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Summary T he United States is missing significant opportunities to reduce traffic fatalities and injuries. The experiences of other high-income nations and of the U.S. states with the best improvement records indicate the benefits from more rigorous safety programs. Most high- income countries are reducing traffic fatalities and fatality rates (per kilometer of travel) faster than is the United States, and several countries that experienced higher fatality rates 20 years ago now are below the U.S. rate. From 1995 to 2009, annual traffic fatalities declined by 52 percent in France, 39 percent in the United Kingdom, 25 percent in Australia, and 50 percent in total in 15 high-income countries (excluding the United States) for which long-term fatality and traffic data are available, but by only 19 percent in the United States. Some U.S. states have fatality rates comparable to those of the countries with the safest roads; however, no state matches the typical speed of improvement in safety in other countries. The experience of these benchmark nations indicates that the successful national programs function effectively at three levels of activity: • Management and planning: Transportation, public safety, and public health administrators systematically measure progress toward quantitative objectives, direct resources to the most cost-effective uses, and communicate with the public and with elected officials to maintain their support. • Technical implementation of specific countermeasures: A range of measures is employed for regulating driver behavior, maintaining effective emergency response, and ensuring safe design and maintenance of roads. The techniques are generally of proven high effectiveness and often intensively applied. • Political support and leadership: Commitment of elected officials ensures that resources are provided, administrators are held accountable for results of safety initiatives, and system users are held accountable for compliance with laws. Among these three areas, the most critical needs for action in the United States today may be in management and planning. Improved management will ensure that the available resources are used to greatest effect and, over time, will foster political and public support by demonstrating that reduction in fatalities and crashes is an attainable goal. The benchmark nations’ experience indicates that systematic, results-oriented management can produce safety progress with the tool kit of countermeasures that is available to the responsible agencies. The tool kit will vary among jurisdictions depending on basic legal constraints, community attitudes, road system and traffic characteristics, and resources. The Transportation Research Board (TRB) undertook a study to identify the sources of safety improvements in other countries. Researchers do not have a complete understanding of the underlying causes of long-term trends in crashes and fatalities. Differences among countries are in part attributable to factors other than government safety policies. To identify keys to success, the TRB study committee examined specific safety programs for which quantitative evaluations are available and relied on the observations of safety professionals with international experience. The committee’s conclusions, summarized below, identify differences between U.S. and international practices that can account for some differences in outcomes. The 1

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2 Special Report 300: Achieving Traffic Safety Goals in the United States: Lessons from Other Nations recommendations below, which are addressed to elected officials and to government safety administrators, identify actions needed in the United States to emulate the successes that other countries have achieved. The recommendations do not comprehensively address all aspects of traffic safety programs but rather address areas of practice that are highlighted by the international comparisons and for which credible evidence of effectiveness is available. MANAGEMENT AND PLANNING Conclusions Successful national safety programs are more distinguished by the programs’ management than by the particular interventions. The essential elements of the management model are the following: • A systems perspective that integrates engineering design, traffic control, regulatory enforcement, and public health methods to identify and reduce risks; • A plan that specifies goals and milestones, methods, and resource requirements and that constitutes a commitment for which the government agencies responsible for delivery may be held accountable; and • Regular monitoring to identify problems and measure progress toward goals and ongoing evaluation to determine effectiveness of the actions taken. Monitoring allows feedback so that programs can be improved and reinforces accountability of program managers. In the United States, management practices in traffic safety programs typically are deficient in elements of this ideal management model. Meaningful goals and milestones are not published, data systems do not adequately monitor effort or performance, program impacts are not scientifically evaluated, and initiatives are episodic and reactive rather than strategic. Lack of safety planning analytical tools inhibits planning and weakens the case for safety spending in the competition for public resources. Activities of the U.S. Department of Transportation (USDOT) and the American Association of State Highway and Transportation Officials over the past decade have emphasized state and local safety planning, management processes, and evaluation, yet it is unclear that many states are making significant progress in critical elements of safety management. Comparison of management methods in other countries with those of the United States must take into account the decentralized structure of U.S. government. The U.S. federal government regulates vehicle safety, but otherwise its involvement is indirect, through the rules of federal highway and traffic safety grant programs. State governments build and operate intercity roads; state police enforce traffic regulations mainly on major roads; and state laws and courts govern driver licensing, vehicle inspection, and traffic safety. Local governments independently operate local streets and roads, enact regulations, and provide police and courts. In contrast, most of the benchmark countries’ governments are highly centralized; for example, a national police force may conduct most traffic enforcement. This difference complicates the introduction of management practices of other countries in the United States.

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Summary 3 Recommendations 1. Congress should authorize and provide funding for three USDOT and state activities: • USDOT should cooperate with selected states in organizing, funding, evaluating, and documenting a series of large-scale demonstrations of important elements of safety management. • USDOT should work with the states in revising the National Highway Traffic Safety Administration (NHTSA) Uniform Guidelines for State Highway Safety Programs to ensure that these documents provide directly applicable and practical guidance for development of state programs. • USDOT, in cooperation with the states, should develop a new model for the state Strategic Highway Safety Plans that is more rigorous in specifying resource requirements and expected outcomes. The purposes of the recommended demonstrations would be (a) to document the functioning of a program conducted according to stringent and specific guidelines (e.g., the NHTSA Uniform Guidelines) and (b) to disseminate information on safety program management methods, problems, costs, and benefits to transportation agencies, officials, and the public through training, publications, and other media. Most U.S. state and local transportation safety agencies lack the institutional and technical capacities required to apply the management techniques observed in the benchmark countries. Communicating the concepts of safety management to the responsible agencies will require a greater level of effort than has been devoted to the task. A demonstration would concentrate on specific components of a state’s safety program, which could be a category of countermeasure (e.g., a speed management program or corridor improvement program) or a management process (e.g., monitoring and evaluation or preparation of elements of the Strategic Highway Safety Plan). Demonstrations could be designed to show how states can apply the NHTSA Uniform Guidelines effectively. Most demonstrations would entail recruitment of local government cooperation and training of local highway departments and police. Demonstrations also would require intensive collaboration among the government agencies with safety responsibilities. 2. Congress should consider designating and funding an independent traffic safety evaluation and policy research organization to provide technical support in development of interventions and management methods, advise officials on policy, and reinforce accountability of the operating agencies to legislators and the public through performance evaluations. 3. Transportation agencies should take into account demonstrated competency and professional qualification in highway safety in their hiring and promotion decisions. Engineering schools and accreditation associations should set standards for safety competencies of engineers practicing in areas that affect highway safety. In addition, in-service training programs are needed, especially short courses designed for local government public works engineers.

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4 Special Report 300: Achieving Traffic Safety Goals in the United States: Lessons from Other Nations COUNTERMEASURES Conclusions Safety officials in the benchmark nations have attributed progress to their implementation of comprehensive safety programs that include improvements in road design and traffic management; regulation of vehicle safety; regulation of driver behavior with regard to speed, alcohol and drug use, and seat belt and helmet use; restrictions on younger and older drivers; and reliable emergency response. These programs require consistent actions by legislators and by administrators responsible for roads, police, courts, and public health. Within this comprehensive framework, countries that have sought rapid declines in casualty rates have emphasized curbing high-risk driver behavior, especially speeding, drunk driving, and failure to use seat belts, by means of stringent laws, intensive public communication and education, and rigorous enforcement. Two enforcement techniques aimed at driver behavior that have contributed to fatality reductions in the benchmark nations are automated enforcement of speed limits (i.e., detection and identification of speeding vehicles by means of automated cameras and speed-measuring devices installed in the roadway) and frequent roadside sobriety checks to enforce laws against alcohol-impaired driving. The objective of these techniques is general deterrence, that is, to make the risk of detection and punishment high enough to change the driving behavior of the population. Neither technique is in common use today in the United States because of legal restrictions, popular opposition, and cost considerations. Despite these constraints, the United States can learn important lessons from the benchmark nations’ enforcement practices. They demonstrate that sustained and intensive enforcement, rationally organized and managed, can alter driver behavior sufficiently to produce worthwhile systemwide safety improvement. As case studies of international differences, the committee compared five categories of countermeasures—alcohol-impaired driving prevention, speed control, motorcycle helmet laws, seat belt laws, and highway network screening (identifying and correcting high-hazard locations on the road network)—in the benchmark nations and the United States. Conclusions with regard to opportunities for more effective use of countermeasures are outlined below. Prevention of Alcohol-Impaired Driving • The two most evident differences between drunk driving countermeasures in the benchmark countries and those in the United States are the legal maximum blood alcohol content (BAC) limits and the intensity of enforcement efforts. The BAC limit is 0.8 g/L in the United States and 0.5 g/L or lower in Australia, Canada, Japan, and nearly every country in Europe except the United Kingdom and Ireland. The rate of roadside alcohol testing is about 1 test per 16 drivers per year in Europe and even higher in Australia. Complete U.S. statistics on testing frequency do not exist, but the U.S. rate probably is far lower. • Effective programs to reduce alcohol-impaired driving include public health measures to combat alcohol abuse and efficient judicial procedures that include intensive follow-up on offenders. For follow-up, ignition interlocks are now recognized as an effective means to reduce recidivism. • Programs of sustained, high-frequency sobriety testing in the benchmark countries have achieved reductions of 13 to 36 percent in the annual number of alcohol-involved fatal

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Summary 5 crashes. Evaluations of sobriety checkpoints in U.S. jurisdictions have reported comparable reductions. Widespread implementation of sustained, high-frequency sobriety testing programs in the United States at sobriety checkpoints could be expected to save 1,500 to 3,000 lives annually. There is evidence to indicate that lowering the legal BAC limit to 0.5 g/L, combined with more intensive enforcement, would reduce fatalities further. Speed Control • Successful speed management initiatives in other countries are of high visibility (through publicity and endorsement of elected officials), are long term (sustained for periods of years), target major portions of the road system, use intensive enforcement (e.g., automated enforcement and high penalties), sometimes use traffic calming road features (such as narrow lanes and traffic circles that cause drivers to reduce speed), and monitor progress toward publicly declared speed and crash reduction objectives. No U.S. speed management program today is comparable in scale, visibility, and political commitment to the most ambitious programs in other countries. • In countries that have such programs, typical results have been reductions in average free-flow speed of 3 to 4 mph and a 50 percent reduction in the incidence of speeding more than 6 mph over the limit. Officials in some countries credit these programs, after several years of sustained application, with reductions in fatalities on the order of 15 to 20 percent on the affected road system. • If the results of the most rigorous speed management trials (not using automated enforcement) conducted in the United States could be reproduced and sustained throughout the country and benefits proportional to those reported in the benchmark countries resulted, 1,000 to 2,000 lives annually could be saved. • The cost-effectiveness of conventional intensive speed enforcement strategies employed in the United States (e.g., short-term high-visibility enforcement campaigns that do not use automated enforcement) is uncertain. Evaluation of alternative enforcement strategies should be a research priority. Motorcycle Helmet and Occupant Restraint Laws • Laws in every benchmark country require motorcyclists to wear helmets. Thirty U.S. states lack such laws. If all states required helmet use, about 450 deaths annually would be avoided. • France, Germany, the Netherlands, Sweden, the United Kingdom, Canada, Australia, and some U.S. states all report seat belt use rates by front seat occupants of more than 90 percent. The U.S. average in 2010 was 85 percent. If U.S. belt use were increased by 5 percentage points, about 1,200 lives would be saved annually. State enactment of primary seat belt laws is among the measures that have proved effective. A primary enforcement law is a state law authorizing police to stop a vehicle and issue a citation solely on the grounds of failure to use a seat belt.

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6 Special Report 300: Achieving Traffic Safety Goals in the United States: Lessons from Other Nations Highway Network Screening • Safety corridor programs constitute a more comprehensive approach to reducing the risk of travel on a particular road than traditional state highway hazard elimination programs, which often operated in isolation from other highway and safety functions. Corridor programs target routes with high crash frequencies and combine strengthened traffic law enforcement, publicity, and other measures with roadway physical improvements. • Two new evaluation practices in use in several of the benchmark nations, road safety audits and road assessment programs, are bringing greater attention to the problem of upgrading the safety of road infrastructure. Road safety audits are formal, independent examinations of the safety of the design of new road projects. Road assessment programs are nongovernmental initiatives that aim to increase public demand for safety and to make officials more accountable for the safety performance of highways by revealing and publicizing hazards. Recommendations 1. State and local governments that seek to match the performance of the benchmark nations should recognize that additional resources for enforcement will be required. The level of enforcement can be raised by using existing resources more effectively; by increasing funding; and by adopting more cost-effective methods, in particular, automated enforcement. Cost- effective enforcement methods maximize the impact of a given amount of law enforcement resources on crashes and fatalities. 2. The states and USDOT should give high priority to initiatives to encourage adoption of camera enforcement and regular use of sobriety checkpoints. 3. State officials and the federal government should act to preserve the existing universal helmet use laws by communicating the health, safety, and economic costs of repeal to legislators. 4. Each state should ensure that local police receive regular and substantial training in enforcement against impaired driving, speeding, and other high-risk driver behaviors. 5. The states and USDOT should transform the traditional practice of the hazard elimination program into a corridor safety improvement program that systemically identifies high-priority corridors and designs comprehensive safety improvement strategies for each corridor. POLITICAL AND PUBLIC SUPPORT Conclusions Successful safety initiatives in the benchmark nations have had the advantage of genuine and active support of elected officials in almost all cases, although elected officials were not necessarily the originators. Sustaining the initiatives has depended on eventually gaining the trust of the public. International case studies and the experiences of U.S. states suggest that the following factors have been important in building support for rigorous safety programs:

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Summary 7 • Public and political support has come about through long-term efforts of professionals, officials, and nongovernmental advocates. Safety programs in the benchmark countries and in the United States have long histories of evolutionary development and learning through experience. • Creation of new high-level institutional structures has been a valuable step in the evolution of national programs. For example, in France a ministerial-level committee oversees the national traffic safety program. • The programs have emphasized transparency with respect to goals and in public communications. Public statement of specific and credible goals is essential for accountability. • Regular communication channels exist among the road safety agencies, police, and researchers, and forums exist for interaction of legislators with professionals and researchers. • Public administrators and professionals often have been the initial leaders in educating and developing support among elected officials and the public. • Most programs have used sustained, large-scale, and sophisticated social marketing (that is, the application of business marketing techniques to promote a social welfare objective) to amplify the deterrent effect of enforcement and to influence public attitudes toward high-risk behavior. Recommendations 1. Each state legislature should require the responsible executive agencies to report regularly to it on progress in fulfilling the state’s safety plan and success in meeting the plan’s goals. 2. As a preliminary step to strengthening U.S. capabilities for application of social marketing to traffic safety, USDOT should conduct an in-depth review of methods and outcomes in other countries. 3. The national organizations of transportation and public safety officials, state legislators, and safety researchers should take every opportunity for organization of forums that bring together administrators, legislators, and researchers for exchange of information and views on traffic safety. 4. Public agencies should cooperate in the development of the United States Road Assessment Program, but the program must maintain independence, which is necessary for its effectiveness. 5. All states should enact the minimum framework of traffic safety laws that has been instrumental in achieving the gains that the most successful benchmark country safety programs have attained, including enabling legislation for automated speed enforcement.

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