Long before the COVID-19 pandemic, the US faced an epidemic on wheels. Daily, the US mourns the loss of 100 people on American roads. Vulnerable road users pay the heaviest price - pedestrian fatalities increased by more than 50% over the last ten years - a stark contrast to the 2% increase in other traffic deaths. Americans are not safe from dangerous roads at home or abroad, where they are their #1 killer. For the new Administration, the public health crisis is a personal one - President-Elect Joe Biden lost his daughter and wife in one of the country’s annual six million car crashes.
Under the national Vision Zero policy pledged by Secretary of Transportation nominee Pete Buttigieg, these tragedies would not happen. This policy would have the US follow in the footsteps of Sweden, Canada, the Netherlands and others. Using global road safety as a rallying point, Secretary-designate Buttigieg can help the Biden Administration build back better domestically and restore American standing abroad.
In the US, nothing kills more 5-24-year-olds than road traffic crashes. We must start with our children to build back better and implement Vision Zero nationally. Reaching zero fatalities nationally is ambitious, but zero child fatalities is achievable. Youth can, and must, be the catalyst for a nationwide Vision Zero plan.
To achieve a national Vision Zero plan and meet the Administration’s goals to protect public health, focus on children, and rebuild global engagement and leadership, there are several points Secretary-designate Buttigieg must incorporate in his strategy.
Win-win measures protect children from COVID-19 and their #1 killer
While we celebrate the first COVID-19 vaccinations, for young children it may be months, or even years, before they are vaccinated. This poses risks of further virus outbreaks, as children mix in close quarters at, and on the journey to, school.
The Biden Administration needs to protect children not just at school, but also on the journey to school. Some best practices to prevent the spread of COVID-19 on the journey to school also reduce road traffic injuries, such as opting for safe walking and cycling over personal vehicles. For example, children can physically distance thanks to increased space for drop-off and pick-up areas, pop-up cycle lanes, or walking school buses or bike trains. Active mobility improves physical and mental health and reduces air pollution – which is tied to the severity of COVID-19.
Investment in active mobility now will address the immediate health crisis while reducing childhood obesity, asthma, and other non-communicable diseases that result from inactivity. Approximately 10% of children in the US walked or cycled to school in 2017, down significantly from 48% in 1969. We can start with safety measures for communities of color and low-income neighborhoods, which have higher traffic fatality rates per capita, and where walking or biking are often the only way to get to school. Contributing to the evidence base for such communities also helps low- and middle-income countries, where 90% of fatalities occur, and where it will take even longer to vaccinate children.
High speeds are believed to be a significant reason why deaths on US roads increased 30% in the second quarter of 2020, despite pandemic-induced declines in traffic volume. As we struggle to inoculate the country against COVID-19, the Administration can deploy the lifesaving vaccine we have now – the speed vaccine.
Speeding is most deadly for children. A 40 mph crash will likely kill a child, but at 20 mph there is a good chance of survival. Some cities have already lowered speeds by closing carefully selected roads to traffic and building protective infrastructure so children can get to school safely. We can save lives by lowering speeds to 20 mph or less where kids live, learn, and play. Some cities already have 15 mph school zones, an example all should follow.
Slower streets are ruled by people, not cars. During the pandemic, these streets resulted in clean air. This was proof that getting people out of cars is a crucial part of the equation to reach net-zero emissions and the goals of the Paris Climate Agreement. Investing in safe public transportation and supporting multi-modal infrastructure like well-lit walking paths to bus stops is also crucial.
Vision Zero is often city-based, and for Secretary-designate Buttigieg to take it to a national level, smaller scale projects can demonstrate that zero is achievable and gain buy-in. Zero deaths among youth is achievable. Vision Zero for Youth, born in Washington DC, has grown internationally to achieve this aim as an example of US leadership in global road safety. A Vision Zero for Youth city of eight million people, Bogotá, Colombia has seen periods of zero child fatalities.
Vision Zero for Youth shows that prioritizing youth can be a catalyst for a wider Vision Zero approach and ensures that youth are included in Vision Zero plans. The Administration should increase funding for Vision Zero for Youth, an FHWA-supported program, to build on this established leadership framework.
Protecting youth requires infrastructure that doesn’t just ask people to slow down but requires them to do so. This infrastructure should be part of increased funding for USDOT’s Transportation Alternatives Program to install more accessible sidewalks, crosswalks, and bike lanes. The Biden Administration’s promise to fund public school buildings in federal infrastructure legislation should also include the area outside schools. Drop-off areas, parking lots, bus lanes, and sidewalks were part the US school infrastructure grade of D+, assessed by the American Society of Civil Engineers.
Despite the best of intentions, the US often suffers a dangerous lack of understanding of Vision Zero. The resulting ‘watered down’ version places insufficient emphasis on infrastructure improvements, and too much emphasis on enforcement that can further exacerbate racial and economic inequities. As he focuses on health and equity, Secretary-designate Buttigieg should apply lessons from domestic and international Vision Zero implementation.
A strong Vision Zero strategy will start with an appropriate level of funding. The Biden Administration should pass existing House Reauthorization and Appropriations language that includes Vision Zero’s underlying Safe Systems Approach. Using this funding, FHWA and NHTSA should scale up Vision Zero demonstration projects, with guidance from international experts. NHTSA and CDC can help restore those international dialogues by re-joining the United Nations Road Safety Collaboration, which they helped found. The Administration can help NHTSA re-establish itself in the global arena by increasing NHTSA’s funding for international behavioral and vehicle safety collaboration via Appropriations.
Safe vehicles are essential to implementing Vision Zero correctly. NHTSA should protect vulnerable road users by joining other high-income countries in mandating automatic emergency braking (AEB) and global standards like softened motor vehicle fronts. It should also include pedestrian protection in the New Car Assessment Program (NCAP) program.
Reaching zero requires eliminating drunk driving, responsible for one-third of deaths on US roads and $194 billion in costs. The Administration should quickly scale up passive alcohol detection technology to eliminate drunk driving. This will help achieve economies of scale to increase the supply of this technology in low- and middle-income countries via affordability and the used car market.
The Administration should encourage all States and Territories to follow Utah in passing .05% BAC laws proven to prevent drunk driving. Not only does a .05% BAC law have bipartisan support, it would begin to put the US back on equal footing with most of the world, which has this limit or lower.
The Administration will want to ensure that international aid does not inadvertently lead to preventable deaths and injuries, burdening already fragile health systems. Under the Obama-Biden Administration, a bi-partisan effort in the House and Senate helped ensure the roads we fund via the World Bank have minimum safety standards. These will prevent thousands of deaths and tens of thousands of serious injuries each year. Showcasing our global leadership by promoting those standards will encourage other countries and development banks to follow suit.
To protect those traveling overseas, the State Department should make a home for global road safety. The Office of the US Global AIDS Coordinator and Global Health Diplomacy or Office of Foreign Missions are natural options. Together with Peace Corps, the State Department should also ensure accurate data on US citizens injured or killed in traffic crashes abroad and strengthen global alliances by targeting high-risk areas.
CDC can help protect students at home and abroad via its Traffic Conflict Technique Toolkit, which helps schools identify near misses. CDC should have funding for its National Center for Injury Prevention and Control to act as a road safety ambassador, training other countries on such prevention strategies. “Disease detectives” could help improve surveillance and detect outbreaks of crash-related injuries.
With the next Decade of Action for Road Safety and UN Global Road Safety Week from May 17-23, 2021, there will be plenty of opportunity to engage. US Ambassador designee to the UN Linda Thomas-Greenfield should play a lead role in the high-level meeting on global road safety to be held by 2022. This is a chance to showcase commitments and progress towards the Sustainable Development Goal that includes halving the number of people killed on our roads by 2030. Likewise she should spearhead the call for the Adolescent Health Summit, an effort to strengthen political commitment and funding to crises plaguing adolescents globally, including road traffic injuries and deaths.
Dr. Jill Biden has already shown her commitment to global road safety. In 2015, she attended a US-funded initiative to distribute motorcycle helmets to children in Vietnam. The initiative grew into a universal helmet law that saved 15,000 lives, and $3.5 billion in ten years. This is just one example of the power and need for US leadership in global road safety.
In honor of her visit, Dr. Biden was presented with a helmet proudly displayed in the White House. There is hope that global road safety will have a place in the White House once again.
Marilena Amoni, FIA Foundation Trustee, Former Associate Administrator, Traffic Injury Control Research and Program Development, and National Center for Statistics and Analysis at the National Highway Traffic Safety Administration
The Honorable T. Bella Dinh-Zarr, Former Acting Chairman, Vice Chairman, and Board Member at the National Transportation Safety Board
Tom Louizou, Former Regional Administrator, Region 2 at the National Highway Traffic Safety Administration
Jeffrey Michael, Former Associate Administrator for Research and Program Development at the National Highway Traffic Safety Administration
Richard Pain, Former Transportation Safety Coordinator at the Transportation Research Board,National Academies of Science, Engineering, and Medicine
David Sleet, Former Associate Director for Science in the Division of Unintentional Injury Prevention at the National Center for Injury Prevention at the Centers for Disease Control and Prevention