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5 Conclusions and Recommendations T he study charge asks the committee to examine the experience of other nations in reducing traffic deaths and the strategies these nations use to build public and political support for traffic safety interventions. The committee’s conclusions and recommendations in four areas are presented below: overall lessons from the benchmark nations, safety program management, countermeasures, and sources of political and public support. The conclusions identify the accomplishments of the benchmark nations, sources of success, and differences between U.S. and international practices. The recommendations, addressed to elected officials and to government safety professionals and 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 U.S. traffic safety programs. The committee’s recommendations concerning countermeasures address the areas of practice that are highlighted by the international comparisons and emphasize the areas to which the study charge refers: measures directed at driver behavior. All of the benchmark countries’ safety programs acknowledge the necessity of a comprehensive highway safety strategy that reduces crash losses through improvements in vehicle design, road design, licensing requirements, and emergency response as well as through regulation of driver behavior. LESSONS FROM THE INTERNATIONAL COMPARISONS The 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 safety improvement records indicate the potential payoffs from more rigorous safety programs and point to measures that could lead to immediate improvements. 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 2007, annual traffic fatalities declined 48 percent in France, 20 percent in Australia, and 19 percent in the United Kingdom, but only 2 percent in the United States. Some U.S. states have traffic fatality rates comparable with those of the countries with the safest roads; however, the typical speed of improvement in safety in other high-income countries is not matched in any state. Researchers do not have complete understanding of the underlying causes of long-term trends in crashes and fatalities. Identifying the countries with the most effective government safety policies would require first sorting out the effects of demographic, geographic, and economic influences. For example, results of empirical studies suggest that changes in the following factors can affect the change over time of a country’s traffic fatality rate: the median age in the population (an aging population experiences a declining fatality rate), the quantity and patterns of alcohol consumption in the general population, the overall level of road congestion (increasing average congestion slows speeds and may thereby reduce the fatality rate), and the 151

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152 Special Report 300: Achieving Traffic Safety Goals in the United States: Lessons from Other Nations quality of general medical services. Business cycles influence the fatality rate over short periods, with the rate declining during recessions. In most instances, the committee was not able to verify fully the statements of the benchmark countries’ safety agencies about the overall effects of their programs on crash losses compared with experience in similar circumstances in other jurisdictions with less developed safety programs or about the effectiveness of particular interventions that these countries used. The necessary data collection and analyses have not been conducted by the agencies or in some cases the analyses may have been done but were not examined by the committee. In reaching its conclusions, the committee relied on reports of the responsible safety agencies that appeared to be credible and for which empirical support was available. This incomplete understanding does not prevent learning from the experience of other countries. It does mean that, to identify the keys to success, singling out the countries with the lowest overall fatality rates or the fastest aggregate improvements will not be sufficient. Instead, it is necessary to identify specific safety intervention programs for which quantitative evaluation shows benefits and then to isolate the elements of those programs that led to success. The experience of the 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: High-level political commitment ensures that resources are provided, administrators are held accountable for results of safety initiatives, and systems users are held accountable for compliance with laws and regulations. Within these three areas, the most critical needs for action in the United States today may be in management and planning. Without effective management, neither elected officials’ demands for progress nor advances in safety techniques will bring about sustained reductions in crash losses. However, 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. State and local government executives and professionals responsible for highway safety are aware of potential solutions to safety problems. They are positioned to provide leadership by making concrete proposals to legislatures for comprehensive safety initiatives that promise specific results if the necessary resources and support are supplied. The development of aggressive safety programs in several of the benchmark nations (for example, in France and New Zealand) appears to have followed this path. The effective use in the benchmark nations of countermeasures that are unavailable or little used in the United States (in particular, automated speed enforcement and high-frequency alcohol testing) has received attention from U.S. observers. However, there is experience to support the view that systematic management can produce safety progress with the tool kit of

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Conclusions and Recommendations 153 countermeasures that is available to the responsible agencies. The tool kit will vary among jurisdictions depending on legal constraints, community attitudes, road and traffic characteristics, and resources. For example, in a jurisdiction where the methods of rigorous speed and alcohol enforcement typical of the benchmark countries cannot be practiced, the benefits of conventional enforcement and of passive countermeasures such as safe road design are all the greater, and progress will be more dependent on investment in these kinds of countermeasures. Similarly, if the high-intensity enforcement methods used in the benchmark countries are not available, vehicle-based safety improvements become more valuable and their implementation more urgent. In contrast, without effective management, legal authorization of new enforcement methods or increased spending on safety would be likely to yield disappointing results. Management success will depend on political support that holds administrators accountable for outcomes and provides needed resources. The countries or U.S. states that make progress will be those with the best overall long-term management of their safety programs. Any comparison of management methods in other countries with those of the United States must take into account the highly decentralized structure of U.S. government. The U.S. federal government regulates motor vehicle safety, but otherwise its involvement is indirect, exercised through rules imposed on state and local government recipients of federal highway and traffic safety grants. 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, speed limits, impaired driving, and other aspects of traffic safety. Local governments operate local streets and roads, enact local regulations, and provide local police and courts for enforcement of traffic laws within their jurisdictions. In contrast, most of the benchmark countries’ governments are relatively highly centralized; for example, a national police force may conduct most traffic enforcement. Australia’s federal system has similarities to the U.S. structure, but no country’s institutions match the thousands of U.S. entities with independent authority for public safety and for road maintenance and operation. This difference does not imply that the management practices of other countries necessarily are inapplicable in the United States, but it complicates the challenge of introducing them here. The following sections present conclusions about effective practices in the benchmark nations and possible lessons for the United States at each of the three levels of activity, beginning with management and planning. Conclusions in each section are followed by recommendations for U.S. practices. MANAGEMENT AND PLANNING OF SAFETY PROGRAMS Management is the direction of resources to attain defined objectives. The senior managers of transportation, public safety, and health agencies are expected to define traffic safety program objectives and strategies, budget and allocate resources to interventions, coordinate programs across agencies and jurisdictions, monitor the effectiveness of interventions and progress toward objectives, and interact with elected officials and the public to maintain support and justify the commitment of the required resources.

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154 Special Report 300: Achieving Traffic Safety Goals in the United States: Lessons from Other Nations Conclusions The most characteristic features of successful national safety programs are to be found in the management of the programs. The case studies in Chapter 4 illustrate the value of systematic management and evaluation in the benchmark countries’ safety programs. The following are essential elements of the management model: • A systems perspective that integrates engineering design, traffic control, regulatory enforcement, and public health methods to identify and reduce risks. This approach requires collaboration across government agencies and levels of government. • A plan that specifies goals and milestones, methods, schedule, and resource requirements. A jurisdiction’s traffic safety plan constitutes a commitment for which legislatures may hold executive agencies accountable, and the public may hold accountable the government agencies responsible for delivery. The plan provides for long-term continuity in funding and in strategies. The most credible plans quantitatively specify the expected impact of individual planned countermeasure initiatives in order to demonstrate that aggregate casualty reduction goals are consistent with the means proposed. • Regular monitoring to identify problems and measure progress toward goals and ongoing evaluation to determine effectiveness of the actions taken. In most countries, adherence to the model depends on a recognized lead government safety agency with powers to manage resources and to coordinate efforts among agencies and levels of government. The benchmark nations’ safety administrators generally acknowledge these requirements and have taken steps to implement them, although not all have yet achieved fully satisfactory implementation in all areas. In the United States, management practices in traffic safety programs typically are lacking in essential elements of this ideal management model. Meaningful goals and milestones are not published, data systems for monitoring effort and performance are inadequate, program impacts are not scientifically evaluated, and initiatives are reactive and episodic rather than strategic. Important differences between practices in the most proficient benchmark nation safety programs and common U.S. practice, as observed in the case studies in Chapter 4, are listed below. Planning and Goals The benchmark nations and all U.S. states prepare traffic safety plans that state goals for the jurisdiction’s traffic safety program for a period of several years and describe the strategies for meeting the goals. U.S. state plans as well as those of the benchmark nations commonly declare a primary goal of reducing aggregate fatalities by a certain percentage by a certain year. Such a goal is likely to be useful only if it is backed up by a quantitative plan for attainment. Otherwise, it lacks credibility and does not entail accountability. A “stretch” goal (such as Sweden’s Vision Zero program) can be constructive as a declaration of values in a high-level policy statement, but a state’s safety plan should be thought of as a business plan, which must lay out practical means to reach the stated objectives.

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Conclusions and Recommendations 155 Safety Plans The safety plan can lead to realization of goals if it specifies • Countermeasures to be used, • The budget and other resources devoted to applying the countermeasures (for example, in the program to control alcohol-impaired driving, the annual numbers of roadside sobriety checks to be conducted and the resources required for the checks), and • Projections of the expected intermediate outputs as well as the ultimate impacts of each countermeasure initiative. An intermediate output is a measure of the direct effect of an intervention—for example, the trend in median speed on a road is a measure of the effect of speed control measures over time, and the frequency of alcohol impairment among all drivers in a locale is a measure of the effect of anti–drunk driving initiatives. Published plans of the benchmark nations do not all show this level of detail. However, the continuity and stability in strategies and effort of those countries’ safety programs are evidence of substantial planning. Analytical Tools in Planning Lack of analytical tools for safety planning inhibits planning and weakens the case for safety spending in the competition for public resources. Safety planning and management require models analogous to those available to transportation administrators for air quality, pavement condition, and congestion evaluation. The necessary tools are systems for screening of road networks, diagnosis of crash causes, and selection of cost-beneficial countermeasures. Recently developed formal safety planning and management tools, as described in Chapter 3, promise benefits if the states devote the necessary resources to their proper use. Among them are the Interactive Highway Safety Design Model, an expert system to evaluate the safety of highways in the planning and design stage, and SafetyAnalyst, an expert system to screen the road network for high-hazard locations and assess costs and benefits of countermeasures. These analysis tools also can contribute to safety planning. States can use them to set quantitative targets for their hazard elimination programs and for the safety performance of planned new construction, to help guide allocation of resources among roadway safety improvements and other safety programs, and to show how capital programs will contribute to the plan’s overall safety goals. Performance Monitoring and Evaluation The benchmark nations have data systems designed to meet management needs with respect to content and timeliness (although deficiencies exist in most if not all systems). In the United States, state safety agencies lack the data systems necessary for efficient management of safety programs. The following are examples: • U.S. jurisdictions generally do not have systematic data on the frequency, locations, and results of sobriety checks. States maintain data on sobriety checkpoints and targeted patrols funded with federal grants, but the portion of the total enforcement effort that these activities constitute is unknown. The benchmark nations’ anti–drunk driving enforcement programs typically monitor all these statistics as measures of level of effort and to help in directing

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156 Special Report 300: Achieving Traffic Safety Goals in the United States: Lessons from Other Nations enforcement resources. Because of the lack of sobriety test data, U.S. data on the extent and patterns of impaired driving are incomplete and of uncertain reliability. • Few U.S. jurisdictions maintain systematic speed data. Therefore, states are handicapped in allocating enforcement resources, cannot measure the effectiveness of their enforcement or improve their enforcement strategies, and cannot observe how speed affects crash rates. In contrast, several of the benchmark nations routinely monitor speed trends, which they regard as essential information for managing and evaluating their speed control programs. • The 2010 Highway Safety Manual of the American Association of State Highway and Transportation Officials (AASHTO) and the new safety analysis tools developed by the U.S. Department of Transportation (USDOT) and AASHTO provide techniques for evaluation of the safety effects of infrastructure improvements. (See Box 3-7 in Chapter 3.) Many states will need new data systems to apply these techniques. In general, states have not had either capabilities or standard procedures for routine monitoring and evaluation of the safety consequences of infrastructure improvements. In general, the manager of a safety program, to supervise the program adequately, must track three kinds of measures: 1. Measures of enforcement or intervention effort, for example, numbers of citations issued for particular kinds of violations, numbers of alcohol tests administered, expenditures on public service advertisements, and audience ratings of advertisements. Accounting of expenditures and person-hours by safety program activity is essential in measuring cost- effectiveness and guiding resource allocation. 2. Intermediate output measures that indicate the immediate impacts of interventions: If an intervention targets driver behavior, then the behavior that it is intended to influence (e.g., average speeds and speed distributions on the roads targeted for enforcement, frequency of driver impairment as indicated by alcohol tests) should be measured so that the direct effects of interventions can be observed and as a guide resource allocation. Every intervention should have measurable intermediate outputs defined for it. If no intermediate output is monitored, management of the intervention must proceed by guesswork, and the likelihood of good results is reduced. Examples of intermediate output measures in a roadway hazard elimination program are the road protection scores assigned to roadways in the European Road Assessment Program described in Chapter 4 and counts of quantities of specific road improvements installed (e.g., as described in Chapter 3, France periodically reports the cumulative number of intersections replaced by roundabouts, and Sweden reports the miles of roads with median barriers installed). Surveys showing whether awareness of risks and attitudes toward high-risk behavior have changed among the target audience are intermediate output measures for safety advertising campaigns that are used in Australia and elsewhere. An example of an intermediate output measure for vehicle safety is the fraction of all cars on the road that meet the European Union’s highest crashworthiness rating, which is tracked by Sweden. Although the committee did not observe them in use, intermediate output measures could be developed for driver testing and licensing programs in terms of the fraction of all drivers meeting specified standards of skill, knowledge, or fitness. 3. Measures of safety impact: changes in the frequency of the categories of crashes that were targeted by the intervention (e.g., trends in speed- or alcohol-related crashes).

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Conclusions and Recommendations 157 In a well-managed program, these measures are available promptly and at a level of temporal and spatial detail allowing managers to follow events. Assembly of these data would be the basis of a real-time management information system. In addition, periodic formal evaluations of program effectiveness would be conducted by using these data and possibly specially collected data. Monitoring would be public and easily accessible, because introducing accountability would be one of the main benefits of the information system. The benchmark nations’ safety programs appear to have most of these measures in some form, although probably all have gaps. In contrast, U.S. safety programs generally are not monitored in this way; capacities for tracking enforcement effort and behavioral responses appear especially weak. As described in Chapter 3, the states and the National Highway Traffic Safety Administration (NHTSA) have a plan for more systematic monitoring of certain measures of enforcement level of effort and for beginning work on developing speed monitoring systems. Attaining the capabilities of the benchmark countries to produce measures and to use them to improve safety program effectiveness will require a major state effort not only in data collection but also in implementing fundamentally new management practices. Systems Perspective and Intergovernmental Collaboration Traffic safety policies in several of the benchmark nations call for optimizing the performance of all components of the road transportation system, including infrastructure, vehicles, and drivers, by using the full range of available tools: regulation, enforcement, judicial penalties and offender supervision, engineering and technology applications to reduce road- and vehicle- related risk, and public information and education. In the U.S. institutional setting, strong cooperation among government agencies and levels of government is a prerequisite for such a systems approach to safety. The centralized administrative structure of most of the benchmark nations allows government to act expeditiously and nationwide to coordinate activities among multiple agencies. In contrast, thousands of U.S. state and local agencies have responsibilities for public safety; for the courts; and for highway and street construction, maintenance, and operation. The states independently manage their traffic safety programs, with a degree of central control through federal-aid highway program rules and NHTSA regulations. This structural difference between U.S. institutions and most of the benchmark nations limits the transferability of management methods to some extent. Integration of law enforcement with the planning and operation of the comprehensive safety programs of the U.S. states is needed. Collaboration must involve line officers as well as leadership. The practicality and effectiveness of measures such as automated enforcement, sobriety checkpoints, and corridor safety campaigns depend on recruiting cooperation of police at all levels. Law enforcement agencies will require capabilities for training and evaluation to support their participation in safety initiatives. The U.S. federal system, although it can complicate administration, has been a source of innovation. Leadership by individual states has been crucial for safety progress and should be fostered. Examples are Tennessee’s leadership on child safety seats and leadership from Florida, Michigan, North Carolina, and other states on graduated driver licenses for young drivers in the 1990s. The U.S. federal government has used a variety of mechanisms to influence the safety policies of the states: mandates for the states to enact certain laws or be penalized by loss of a

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158 Special Report 300: Achieving Traffic Safety Goals in the United States: Lessons from Other Nations fraction of their federal highway aid or by transfer of grants from general highway construction to funds that can be used only for safety improvements; design standards for federal-aid highway projects; formula safety grants and incentive grants that reward states for enacting laws or programs meeting federal standards; and research, technical assistance, and demonstrations conducted by USDOT. These activities have had mixed success. A federal mandate has strengthened blood alcohol content (BAC) laws, but the federal speed limit and helmet use mandates met with opposition and were repealed. USDOT technical assistance programs are potentially of high value but operate with limited resources. The overall impact of federal grant programs has not been measured. Federal leadership has demonstrated its value in the past, but stronger national direction will be needed if highway safety progress is to be accelerated. Recommendations Initiatives of USDOT and AASHTO over the past decade have emphasized state and local traffic safety planning, management processes, and evaluation. These organizations have published guidelines and manuals outlining management practices that are consistent with the practices that have contributed to the successes of the benchmark nations and with the principles outlined above. Yet it is unclear that many states are making significant progress in critical elements of safety management: meaningful planning, monitoring and evaluation that support management decisions, or adoption of systems solutions to problems. Overcoming the obstacles to implementing fundamentally new management practices will require capacity building and technology transfer in support of state and local government safety programs. Highway safety is primarily the responsibility of the state and local governments that operate the road system, but federal leadership is needed to stimulate reform. Therefore, Congress should authorize and provide funding for three USDOT activities to be conducted cooperatively with the states: • A series of large-scale, carefully managed demonstrations of safety program management; • Revision of the Uniform Guidelines for State Highway Safety Programs to provide practical guidance; and • Development of a new model for state traffic safety planning. In addition, in support of reform of safety management, governments, universities, and professional organizations must strengthen the safety training of transportation engineers and other safety professionals and administrators. Large-Scale Demonstrations Congress should authorize USDOT to cooperate with selected states in organizing, funding, evaluating, and documenting a series of large-scale demonstrations of important elements of safety management. Experience suggests that communicating the concepts of safety management to the responsible jurisdictions will require a much greater level of effort than has been devoted to the task.

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Conclusions and Recommendations 159 Objectives The purposes of a demonstration 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 widely on safety program management methods, problems, costs, and benefits to transportation agencies, officials, and the public through training, publications, and other media. A fully successful demonstration would show that an efficiently managed program can reduce crash losses; gain wide recognition of this potential benefit from elected officials, professionals, and the public; and stimulate adoption of the techniques as standard practices by transportation and public safety agencies. The techniques for making highway safety progress are increasingly well attested, and initiatives are under way in the United States to promote their adoption. As described in Chapter 3, the initiatives include new requirements and guidance for safety planning, revisions of the NHTSA Uniform Guidelines, and dissemination of quantitative analytical tools. However, institutional and technical capacities required to apply these techniques are lacking. NHTSA’s speed management guideline illustrates this need: it calls for painstaking monitoring of speed and evaluation of the effectiveness of local speed enforcement, but few state or local jurisdictions have the institutional capacity or resources to carry out these activities. The demonstrations would contribute to building the necessary capacity in participating states; in USDOT; and, indirectly, in nonparticipating states. Finally, the demonstrations could be a means of introducing unfamiliar and potentially controversial safety measures in a manner that might mitigate concerns of the public, police, and transportation administrators. It would be understood that the measures would not be continued unless they proved effective; the federal government would endorse the demonstration, share in the cost, and provide technical support; and information about the demonstration and the evaluation would be readily available. Research to evaluate the effectiveness of particular countermeasures would not be a primary purpose of the demonstrations (although the evaluation results would contribute to knowledge of effectiveness). They would use countermeasures whose effectiveness was reasonably well established. Trials specifically designed to evaluate countermeasure effectiveness are a valuable research technique, but this recommendation does not address the conduct of such trials. Design Requirements The requirements for a demonstration that would be useful for these purposes are the following: • A plan containing a specific and detailed statement of goals and methods. • Scale and resources adequate to meet the goals and identified in the plan. The demonstration should be of a magnitude to allow measurement of safety impacts. • Use of state-of-the-art interventions. The plan should present a quantitative estimate of the results expected from the interventions to be used. • Provision for real-time monitoring and for scientifically rigorous independent evaluation. Demonstrations with multiple participants should use uniform evaluation methods in all jurisdictions. Monitoring must measure level of effort and intermediate outputs as well as ultimate safety impacts. • Arrangements to provide the public and officials with information about the demonstration’s objective, methods, and results in accessible form at all stages of its progress.

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160 Special Report 300: Achieving Traffic Safety Goals in the United States: Lessons from Other Nations • Provision for technology transfer; that is, ensuring that the demonstration will be useful to jurisdictions that do not participate. Documentation, full and prompt publication of results, and preparation of a variety of training and publicity materials would be required. 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). Demonstrations involving areas of state programs that are covered by the NHTSA Uniform Guidelines for State Highway Safety Programs should be designed to show how states can use the guidelines effectively. Similarly, demonstrations involving the activities that states must conduct to prepare the federally required Strategic Highway Safety Plan should show methods and results of these planning activities. The minimum necessary scale for the proposed demonstrations is suggested by examples of past demonstrations: the Minnesota 2005 speed management demonstration (described in Chapter 4), which covered major portions of the state’s road system, involved multiple local jurisdictions, had a duration of 1 year, and cost $3 million; and the Gloucester (United Kingdom) Safer City project (described in Chapter 3), which was a 5-year urban traffic safety demonstration partially funded with a £5 million competitively awarded grant from the national government. USDOT conducts demonstrations today, but they are of relatively small scale, and provisions for evaluation have been incomplete. Small-scale demonstrations with narrowly defined objectives can be useful if they are carefully designed, but they are not addressed in this recommendation. Organization To participate in the large-scale safety management demonstration program, a state would submit a proposal in response to a USDOT request. Costs would be shared by the state and the federal government. The state would operate the program, and USDOT would ensure that standards were followed and proper evaluations conducted. External technical assistance from USDOT and other expert sources would be available to participating state and local governments. USDOT would support only proposals that met minimum requirements with regard to administration, organization, resource commitment, and monitoring and evaluation. The grant program should be constructed to attract strong proposals from motivated state and local governments through the offer of substantial aid and the prospect of visible results. Strong proposals would most likely come from states in which the commitment to safety of the highest levels of government, including elected officials, was evident. Most demonstrations would entail recruitment of local government cooperation and the training of local highway departments and police. Demonstrations also would require intensive collaboration among the government agencies with safety responsibilities [police, highway agencies, emergency medical services (EMS), and the judiciary]. Certain of the Uniform Guidelines propose organizational arrangements for collaboration, for example, the speed management working groups that the guideline on speed management calls for. To help it evaluate the organizational arrangements proposed for the large-scale demonstration projects, USDOT should refer to the World Bank’s 2009 Country Guidelines for the Conduct of Road Safety Management Capacity Reviews. The checklists in that document provide a practical test of the adequacy of arrangements for attaining the demonstrations’ dual

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Conclusions and Recommendations 161 goals of building capacity in state and local safety agencies and showing that evidence-based interventions can produce sustainable and cost-effective safety benefits. To help ensure quality and credibility of results, an independent advisory and review board should observe each demonstration. Inclusion of experts from other countries on the board would add valuable perspectives. The board should be independent of the agencies conducting the demonstration, have access to all relevant information and receive regular reports from managers of the demonstration, and publish its advice and reviews. It should advise throughout the course of the demonstration and review evaluations for technical soundness. Revised Guidelines and Safety Plans USDOT should work with the states to revise the 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 state Strategic Highway Safety Plans that is more rigorous than present practice. Plans should be required to contain meaningful goals expressed in terms of quantitative measures of level of effort and of intermediate outputs (changes in driver behavior or changes in road conditions) as well as changes in frequencies and rates of crashes and injuries, specific strategies for attaining the goals that specify the countermeasures to be used and resources required, provisions for monitoring progress toward goals, and concrete provisions for interagency coordination. The more specific and detailed the plan, the more accountable officials will be for their performance. As described in Chapter 3, parts of the present guidelines are impractical because state and local governments lack necessary technical and organizational capacities. NHTSA recently has revised several of the guidelines. The experience of the demonstrations recommended above would aid NHTSA’s efforts in making the guidelines more useful and influential and would help state and local governments in strengthening the capacities needed to benefit from the guidelines. Future revised NHTSA Uniform Guidelines should make clear the priorities for action within each of the guideline areas and define the minimum requirements for an effective program. They should provide officials and the public with a benchmark for judging the adequacy of state and local resources. In addition to their present focus on process, they should emphasize measuring the impacts of safety measures. They should identify sources of detailed technical guidance for each of the recommended program elements. Each guideline should have enough detail to allow the guideline’s use as a checklist to grade a state’s program according to its degree of compliance. Direction for improving planning is provided in the Governors Highway Safety Association (GHSA) 2009 recommendations to Congress for revision of the federal highway safety programs authorized in the expiring federal surface assistance transportation act, the Safe, Accountable, Flexible, Efficient Transportation Equity Act: A Legacy for Users (SAFETEA- LU). Four of the recommendations relate to planning. In them, GHSA proposed that Congress • Encourage states to apply performance-based planning (i.e., to use a minimum, standard set of performance measures in their planning) and fund development of performance measures, • Increase federal aid to the states to fund safety data improvements,

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162 Special Report 300: Achieving Traffic Safety Goals in the United States: Lessons from Other Nations • Strengthen state Strategic Highway Safety Plan requirements, and • Authorize development of a National Strategic Highway Safety Plan. Enactment of these provisions in the successor legislation to SAFETEA-LU would be consistent with the committee’s recommendation above for action to strengthen state safety planning capabilities. Independent Evaluation and Research Capability Congress should consider designating and funding an independent traffic safety evaluation and policy research organization. This entity would have three charges: (a) to provide technical support in development of interventions and management methods, (b) to advise senior executives and elected officials on policy, and (c) to reinforce accountability of the operating agencies to legislators and the public through independent performance evaluations. The entity would have independent authority to review and advise federal programs and could offer services to a state at the state’s request. This charge could be given to an existing organization (e.g., a university-based research organization) or to a newly created entity. Organizations with these functions have made important contributions to safety progress in the Netherlands, Australia, France, and the United Kingdom. Their objective evaluations have strengthened the position of the safety agencies interacting with elected officials and the public by showing that the agencies’ actions and proposals are evidence-based and can be expected to produce results. Several U.S. organizations now perform some of these functions at the national level, including USDOT, the National Transportation Safety Board, and the Government Accountability Office. However, none of these organizations has both independence from transportation program administrators and the broad charge to review safety performance on a regular basis and from the point of view of the entire system. Professional Development Transportation agencies should take into account demonstrated competency and professional qualification in highway safety in their hiring and promotion decisions. Engineering schools and state engineering accreditation associations should set standards for safety competencies of engineers practicing in areas that affect highway safety. It was noted above that overcoming the obstacles to implementing fundamentally new safety management practices will require substantial effort toward capacity building in government agencies responsible for safety. This effort should encompass professional training. Professional training in road safety management is lacking in U.S. engineering schools. The 2007 report of the Transportation Research Board’s (TRB’s) Committee for a Study of Supply and Demand for Highway Safety Professionals in the Public Sector (TRB Special Report 289) noted inadequacies in education and training programs and recommended that state government safety agencies and USDOT directly engage universities to advocate and promote development of comprehensive education programs for road safety professionals. The National Cooperative Highway Research Program (in Project 17-40) has defined a set of core competencies for traffic safety professionals and is developing and testing a model curriculum to impart these competencies.

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Conclusions and Recommendations 163 Administrators in state and local government traffic safety programs are not all engineers but may have professional training in public administration, public safety, or an applied social sciences field. Outside engineering schools, few specialized education programs would have a sufficient concentration of future transportation professionals among their students to justify a traffic safety curriculum. Therefore, in addition to training in university curricula, in-service training programs are needed, especially short courses designed for local government public works engineers. TECHNICAL IMPLEMENTATION OF COUNTERMEASURES A countermeasure is a law, regulation, enforcement method, or engineering technique intended to reduce a specific targeted risk. Emergency response capabilities, adjudication practices, and public information programs also are forms of countermeasures. As explained above, the committee examined the application of selected categories of countermeasures as case studies to compare safety practices internationally. The case studies provided the basis for the conclusions and recommendations presented below. The study did not survey the use or results of all countermeasures employed, and therefore the recommendations are not intended as a complete catalog of opportunities for improving the effectiveness of countermeasures. Conclusions Safety officials in the benchmark nations have attributed progress to their implementation of comprehensive safety programs, which 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 lawmakers, road authorities, the justice system, and public health officials. 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 and widely credited with contributing to fatality reductions in the benchmark nations are automated enforcement of speed limits and high-frequency 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. The deterrent effect is reinforced with social marketing. Neither technique is in common use today in the United States. Because of the constitutional protection against unreasonable searches and seizures, U.S. police cannot legally require a sobriety test without probable cause (i.e., a reasonable suspicion that a violation has occurred). Automated enforcement has proved to be controversial and politically unpopular in some U.S. jurisdictions that have applied it, although progress has been made in gaining acceptance of the technique.

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164 Special Report 300: Achieving Traffic Safety Goals in the United States: Lessons from Other Nations Despite these differences, the benchmark nations’ enforcement practices provide important lessons applicable in the United States. They demonstrate that sustained and intensive enforcement, rationally organized and managed, can alter driver behavior sufficiently to produce worthwhile systemwide safety improvement. Enforcement probably is more expensive in the United States because of restrictions on the techniques used; therefore, resources must be employed judiciously. However, benefits ought to be attainable in the United States by using the available enforcement techniques to their best effect. The subsections below present conclusions with regard to five kinds of countermeasures: prevention of alcohol-impaired driving, speed control, motorcycle helmet use, seat belt use, and highway network screening and corridor safety improvement programs. The conclusions include estimates of the order of magnitude of reductions in annual fatalities in the United States that might be practically attainable with application of certain of the countermeasures described. Such estimates are highly approximate. Outcomes would depend strongly on the level of effort and expenditure devoted to the countermeasures and the quality of management of safety programs. The benefits of implementing multiple countermeasures would not necessarily be additive; for example, if improved enforcement caused the frequency of impaired driving to decline, then the fatality reduction benefits of programs to increase seat belt use might decline because crashes became less frequent or because sober drivers are more likely to use seat belts. Prevention of Alcohol-Impaired Driving Several of the benchmark countries (including Germany, the United Kingdom, Sweden, and the Netherlands) have reported lower rates of alcohol involvement in crashes than has the United States consistently for many years. To what extent these differences result from differences in impaired-driving laws and programs rather than from differences in patterns of alcohol use or other social differences is unknown. The United States and many other countries, including Great Britain, Australia, and Sweden, have experienced slowdowns or reversals of progress in reducing alcohol-related traffic fatalities since the 1990s. Again, the causes are not well understood. The two most evident differences between drunk driving countermeasures in the benchmark countries and those in the United States are the legal maximum BAC limits and the intensity of enforcement efforts. Research supports the effectiveness of lowering the BAC limit and of high-frequency testing (by means of sobriety checkpoints) in reducing alcohol-related motor vehicle fatalities. The BAC limit is 0.8 g/L (0.08 percent) in the United States and 0.5 g/L (0.05 percent) 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 1 test per 3.6 registered drivers per year in France and 1 test per 2.6 drivers in Sweden. In the Australian state of South Australia, the rate is 1 test per 1.6 registered drivers per year, and other Australian states maintain similar rates. Most European countries and Australia conduct random roadside alcohol checks. In the United Kingdom, where testing restrictions are similar to those in the United States (although more permissive), the rate is 1 test per 56 drivers annually. No systematic U.S. statistics on testing frequency exist, but the U.S. rate probably is well below the British rate. A 2003 survey found that only 11 U.S. states operated sobriety checkpoints as often as once a week. Roadside sobriety checkpoints, operated by most U.S. states following protocols dictated by court decisions and state laws, make heavy use of police resources. To apply this technique

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Conclusions and Recommendations 165 effectively, there is need for design and evaluation of alternative strategies for deploying checkpoints; demonstration of the value of the best strategies to legislators, police officers, and the public; and provision by legislatures of budgets and personnel required to maximize the cost-effectiveness of the technique. Research in the United States has shown that frequent use of small-scale checkpoints (staffed by three to five police officers) can effectively reduce alcohol- related crashes. All countries recognize that enforcement is only one aspect of the program required to combat alcohol-impaired driving. The program must include public health measures to prevent, identify, and treat alcohol abuse; public education programs on the costs of drunk driving; and judicial procedures that allow efficient adjudication of alcohol-impaired driving cases and intensive follow-up on offenders and penalties. For follow-up, ignition interlocks (devices installed in vehicles to prevent operation by any person with BAC over a specified level) recently have been recognized as an effective means to reduce recidivism. In countries that have instituted sustained, high-frequency programs of preventive (i.e., not exclusively subsequent to a crash or violation) sobriety testing, including Australia, Finland, and France, reductions of 13 to 36 percent in the annual number of alcohol-involved fatal injury crashes have been achieved. Evaluations of intensive campaigns of selective testing at sobriety checkpoints in U.S. jurisdictions (following procedures now legal in most states) have reported reductions of 20 to 26 percent in fatal injury crashes involving alcohol use. In the United States in 2007, 13,000 persons were killed in crashes involving a driver who was alcohol-impaired. Therefore, 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 (0.05 percent), combined with more intensive enforcement, would reduce U.S. fatalities further. Evaluations of the effects of reducing the limit from 0.8 g/L (0.08 percent) to 0.5 g/L (0.05 percent) in the Netherlands, Austria, France, and Australia found that the change reduced alcohol-impaired driving and crashes and that at least part of the effect was independent of any concomitant changes in enforcement. Speed Control Governments in several countries today place high priority on speed control in their safety strategies on the premise that reducing speeding can immediately reduce the frequency of fatalities and injuries and therefore is a necessary element of national plans that specify demanding road safety targets. Successful speed management initiatives in other countries are of high visibility (through public outreach and endorsement of elected officials), are long term (planned and sustained for periods of years), target major portions of the road network, sometimes use intensive enforcement methods (for example, automated enforcement and high penalties), use traffic calming road design features in urban areas, and monitor progress toward publicly declared speed and crash reduction objectives. No U.S. speed management program in operation today is comparable in scale, visibility, and high-level political commitment to the most ambitious speed management programs in other countries. Traffic safety experts in the United States have advocated a more selective initial application of automated enforcement than has been the practice in the most ambitious safety programs in the benchmark nations. Automated speed enforcement may be most readily

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166 Special Report 300: Achieving Traffic Safety Goals in the United States: Lessons from Other Nations introduced in locations such as work zones, where a need can be demonstrated and public acceptance is easier to gain. The evidence from numerous research studies, synthesized in several credible reviews, is that reducing the mean speed on a road reduces injuries and fatalities in crashes on the road, when traffic volume is controlled for (i.e., speed reductions reduce casualty risk). Methodological difficulties in such research imply that estimates of the relationship between speed and casualty frequency have considerable uncertainty. Nonetheless, the assumption that decreasing mean speed will reduce casualty rates is one of the foundations of traffic safety programs in the benchmark countries, and the success of these programs in France, Australia, and elsewhere adds credibility to the assumption. The cost-effectiveness of conventional speed enforcement strategies in the United States is uncertain. The most ambitious enforcement method commonly applied is the high-visibility enforcement campaign, which combines increased frequency of police patrols on a targeted portion of the road system with a publicity campaign to inform the public that speeders are likely to be ticketed. These campaigns typically are short term and do not use automated enforcement. Evaluation to measure the costs of alternative enforcement strategies and their effects on speed and casualties should be a research priority. In countries that have implemented sustained, wide-area speed control programs using automated enforcement, including France and Australia, reductions in average speeds in free- flowing traffic on the order of 3 mph have been attained, and the incidence of speeding more than 6 mph over the limit typically has been reduced by about half. In the United States, a 1-year trial speed management program in Minnesota attained average speed reductions on the order of 1 mph on rural roads and urban expressways and substantial reduction in the frequency of speeding by using available personnel (diverted to speed enforcement from other duties). Standard methods of patrol and speed measurement were used, but more intensively; the trial did not involve automated enforcement. Syntheses of research on the effect of changes in average speed on crash rates have concluded that a 1 percent reduction in average free-flow speed on a road system can be expected to yield about a 4 percent reduction in crash fatalities (although the body of research on this relationship is not definitive). These data suggest that systematic speed control programs applied nationwide in the United States could save 1,000 to 2,000 lives annually at a feasible cost and with standard enforcement techniques (i.e., without use of automated enforcement). Programs with greater resources or that improved cost-effectiveness by using automated enforcement could achieve better results. Motorcycle Helmets Laws in every benchmark country require motorcycle riders to wear helmets. Only 20 U.S. states have such laws. Research has demonstrated that helmet laws substantially reduce the risk of death or injury from riding a motorcycle. Historically in the United States, enacting a helmet law has led directly to safety benefits; that is, implementation of the law has not been an obstacle. In contrast, in other areas of highway safety, such as speed control and roadway hazard elimination, effective implementation poses great management challenges and is critical for success. Well-organized grassroots advocacy by motorcyclist groups opposing helmet laws has been highly effective, as such advocacy often is in the United States on issues that most affect a single well-defined group and that do not attract strong interest in the general population. The

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Conclusions and Recommendations 167 importance of advocacy groups may be a significant difference between the process of forming safety policy in the United States and that in many other countries. NHTSA studies of the consequences of changes in helmet laws suggest that if all states had universal helmet use laws, on the order of 450 motorcyclist deaths per year would be avoided. Occupant Restraint Laws 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 exceeding 90 percent. The U.S. average in 2010 was 85 percent; 47 percent of passenger vehicle occupants killed in crashes in 2009 were belted. 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 in the United States in raising the use rate. Nearly every high-income country requires rear seat occupants to wear seat belts; only 20 U.S. states have this requirement. Highway Network Screening and Corridor Safety Improvement Programs State hazard elimination programs, funded by federal-aid funds earmarked for the purpose, have tended to operate in isolation from other state highway and safety functions. The effectiveness of these programs has never been adequately evaluated. Recently, efforts have been made to integrate these programs more closely with mainstream state transportation and safety activities. The new federal Highway Safety Improvement Program increased funding and required that the state hazard elimination program be developed within the framework of a state Strategic Highway Safety Plan to ensure broad collaboration in forming the program and consideration of the full range of countermeasures. Two evaluation practices in use in the benchmark nations, road safety audits and road assessment programs, are bringing greater attention to the problem of upgrading the inherent safety of road infrastructure. Road safety audits are formal, independent examinations of the safety of the design of new road projects. (Similar procedures have been developed for roads already in use.) Audits originated in the United Kingdom, are practiced in Canada, Australia, and New Zealand, and are beginning to be conducted in the United States. Road assessment programs, in operation for several years under the sponsorship of automobile clubs in Europe and Australia and under development in the United States, are an important experiment in highway safety action. They are nongovernmental efforts that aim to increase public demand for safety and make public officials more accountable for the safety performance of highways by revealing and publicizing the differences in crash risks among roads. Safety corridor programs, now in operation in several states, constitute a more comprehensive and systematic approach to reducing the risk of travel on a particular road than the traditional infrastructure-oriented hazard elimination program. These programs identify highway corridors that demand high priority for crash reduction. Corridor treatments are designed that combine enforcement, publicity, engineering improvements, and EMS improvements. Coordination is required with local governments on enforcement and EMS and with the state’s capital programming process where capital improvements are called for. The corridor program will be most effective if it is guided by a systematic analysis of the state’s highway system that selects corridors and designs improvements with crash risk and cost-

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168 Special Report 300: Achieving Traffic Safety Goals in the United States: Lessons from Other Nations effectiveness as the basis for decisions. The risk maps of usRAP (the U.S. Road Assessment Program) and the corridor screening method in SafetyAnalyst (see Box 3-7 in Chapter 3) are two tools that can be used to identify corridors in greatest need of improvement. The safety corridor approach, combined with the safety planning and analysis tools now becoming available to the states, hold the promise of integrating safety improvement goals into highway planning and management far more effectively than the traditional hazard elimination programs. Road safety audits, road assessment programs, and safety corridor programs all represent a positive, systematic approach to infrastructure safety. They actively and continuously seek opportunities to avoid casualties, in contrast to the reactive perspective of traditional hazard elimination programs. Recommendations If state and local governments seek to match the performance of the benchmark nations, they should recognize that additional resources for enforcement will be required. The level of enforcement can be increased by managing existing resources more effectively; increasing funding for conventional enforcement methods; and adopting more cost-effective enforcement methods, in particular, automated enforcement. Cost-effective enforcement methods maximize the impact on crashes and fatalities for a given amount of law enforcement resources. Enforcement budget data were not available to the committee; however, high-intensity enforcement programs like the alcohol and speed control programs of the benchmark nations evidently have high costs in personnel and other resources. The experiences of the benchmark nations as well as research on the effectiveness of interventions suggest that greater investment in enforcement can be cost-effective if the effort is guided by appropriate management techniques. Increased resources for enforcement would necessarily entail increased resources for the essential supporting activities of training, management information systems, and evaluation. Increased resources will be needed at the federal level for USDOT research, training, and technology dissemination functions that can be valuable aids to state efforts to upgrade enforcement techniques. The states and USDOT should give high priority to initiatives to encourage adoption of camera enforcement and regular use of sobriety checkpoints. The needs include research to design and evaluate methods for using these enforcement techniques effectively (for example, the small-scale sobriety checkpoints whose use is promoted by USDOT); definition of detailed guidelines for their application; evaluations that document the value of these techniques as elements in an overall enforcement strategy; communication to inform elected officials, police officers, and the public of the value of the techniques; and training programs for police in their application. Evaluations should ensure that the safety benefits of the techniques adopted justify their costs in agency resources and in road user delay and inconvenience. Application guidelines should be developed with the active cooperation of the International Association of Chiefs of Police. Federal safety grant programs dedicated to these enforcement techniques would aid in their promotion. NHTSA grant program rules should explicitly highlight these techniques as eligible for funding in all existing programs where they are allowable expenditures. Police in all states should have authority under state law to operate sobriety checkpoints and to use speed cameras.

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Conclusions and Recommendations 169 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. NHTSA and the state safety agencies also should place high priority on design, evaluation, and implementation of effective motorcycle safety measures other than helmet use laws. Such measures may include speed enforcement, training and licensing requirements, more effective enforcement of licensing requirements, fees commensurate with public costs, insurance requirements, publicity campaigns, and reforms in penalties for violations and in follow-up monitoring of offenders. Each state should ensure that local police receive regular and substantial training in enforcement against impaired driving, speeding, and other high-risk driver behaviors. The experience of NHTSA demonstration programs shows that local police often lack the level of training necessary for successful enforcement. Training also should impart to police officers the value and importance of safety enforcement. The states and USDOT should refine the traditional practice of the hazard elimination program into a corridor safety improvement program that systemically identifies high- priority corridors, designs comprehensive safety improvement strategies for each corridor encompassing physical improvements and enforcement, and routinely evaluates the impacts of the strategies implemented. Road safety audit reviews would be a component of such a program. POLITICAL LEADERSHIP AND PUBLIC SUPPORT Successful safety initiatives in the benchmark nations that the committee examined have had the advantage of genuine and active support of elected officials in almost all cases, although elected officials were not necessarily the originators. In addition, sustaining the initiatives has depended on eventually gaining the trust of the public. Conclusions Although no universal prescription can be offered for earning political and popular support for ambitious traffic safety interventions, the international case studies and the experiences of U.S. states that the committee examined suggest the following observations on how support came about: • Building support commonly is a long-term process. Gaining support for seat belt regulations and changing public and official attitudes toward impaired driving in the United States have been matters of slow progress over decades. Similarly, safety programs in the benchmark countries have long histories of evolutionary development and learning through experience. • Creating new high-level institutional structures has been a vital step in the evolution of programs in certain of the benchmark nations. For example, a ministerial-level committee in France oversees and directs the national traffic safety program. These groups meet regularly and interact with public administrators and professionals. Such arrangements reinforce accountability of managers to the legislature and of the legislature to the public. In contrast,

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170 Special Report 300: Achieving Traffic Safety Goals in the United States: Lessons from Other Nations legislative interest in the U.S. states tends to be episodic (for example, when a controversial law is proposed), and the continuing and routine aspects of safety programs seldom receive legislative oversight or high-visibility political support. • The programs have emphasized transparency with respect to goals and in public communications. Public statement of specific and credible goals is essential for accountability. In several of the benchmark countries, prominent independent research centers evaluate and publicize progress toward goals. Making public the motivation and expected benefits of enforcement campaigns can help reduce skepticism in the community. • In at least some of the benchmark countries, regular communication channels exist among the road safety agency, police, and researchers, and forums exist for interaction of legislators with professionals and researchers. The Australasian College of Road Safety is an example of an organization providing opportunities for multidisciplinary interaction. The benefit is a common understanding of safety problems and solutions. • Public administrators and professionals often have been the initial leaders in educating and developing support among elected officials and the public. The evolution of policies in France, Australia, New Zealand, and several U.S. states illustrates this pattern. It has been necessary for safety programs to pull themselves up by their own bootstraps; that is, to build public and political support over time through transparency with regard to goals and methods, public communications efforts, and demonstrated results. • 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). The objectives of publicity campaigns have been to amplify the deterrent effect of enforcement and to influence public attitudes toward high-risk behavior. Publicity campaigns have been scientifically designed and evaluated. Social marketing of safety programs is highly developed in Australia, New Zealand, the United Kingdom, Ireland, France, and other benchmark countries. The benchmark nations’ publicity campaigns serve dual functions: they directly affect driver behavior, amplifying the effect of enforcement, and in the longer term they affect public attitudes toward unsafe driving and rigorous enforcement. The programs share a number of key features: a repeated theme is the consequences of failure to obey the law; advertisements use emotion and realism; funding is sufficient for high production values and prime time broadcasting; each campaign has a single, focused message; publicity is synchronized with enforcement; and the effectiveness of the activity is scientifically evaluated. Safety advertising campaigns in the United States usually lack some of these key features. In general, U.S. campaigns do not show awareness of the lessons learned in other countries with extensive experience and evidence of success. Recommendations Each state legislature should require the responsible executive agencies to report regularly to it on progress on fulfilling the state’s safety plan and success in meeting the plan’s goals. The legislature should expect agencies to report up-to-date summaries of each of the three kinds of program measures defined in the section on management: measures of level of effort and resources expended, measures of intermediate impacts of efforts (for example, changes in the frequency of speeding and of alcohol-impaired driving), and the final impact on numbers of crashes and casualties related to the risks that state programs are targeting. The agencies should

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Conclusions and Recommendations 171 be required to publicize these reports. Legislatures should consider linking their reviews of agency performance to the budget process; that is, requiring programs seeking continued funding to report on their past effectiveness. 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. Then one or more pilot campaigns should be conducted to test and demonstrate social marketing methods at the level of the international state of the art, ideally as components of some of the large-scale demonstrations recommended above, with partial federal funding and federal oversight of evaluation. 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. Cultivation of working relationships among these groups will be necessary for implementation of long-term, systematic traffic safety strategies. Public agencies should cooperate in the development of usRAP, but the program must maintain independence, which is necessary for its effectiveness. The road assessment programs in Europe and Australia are important examples of an innovative technique to engage the public in safety, to increase understanding and support of public agencies’ safety programs, and to reinforce public agency accountability for safety. All states should enact the minimum framework of traffic safety laws that has been instrumental in achieving the safety improvements that the most successful benchmark country safety programs have attained. According to ratings of state laws applied by the Insurance Institute for Highway Safety, only 16 states have adequate laws (rated “good” or “fair”) in as many as five of six key areas of traffic safety (strict impaired driving enforcement, meaningful restrictions on young drivers, primary enforcement of seat belt use, strong child restraint requirements, mandatory helmet use, and authorization of camera enforcement at red lights). In addition to the laws on this list, all states in which existing law impedes its application should enact enabling legislation for automated speed enforcement. Safety professionals in the states and at USDOT can promote improvements in traffic safety laws by conducting evaluations that show the benefits of enacting the laws and by thoughtfully planned efforts to communicate information on benefits to elected officials, senior agency administrators, and the public.

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