UN Global Road Safety Week: A Call to Move Evidence to Action for Effective Leadership
May 3, 2019
By: Alex Quistberg, PhD, MPH
Assistant Research Professor
Dornsife School of Public Health
May 6-12, 2019 marks the Fifth United Nations Global Road Safety Week, a platform for awareness, education and advocacy to target the worldwide epidemic of traffic injuries and deaths. This year’s focus is specifically on the role of leadership and action to advance road safety, a theme increasingly pertinent to urban health and development. There is substantial evidence to guide the policies that leaders, whether in government, education, the private sector, NGOs, or other types of agencies, can enact to prevent or reduce the roughly 1.35 million road traffic deaths and 50 million more injuries annually.
Evidence-based road safety policies can all help save lives and prevent lifelong disability and economic hardships due to road traffic incidents. These types of policies can include:
- guaranteeing and protecting the right-of-way to vulnerable road users (e.g., pedestrians and pedal cyclists)
- reducing roadway speeds
- requiring use of safety belts and child passenger safety devices
- prohibiting driving under the influence of alcohol and/or drugs
- enforcing mandatory helmet laws for motorcyclists
Much of the evidence for these policies and interventions has originated in high-income settings, though roughly 90% of road deaths occur in low- and middle-income countries. This disconnect creates challenges to implementation and enforcement. Some of these challenges may include limited financing, a lack of coordination between agencies, vaguely written policies or legislation, a lack of authority or a mandate, lack of perseverance, a lack of popular support, changes in leadership, as well as many other factors.
As part of its activities, the Salud Urbana en América Latina (SALURBAL) project has several studies focused on the role of urban built environments such as form (i.e. centrality, sprawl), landscape metrics, characteristics of street design and connectivity, and transportation infrastructure in influencing traffic injuries and mortality. These studies are utilizing data compiled and harmonized for SALURBAL’s data platform for within-city and cross-city comparisons. SALURBAL is also conducting an evaluation of Mexico City’s Vision Zero policy for its effects on crashes, fatalities and air pollution. The evaluation team is working to integrate data sources and collect geocoded crash records linked to the characteristics of the roadways on which they occurred to assess the effects of Vision Zero regulations over time. Evidence generated from SALURBAL will help to design and implement interventions and other prevention efforts, responsive to the types of strategies that work and the mechanisms behind effective action.
Challenges to implementing and enforcing road safety policies may seem insurmountable to many leaders, who may forgo attempts to address road safety issues, may only enact policies without an expectation that they are implemented, or may only support the policy for a brief period. However, actions grounded in available evidence and best practices, importantly Global Road Safety Performance Targets, can help policymakers identify a path forward.
Recommendations for Leaders
HAVE A PLAN
The planning stage should involve road safety experts from public health, medicine, transportation, urban planning, law enforcement, emergency responders, the judicial branch, motor vehicle manufacturers, schools and universities, NGOs, and the general public. Professionals from these different areas all have specializations that contribute to improving road safety, but collaboration between is needed to ensure effective policies are enacted and have support from those implementing them.
BRING TOGETHER DIFFERENT SECTORS
Building rapport and respect between these stakeholders through regular meetings and collaborations is necessary to strengthen the group, as well as seeking “low-hanging fruit” to accomplish road safety goals. Such goals may include describing and quantifying the road safety issues nationally including identifying subpopulations or geographic areas more affected than others, passing legislation and enacting a policy that is agreeable to multiple sectors and that has popular support, and/or conducting a public education and information-seeking campaign.
A key to setting goals and actions is to ensure appropriate data is being collected via surveillance of road traffic injuries and deaths. Police reports, death records, and/or hospital records are typical sources for surveillance, though each has important limitations. Initially, it is likely that the understanding of road safety issues will be limited, though key issues that are common across countries are speeding by motorists, alcohol or drug use by road users, use of safety devices (e.g., safety belts or helmets), and distraction from mobile devices.
MONITOR AND TRACK CHANGES
Establishing an integrated and comprehensive surveillance system should be a key long-term goal. The system should include information about the road traffic incident victims from the time of the injury until death or recovery, such as police collision reports, emergency response services, hospital records, insurance records, and rehabilitation records. Surveillance should include information about the road environment and contributing causes. Death records must be accurately and completely coded with the appropriate and corresponding ICD-10 external cause of injury codes. Integrating data from different sectors is a major challenge, but the benefits for understanding and measuring road are immense.
Ideally, national governments will set road safety standards and policies, and city and local leaders will enact those and will have some flexibility for implementation in their jurisdiction. Additionally, while many road safety efforts may rely on actions by the national government, there are often actions that leaders in city and other subnational governments can do to address road safety in their jurisdiction, especially if national action is absent or limited. Much of what this blog describes applies to how cities can take action towards road safety, especially as they are more directly responsible for many aspects of preventing and reducing road traffic injuries and deaths in their jurisdictions. Some of the ways that city and local leaders can improve road safety include:
- adopting a Vision Zero strategy to reduce traffic fatalities and severe road injuries to zero
- ensuring urban planners and traffic engineers consider all road users, particularly vulnerable road users like pedestrians, as they design roadways, neighborhoods and infrastructure
- setting policies that encourage active forms of transportation like walking or biking or public transportation
- measuring mobility regularly in the city to determine how city residents get around and where the transportation system can be strengthened and safety can be improved
- assessing inequality in mobility options and road safety by different neighborhoods of the city
This week’s visibility and call to action is a reminder of the progress that can be made through effective leadership and multisectoral approaches driven by data and evidence. Generating, sharing and tracking evidence regarding predictors of crashes and intervention sites provide leaders with the tools to make the best possible decisions. National, local and city leaders can do their parts to prioritize these issues, by providing institutional support and financial backing of multisectoral initiatives and delivering policies and laws that are clearly written with compliance and enforcement mechanisms. Now is the time to act to save lives throughout the globe by harnessing resources and capitalizing on unique strengths to build safer environments from our roadways to our legal regulations.
Global status report on road safety 2018
This post was written as a contribution to Cities, Sectors, and Health, run by SALURBAL. To contact the blog or learn more about the SALURBAL project email firstname.lastname@example.org.