Road trauma – a preventable epidemic

Yesterday, globally, over 3700 people lost their lives in road crashes. Across the world, there were knocks on the doors of thousands of families affected. Phone calls were made and messages sent, as grief and shock spread. Those who have experienced the sudden unforeseen loss of someone close to them know the feelings evoked only too well.

Today, the events from yesterday will repeat over 3700 times, and the same will occur tomorrow. Tragically, this is a daily reality that equates to over 1.35 million road deaths around the world each year.

In New Zealand, the grief has no less impact. Increasingly here, media coverage is compelled to describe road trauma as a ‘horror crash’. This is where multiple fatalities have occurred in a single crash. Interviews appear with friends and family who describe whom the victims were and the grief, and often include the resonating comment ‘I’ll never get over it’. For many, that will be true. The sudden preventable loss of a loved one, in an entirely preventable road crash, creates indescribable despair.

Sadly though, the news cycle moves on, there is no ‘call to action’, no ‘crisis meeting’ demanded, no insistent cry for immediate solutions, and the carnage is allowed to continue.

However, when highly effective activity is begun – activity such as rigorous speed enforcement, which research has proven will reduce road trauma – such action is often wrongly criticised. It is dismissed as revenue raising, or as being ineffective, and commentators ignore the tidal wave of evidence that demonstrates how enormously effective such enforcement actually is.

In the face of baseless criticism and generally little vocal public support, the police back off and the behaviours that kill and injure on the road continue.

Primal instincts

The question for those of us working in the road safety community is why? Why is there not the same outrage, the same demand for immediate and effective action, and a genuine crisis response as there is to other tragic losses of life?

One academic offers an explanation. In a book entitled ‘Risk Savvy: How To Make Good Decisions’, German psychologist Dr Gerd Gigerenzer lays out ways in which ordinary people can make better decisions. In his very first chapter, he asks ‘Are People Stupid?’ The answer is no, but rather, alongside statistical information, ‘being risk savvy requires a basic knowledge of our intuitive psychology …’

Gigerenzer argues that in our primal past, human beings lived in small hunter-gatherer communities that were generally made up of 20–50 people, with the largest groups being 100 or so. In these communities, what people feared was not the random deaths that occurred from time to time, as these did not threaten the survival of the group. What was feared more was mass death.

Mass death within a community puts survival of the whole group in jeopardy. Therefore, he concludes, as human beings we continue to fear mass death events such as aircraft crashes, a pandemic or a terrorist event where there are mass casualties. These scenarios trigger deep fears within each of us.

For example, typically, we have little fear when we get behind the wheel of our car, or riding in a taxi as a passenger, but many people fear flying. This is despite of the reality that aircraft travel is infinitely safer than travelling on the road.

For aircraft travel to result in the same absolute levels of trauma as road transport, 23 mid-size airliners would need to crash and kill everyone onboard every day to keep up with the levels of trauma that occur on the road. This would never be tolerated.

Furthermore, another 230 mid-sized airliners would need to crash each day and injure all onboard to equate to the number of people who are injured worldwide in road crashes each year – estimated at around 20–50 million.

A dispassionate approach

If Dr Gigerenzer is right, then appealing to mass emotion as a way of generating intolerance for preventable road trauma is unlikely to be the answer. What may be required is a more dispassionate approach – one based on the unacceptable economic costs of failing to deal with the road trauma epidemic.

Taking New Zealand as an example, road traffic deaths reduced to 253 in 2013 and a rate of 5.7 deaths per 100,000 population. The social cost of each road fatality in 2015 was calculated at $4.06 million and the total cost of crashes was estimated at $3.79 billion. By any measure, the costs even in 2013 were too high.

Since 2013, road deaths have been consistently increasing, and by 2018 had reached 377 and the rate per 100,000 had increased to over 7. The best-performing nations have reduced their road fatality rates to just 2.7, dramatically lower than New Zealand. New Zealand’s failure to reduce road deaths has resulted in hundreds of millions of dollars of additional cost every year and incalculable pain. However, when serious injury costs are considered, the situation is even worse.

A helpful barometer to track road trauma beyond fatalities is to measure crash casualty hospitalisations of longer than 24 hours – data collected by hospitals. This measure tracks whether a crash casualty remains in a hospital for longer than 24 hours, which is a useful proxy for serious crash injuries that require expensive and, in many cases, long-term treatment and rehabilitation.

In 2015, the lowest level of hospitalisations over a 12-month period was recorded as 2615 casualties. However, by March 2018, casualty numbers had increased to 3378.

This number of casualties is approximately the same number as was recorded 10 years earlier. In other words, 10 years of progress has been eroded, inflicting major costs on already strained health and rehabilitation services, and often leaving thousands of crash victims with preventable lifelong disabilities.

What has gone so wrong?

Rural roads currently generate over 70% of all New Zealand fatalities – the impact of an open-road speed reduction would be enormous

When crash fatalities and hospitalisations are viewed in combination, they demonstrate an alarming and unprecedented increase in road trauma which begs the question: what has gone so wrong with road safety in New Zealand?

The reasons are complex. However, there is no question that this situation represents a tragic failure to protect road users from trauma levels that are well above those of the best-performing countries in the world. The proverbial elephant in the room remains allowing a speed limit of 100 km/hour to be applied to an open non-divided road when the infrastructure is designed for a 70–80 km/hour speed limit.

In December 1973, the New Zealand government, in response to the fuel crisis, reduced rural speed limits from 55 mph (88 km/h) to 50 mph (80 km/h). This led to average speeds stabilising at 5–8 km/h lower than previous average rural speeds.

In the following year, on these roads, deaths dropped by 37%, serious injuries decreased by 24%, and minor injuries decreased by 22%. These roads currently generate over 70% of all New Zealand fatalities. The impact of an open-road speed reduction would be enormous.

This example of speed reduction benefit is only one of hundreds of examples from across the world that show the enormous benefits of setting and enforcing evidence-based speed limits.

The lessons have been learned and it is now time to apply them. To slow the carnage on New Zealand roads, it is now time to immediately set survivable speed limits, and rigorously enforce them.

Dave Cliff, ONZM, was the former assistant commissioner for road policing for the New Zealand Police and also held positions as the police assistant commissioner for the South Island and the district commander in Canterbury; he led the response to the 2010 and 2011 earthquakes and received royal honours in 2012 and 2013. In 2017, Dave took up the role of chief executive of the Global Road Safety Partnership (GRSP); based in Switzerland, the role of the GRSP is to work globally on the sustainable global reduction of road crash death and injury – see grsproadsafety.org