alcohol amongst the youths that are underage (Graham 1993) as well as some elements of graduated licensing systems (for instance restriction to driving during the night) (Foss & Evenson 1999).
Pedestrians
For the period between 1975 and 1997, the death rates of pedestrians knocked down by motor vehicle in the United States was seen to have reduced by 41 percent to stand at 2.3 deaths in every 100,000 persons, down from 4 persons in every 100,000 individual. This notwithstanding, the death rates of pedestrians as a result of motor vehicles accidents still represents 13 percent of all the deaths that are linked to motor vehicles (National Highway Traffic Safety Administration 1998).
Some of the factors that have thus far been associated with this massive decline in the numbers of pedestrians dying as a result of motor vehicle accidents includes improved pedestrian paths, sidewalks, the creation of childrens playgrounds far away from the streets restricted on-street parking , and the implementation of one way traffic flow (Graham 1993).
Protection systems for vehicle occupants
Safety belts
As a way of responding to law enforcement that is quite highly visible, public education and legislation, the usage rate of safety belts on a nationwide scale in the United States was seen to rise to 68 percent by 10997. This was a 51 percent increase from the usage rate that was recorded in 1981 (National Center for Injury Prevention and Control 1997).
The rise in the use of safety-belts started being more noticeable in the wake of the enactment of the first state mandatory laws in 1984 (Graham 1993). Save for New Hampshire, all the other states in the United States today have in place the usage laws of safety-belts.
In addition the primary laws appears to be more effective (these are the kinds of laws that gives the police a mandate to stop motor vehicles fro the simple reason that is occupants may not be wearing the safety belts) as opposed to the secondary laws (these are the laws that a policeman/woman stops a vehicle due to the violation of other forms of traffic rules, as opposed to the primary laws (Graham 1993; Rivara et al; 1999).
Following this enactment of the primary laws, the rates of fatalities that are associated with motor vehicles was seen to drop to 46 percent, down from 13, with a corresponding rise in the primary laws enactment by between 1.5 and 4.3 times (Rivara et al 1999).
Booster and child-safety seats
In all the states in the U.S, passengers protection laws for child passengers have been enacted, although there appears to be a variation in these with respect to size requirements and age, as well as the penalties that are often meted out to those who fail to comply with them.
In 1996, child-restraint use stood at 85 percent, fro those children that were below the age of 1 year. On the other hand, the same restraining rule for children between the age of 1 and 4 years stood at 60 percent (National Highway Traffic Safety Administration 1997). There has been a witnessed a 30 percent decrease in the deaths of children who are aged below the age of 5 years since 1975, to now stand at 3.1 percent for every 100,000 persons in the population.
At the same time, the rates for those age groups between 5 and 15 years appear to have only declined between 11 and 13 percent (National Highway Traffic Safety Administration 1997). It has also been documented that almost 80 percent of all motorist tend to misuse child seats ((National Highway Traffic Safety Administration 1996; CDC 1998; Taft et al 1999).
Besides, parents at often times fails to seems not to recognize the need of having booster seats for those children who may be too large to occupy child seats, but are nevertheless not larger enough to be restrained using a lap-shoulder belt fro the adult, with safety (CDC 1999). Either way, safety appears to be les guaranteed.
Challenges in the 21st century
In spite of the recorded remarkable success in reducing death rates Associated with motor vehicles, still motor vehicles crash have remained a principal cause of injury-related deaths amongst the population in the United States. According to some 1999 CDC data that is yet to be published, the death rates that are related to motor vehicles in the United States alone accounted for more than a third (31 percent) of all the deaths that were reported in the nation, in 1996.
In addition, injuries linked to motor vehicles were a leading cause of the deaths for the population between the ages of 1 and 24 years. Statistics have also indicated that in 1997, 41,967 deaths were attributed to motor vehicle crashes. This represents a death rate of 16 persons in every 100,000 individuals in the population.
Furthermore, 3.4 million injuries that were considered nonfatal were also reported in the same year, about 1270 injuries for every 100,000 members of the population (National Highway Traffic Safety Administration 1998). For the same period, 23.9 million vehicles were also shown to have been involved in crashes, and their costs have been estimated to be in the ranges of $ 200 billion (National Safety Council 1998).
In light of these developments, it is not hard therefore to realize hat the 21st century is already plagues with a challenge of both improving and sustaining the safety of motor vehicles. In the future, the attainment if success in the motor vehicle industry, and especially in as far as the safety of the vehicle occupants is concerned, there shall be a need to augment an approach to public health concerns with regards to the issue at hand.
In this regard, there shall be needs for expanded surveillance systems with a view to better monitoring the injuries that comes about due to motor vehicle accidents, and which are nevertheless considered to be nonfatal. Additionally, it will also be necessary to see to it that new problems are promptly detected, with a consequent setting of priorities regarding the same. Besides, it is also prudent that a direct research be instituted for both the priority and emerging problems, with regard to motor vehicle safety. Even then, it would be best if the most effective policies and programs concerning motor vehicle safety are implemented in a timely manner. Moreover, there is a need too, for a reinforcement of multidisciplinary partnerships that are focused on enhancing motor vehicle safety.
All the same, there are a number of public health activities that could be implemented to improve the situation. First, it is necessary to advance those efforts that have been shown to result in a reduction of alcohol-impaired driving , as well as associated injuries and fatalities. Secondly, some strategies that have been shown to demoralize the teenagers from both drinking and driving ought to be promoted, and these include graduated licensing.
These strategies have also been shown to check on such errant behavior amongst teenage drivers as a lack of using safety belts, and over-speeding. It is also important that the safety of the pedestrians be enhanced and more so in a case whereby both the elderly and the young children are involved.
To achieve this, it is mandatory to engineer solutions that curtails an exposure by this population to the traffic, while tat the same time also permitting a safe crossing of streets coupled with an encouragement on an observance of safer behaviors by the pedestrians (for example, the crossing of the streets where roads intersect, and enhancing drivers visibility and pedestrian awareness).
It is worth of note here that even the mobility needs of the adult population above the age of 65 years ought to be catered for, seeing that this is a group of the population that is poised to increase two-folds by 2030, to stand at 65 million. In order to achieve this, alternative transport modes could be combined (such as better public transportation, or walking), as well strategies developments that are aimed at reducing the hazards of driving (Graham 1993; Transportation Research Board 1988).
Furthermore, 30 percent of the population of motorists has been shown not to wear safety belts while driving, and it is thus imperative that they are encouraged to wear these, as safety-belts have a positive correlation with a reduction in the numbers of fatalities following say, the crash of a car.
At the same time, parents and adult motorist alike ought to be encouraged to use booster and child-safety seats that are appropriate fro the children in question, and more so fro those children who may be older, thereby having outgrown from using child seats, but are nevertheless same enough to use lap-shoulder bets for the adults.
Moreover, the conduction of biomechanical research should be undertaken with the aim of understanding better what causes disabling and nonfatal injuries, especially the spinal cord and brain injuries. This ought to act as the basis fro an implementation of prevention strategies.
Conclusion
A majority of the fatalities that emanates from motor vehicles could be mitigated to a greater extent if at all the parties involved could be more responsible with their lives as well as those in their vicinity. For example, drivers ensuring that they do not drink and drive, as they could result in over-speeding and possible causation of accidents, accompanied by a loss of lives.
Ultimately, it shall be the responsibility of the traffic and motor vehicle enforcement authorities, in conjunction with the police to see to it that the motorists comply with the set rules. Additionally, punitive fines should be instituted and followed religiously whenever motorists appear to have violated traffic laws. Public safety awareness programs would also go a long way into enhancing the safety of the motorists.
Works cited
CDC. Improper use of child safety seatsKentucky, 1996. MMWR 1998; 47:541-4.
Committee on Injury Prevention and Control. Reducing the burden of injury: advancing prevention and treatment Institute of Medicine. Washington, D.C: National Academy Press, 1999.
Foss, R. D, & Evenson, K. R. Effectiveness of graduated driver licensing in reducing motor vehicle crashes . Am J Prev Med 16.1 (1999):47-56.
Hingson, R, & Howland, J. Promoting safety in adolescents. In: Millstein SG, Petersen AC, Nightingale EO, eds. Promoting the health of adolescents: new directions for the 21st century. New York: Oxford University Press, 1993.
National Highway Traffic Safety Administration. (Research note). National occupant protection use survey, 1996controlled intersection study . Washington D.C.: U.S. Department of Transportation, National Highway Traffic Safety Administration, August 1997.
National Highway Traffic Safety Administration. (Traffic safety facts, 1997).
Washington, D.C.: Department of Transportation, National Highway Traffic Safety Administration, 1998.
National Safety Council (1998). Accident facts (1998 edition). Itasca, Illinois.
Rivara, F.P, Thompson, D. C, & Cummings, P. Effectiveness of primary and secondary enforced seat belt laws . Am J Prev Med 199916.1(1999): 30-39.
Taft, C.H, Mickalide, A.D, Taft, A.R. Child passengers at risk in America: a national study of car seat misuse . National Safe Kids Campaign, 1999. Washington, D.C.:
Transportation Research Board. Transportation in an aging society: improving mobility and safety for older persons National Research Council, 1.218 (1988). Washington, D.C.:
Transportation Research Board. Safety research for a changing highway environment . Washington, D.C.: National Research Council, Transportation Research Board, 1990; (special report no. 229).
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