vehicle injury and on adolescent alcohol use and high-risk driving behaviors; the National Institute for Occupational Safety and Health (NIOSH) studies work-related vehicle safety issues; and the Health Resources and Services Administration and the National Center for Injury Prevention and Control (NCIPC) have funded EMS and trauma systems development and evaluation research. Further, there has been a significant private-sector investment in research through the automobile manufacturers, the Insurance Institute for Highway Safety (funded by more than 75 insurance companies), and nonprofit consumer groups.

State and Local Programs

The Highway Safety Act of 1966 created a partnership among federal, state, and local governments to improve and expand the nation's highway safety activities by establishing the State and Community Highway Safety Grant Program (the Section 402 program) (NAGHSR, 1998). This program's funding has provided for the establishment of a highway safety office in every state, headed by a Governor's Highway Safety Representative, and has enabled a state-level focus for coordinating traffic safety efforts. State offices of highway safety often work closely with driver licensing, driver education, state police, public health departments, and state highway departments, and provide a coordinating function across state agencies that have some responsibility for highway safety. Examples of effective use of 402 funding include evaluation of the effectiveness of motorcycle helmet laws, innovative programs to increase safety belt use, design and implementation of improved driver license examinations for different classes of vehicles, child safety seat programs, and evaluation of effects of changes in speed limits. The 402 programs enable states to serve as laboratories to test new highway safety programs; successful programs are adopted nationwide.

Public Support

Public support for motor vehicle safety has also played a role in the progress achieved, through the burgeoning interest in vehicle safety and consumer movements. A remarkable surge in interest in vehicle safety has occurred in the past decade with the maturation of the ''baby boom" generation. This increased interest has, in turn, provided overall support for highway safety initiatives, particularly child safety, and has influenced automakers to provide and emphasize safety features and to compete in a safety marketplace.

Additionally, citizen activist groups such as Mothers Against Drunk Driving and Remove Intoxicated Drivers have been influential in improving highway safety. These groups elevate the visibility of the families of victims who died as a result of drunk driving and influence the public agenda, bringing pressure to bear on policy makers.

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