Traffic Safety Through a Public Health Lens

By Sophia Peerzada, Safety Advocate

On March 28th, I moderated a webinar titled “Traffic Safety Through a Public Health Lens.” This joint effort between the NTSB and the American Public Health Association (APHA) ahead of National Public Health Week highlighted traffic safety as a public health issue.

This topic is very important to me as a transportation safety advocate with a degree in public health. When I was studying for my Master of Public Health degree at the University of South Florida, I was the only student in my program (that I knew of) who was interested in traffic safety. I was motivated by the Tampa Bay region’s regrettably high rates of traffic-related fatalities, and the perceptible imbalance of safety interventions along socioeconomic lines. I also knew the statistics nationwide: each year, 43,000 people die on US roadways. I thought, of course this is a public health issue—people are getting hurt and dying on our roads each day!  

Since joining the NTSB in November 2023, I have had the pleasure of meeting folks who bring a public health mindset to transportation safety. In fact, the NTSB itself plays a significant role in public health by identifying transportation safety issues and issuing recommendations to make travel safer for the public.

Prior to the webinar, I connected with former NTSB Vice Chair T. Bella Dinh-Zarr, who notably referred to traffic fatalities as an “epidemic on wheels.” Of course, I was thrilled when Dr. Dinh-Zarr and public health colleagues Dr. Kathleen Carlson, Dr. David Ederer, and Dr. Mighty Fine agreed to be panelists on this first-of-its-kind webinar.

Each panelist brought an invaluable perspective to the conversation.

Dr. Carlson, a professor of epidemiology at the Oregon Health and Science University-Portland State University School of Public Health and core investigator at the Portland VA, opened the event with a review of injury epidemiology. She explained that “public health takes a scientific approach to a public health problem” as it seeks to identify the problem’s cause and develop strategies for preventing it from happening again.

Dr. Ederer, an epidemiologist at the CDC’s Physical Activity and Health Branch, followed with a presentation on the Safe Systems Pyramid and how public health principles can be applied to engineering. His presentation underscored the need to apply traffic safety interventions systematically to improve population health.

Dr. Dinh-Zarr, Senior Advisor at FIA Foundation and the Traffic Injury Research Foundation, built upon Dr. Carlson’s and Dr. Ederer’s presentations by providing concrete examples of how the public health lens has been applied to traffic safety efforts. She highlighted the NTSB’s investigation process as an example of taking a public health approach to preventing the recurrence of traffic-related injuries and fatalities.

Finally, Dr. Fine, associate executive director of the APHA’s Division of Public Health Policy & Practice, rounded out the panel by emphasizing the need to apply a health equity perspective to all traffic safety efforts. He urged traffic safety practitioners to ensure that interventions are inclusive, accessible, and culturally relevant.

Overall, it was a wonderful and much-needed discussion that I am certain each attendee walked away from having learned something new. Dr. Ederer said it best in his presentation: “Public health is a way of describing and solving problems.” Given that, I think all of us in the traffic safety space are public health practitioners.

You can view the full webinar recording here: https://youtu.be/DMNxSFNANeI?si=FDR2BhF6vZXdJDut..

NTSB at 2023 National Black Caucus of State Legislators Conference

By Nicholas Worrell, Chief of NTSB Safety Advocacy Division

On November 28, I moderated a discussion at the Pearl-Cohn School in Nashville, Tennessee, during the National Black Caucus of State Legislators (NBCSL’s) 47th Annual Conference Corporate Roundtable (CRT) School Visit. The CRT represents small and large companies, associations, and nonprofit organizations.

The NBCSL is a group of black representatives in state legislatures who are united by their roots in the black community. They work to pass laws that will make life better for all and meet occasionally to ensure that the voices of those in black communities are included in legislative decisions. They also strive to lay steppingstones for the future generations of black leaders. We at the NTSB recognize the significance of equipping and empowering the next generation of leaders.

NBCSL Corporate Roundtable School Visit at Pearl-Cohen High School

The theme of the NBCSL conference was “The Future is Now: Meeting Challenges and Creating Opportunities.”

There is an urgency to the phrase, “The future is now,” and nowhere is that urgency more obvious than in the safety of teens in the face of one of their biggest threats: motor vehicle injuries and death. Their future—potentially spanning so many years—is all too likely to be cut short, now, in traffic violence. Participants were surprised to learn that we lose 43,000 lives on our roads yearly, and that the fatality rate is disproportionately high among both black Americans and teen drivers.

As I told the young people in the audience, their futures are on the line each time they take the wheel, ride as passengers, or even cross the street as pedestrians or share the road as cyclists or motorcyclists. The deadly effect of traffic crashes on teenage lives will only change when our culture around road safety changes.

Driving sober, disconnecting from our phones and other devices, buckling up, and obeying the speed limit are all simple—and safe—practices. However, making the right choice consistently takes integrity (doing the right thing even when nobody is watching). In road safety, knowing the way is not always the hard part. You have to go the way too.

I have long worked with the NBCSL to highlight the NTSB’s many state-level transportation safety recommendations. Our outreach to the NBCSL is in the same spirit as the NTSB’s current webinar series, Reaching Underserved Communities (ntsb.gov): a connection between the affected community and the people who are working on solutions.

NTSB Safety Advocacy Chief Nicholas Worrell moderating the Corporate Roundtable

Although the day focused on more than just transportation, the students asked intelligent questions, both on how traffic violence affects their community and on how they might parlay a passion for safety into a future career. In addition to making the youth aware of the NTSB and the greater federal government as career destinations, I was able to interact with NBCSL state legislators, the people who make the laws that govern our roads. And I also put in a good word for the NTSB as a workplace to aspire to.

The November 28 program helped each attendee concentrate on their own ability to grow and change the world, rather than focus on the obstacles in their way. To hear that many were interested in working for transportation safety was an additional bonus.

I felt confident that the NBCSL’s conference would motivate young attendees to strive to build the world they want to live in, rising to meet the challenges and eagerly pursuing leadership opportunities. And now that I’ve made them aware of some opportunities at the NTSB, many may consider putting their energy into making transportation safer throughout their communities and the entire country.

Back to School – Safely!

By Leah Walton, NTSB Safety Advocate

The 2023-2024 school year is upon us, and parents all over the country are preparing to send their students back to school.

In the rush to gather back-to-school supplies, it’s easy to lose sight of what “back to school” means at the basic, literal level. Your student is going to school again, and coming home again, every day. How can they do that most safely?

The answer for most families is the big yellow bus.

The hours before and after school are the most dangerous times for students on the roads, but students traveling in school buses are the best-protected passengers on the roads during these times.

Yet not every student has access to the bus, so let’s review best practices for getting to and from school, however your student gets there.

On the School Bus

Less than one percent of all traffic fatalities involve students in school transportation vehicles.  In other words, students are more likely to get to school safely if they take the school bus instead of traveling by car. If your student can ride the school bus, make this your first choice. 

School bus travel is a resounding success, and it is getting better all the time, thanks in part to the attention the NTSB brings to remaining vulnerabilities in school bus travel. For further information about school bus safety, and the NTSB safety recommendations related to school bus design, watch our School Bus Safety video. If your student’s school bus is equipped with seatbelts, make sure to remind your students to buckle theirs.

But rest assured that your student’s school bus ride keeps them safe on the way to and from school:

According to School Bus Fleet, in the 2021-22 school year, an estimated 489,748 yellow school buses provided transportation service daily in the United States. About 20.5 million elementary and secondary school students ride school buses to and from school each day.  School buses are the safest way to travel to school, and even when they do crash, occupants of school buses are safer than other road users. Seventy percent of deaths in school bus-related crashes are occupants of vehicles other than the school bus, and 16% are pedestrians. Out of all recorded school bus-involved deaths, only 5% of those who died were school bus passengers inside the bus.

But our students must get onto and off the bus, and during these phases they are much more vulnerable. As parents and as citizens we must all work together to ensure the safety of students on their way to and from school.  Drivers and parents, be careful and keep your eyes on the road for our most vulnerable road users. If you approach a school bus with red flashing lights on and stop-arm out, STOP! And remain stopped until stop signal and flashing lights are off and the bus is in motion again.

According to the American School Bus Council, passing vehicles cause nearly two thirds of school bus loading and unloading fatalities. In the National Association of State Directors of Pupil Transportation Services’ 2023 Stop Arm survey, 94,581 school bus drivers reported that 62,482 vehicles passed their buses illegally on a single day. Throughout a 180-day school year, these sample results point to more than 43.5 million violations among America’s driving public—don’t be that driver!

As Pedestrians

According to data from the National Highway Traffic Safety Administration (NHTSA), among the 206 school-age fatalities from 2012 to 2021, more school-age pedestrians were killed from 6 to 6:59 a.m. and 3 to 3:59 p.m. than any other hours of the day. Planning a safe route with your student is essential to their safe walk to and from school.

Map out the safest route for your student before school is back in session and practice it a few times. This will help them become familiar with the route, including any crosswalks or intersections they may need to negotiate, and allows you the opportunity to demonstrate safe walking behaviors.

• Choose bright colored clothing or outerwear for your student, ideally with retroreflective material.
• Consider creating a neighborhood group to walk together with at least one other student or older sibling.

As Bicyclists

If you have a student riding a bicycle to school, make sure you map out the route with them in advance, and practice as well! Make sure to remind your student of the rules of the road and to be as safe as possible.

Be sure your student wears a helmet and reflective gear! No matter how short or long the ride, wearing a helmet is important. It can cut the risk of head injuries by about 85% and facial injuries by about 65% among bike riders.

As Car Riders and Drivers

If you must drive your student to and from school, make sure all vehicle occupants are buckled up for every trip. A seat belt is the best defense in the event of a crash.

If your teen is driving to and from school, make sure they keep their safety and those around them in mind. As a parent or caregiver:

• Ensure their vehicle is in good operating condition – routinely have the vehicle serviced to ensure the brakes are working properly, there is adequate tire air pressure, and windshield wipers are in working order for maximum visibility.
• Be aware of how much sleep your teen is getting – teens need between 8-10 hours of sleep each night. Drowsy driving can be as dangerous as impaired driving.
• Limit the number of passengers in the vehicle to reduce distractions. In some states, it’s part of the Graduated Driver License law!
• Set the expectation that your teen driver put their phone away while driving. Hands-free cell phone use is not risk-free!
• Remind your teen of the importance of always following safe speeds, and never driving while under the influence of impairing prescription or illicit drugs.

We at the NTSB wish all students a safe and enriching 2023-2024 school year!

For more information on school bus safety, visit the NTSB School Bus Safety webpage.

Prioritizing Safety This Holiday Travel Season

By Stephanie Shaw, Acting Chief, NTSB Safety Advocacy Division

This week, families and friends will gather to celebrate the Thanksgiving holiday. According to estimates from AAA, nearly 55 million people will travel away from home this year, with about 49 million of them taking to the roads.

As we mark the beginning of the holiday travel season, we want to ensure that everyone arrives safely at their destinations. Unfortunately, travel on our roads can be the riskiest mode of travel during the holiday season.

NTSB investigations continue to highlight actions needed by regulators, legislators, and industry to ensure the safest transportation system for the traveling public. Our Most Wanted List (MWL) identifies specific transportation safety improvements needed across all modes. It includes five road safety improvements that address pervasive problems like speeding, alcohol and other drug impairment, and distraction. The MWL also calls for collision-avoidance and connected vehicle technologies and implementation of a Safe System Approach to better protect all road users.

At the NTSB, we believe that safety is a shared responsibility, so for the traveling public, we’ve highlighted some ways you can keep yourself and others safe, regardless of the travel mode you choose.

By Car

Impairment by alcohol and other drugs, unsafe speeds, fatigue, and distraction continue to play major roles in crashes. Here’s what you can do:

• Designate a sober driver, or call a taxi, or ridesharing service if your holiday celebrations involve alcohol or other impairing drugs.
• Follow safe speeds. In bad weather, safe speeds are often below the designated speed limit. Speeding increases the chance of being involved in a crash and intensifies the severity of crash injuries.
• Make sure you’re well rested! A fatigued driver is just as dangerous as one impaired by alcohol or other drugs.
• Avoid distractions. Don’t take or make calls or text while driving, even using a hands-free device. Set your navigation system before you start driving. If you’re traveling with others, ask them to navigate.
• Make sure to use the correct safety restraint for child passengers, and be sure it’s installed correctly.
• Ensure you and all your passengers are buckled up! In a crash, seat belts (and proper child restraints) are your best protection against death and serious injuries.

By Bus

The NTSB has made recommendations to improve motorcoach operations and vehicle crashworthiness, but travelers should know what to do in an emergency.

• Pay attention to safety briefings and know where the nearest emergency exit is. If it’s a window or roof hatch, make sure you know how to use it.
• Ask your driver to give you a safety briefing if you’re unsure of where the exits are or how to use them.
• Use your seat belt when they’re available!

By Plane or Boat

These tips can help you and your loved ones in an emergency on planes or vessels.

• Pay close attention to the safety briefing! Airline and marine accidents have become very rare, but you and your family can be safer by being prepared.
• Know where to find the nearest emergency exit and flotation device whether you’re on an airplane or a boat.
• Confirm that you and your traveling companions—even children under age 2—have your own seats and are buckled up when flying.
• Don’t forget your child’s car seat. The label will usually tell you if your child car seat is certified for airplane use; the owner’s manual always has this information.
• Call the airline and ask what the rules are for using a child’s car seat on your flight, if you don’t already know.
• Follow crewmember instructions and remain calm in an emergency.

By Train

The NTSB has made recommendations to improve passenger rail operations and vehicle crashworthiness, but travelers should also follow these safety tips.

• Stow carry-ons in the locations provided (overhead and racks). Don’t block aisles.
• Review your trains safety information which may be provided as a safety card in your seat pocket or displayed in your railcar.
• Follow crewmember instructions and remain calm in an emergency.

No matter how you travel, make a commitment to put safety first.

We wish everyone a safe and happy Thanksgiving.

Honor Traffic Victims with Action

By Chair Jennifer Homendy

50 million deaths. Hundreds of millions of injuries.

That’s the worldwide cost of traffic violence, in human terms. It’s difficult to comprehend fully, which is why the World Day of Remembrance for Road Traffic Victims is so meaningful.

This annual observance provides a time to reflect on the real people behind the statistics: mothers, fathers, sons, daughters, grandparents, aunts, uncles, cousins, colleagues, best friends, and neighbors.

It’s a time to support those who’ve lost a loved one to the public health crisis on our roads.

And it’s a time to act, starting with NTSB recommendations.

Lessons from Tragedy

Since last year’s World Day of Remembrance, the NTSB has made 26 new recommendations to improve road safety. All remain open.

Where did these recommendations come from? They are the result of rigorous NTSB investigations into devastating crashes, outlined below. Each one is a lesson from tragedy, which is why we don’t rest until a recommendation is implemented.

At the NTSB, we believe the most meaningful thing we can do for victims of traffic violence is to advocate for our safety recommendations.

In other words: we choose to honor the victims with action.

Here are just some of the victims we’re remembering today — along with the recommended safety improvements to best honor their memory. 

Today we remember two people who were killed and seven who were injured in a Belton, SC, crash between an SUV and a bus carrying disabled passengers. The actions we demand on their behalf include the following:

• Ban nonemergency use of portable electronic devices, like cellphones, for all drivers.  
• Recruit cellphone manufacturers in the fight against distracted driving; they should automatically disable distracting functions when a vehicle is in motion.
• Provide annual safety training for people employed to transport wheelchair users.  
• Develop a side-impact protection standard for new, medium-size buses, regardless of weight — and require compliance.

We should honor the victims of the Pennsylvania Turnpike crash that injured 50 people and killed five others — including a nine-year-old child — by taking the following actions:

• Develop performance standards for advanced speed-limiting technology, connected-vehicle technology, and collision-avoidance systems — and require their use on new vehicles, as appropriate.
• Require newly manufactured heavy vehicles to have onboard video event recorders.
• Deploy connected-vehicle technology nationwide.
• Take a comprehensive approach to eliminate speeding. Among other measures, this means thinking long and hard about the 85th percentile approach and using speed safety cameras, which includes working to remove restrictions against them. 

Here’s what we must do to honor the three people who were killed and the 18 who were injured when a bus overturned in Pala Mesa, California:

• Require all new buses to meet a roof strength standard.
• Sponsor research into safe tire tread depths for commercial vehicles.
• Require seat belt use.

The best way to remember the victims of the Decatur, Tennessee, school bus crash that injured 14 people and killed two people, including a 7-year-old child, is to take the following steps:

• Make lap-shoulder belts mandatory in new school buses.
• Require lane-departure prevention systems on heavy vehicles.

And what about the nine people who died in a head-on crash in Avenal, California, on New Year’s Day — seven of whom were children? We must implement the following NTSB recommendations in their memory:

• Require alcohol-detection systems in all new vehicles to prevent alcohol-impaired driving.
• Encourage vehicle manufacturers to combat alcohol-impaired driving by accelerating progress on advanced impaired driving prevention technology and finding new ways to use existing technology, like driver monitoring systems.
• Incentivize vehicle manufacturers and consumers to adopt intelligent speed adaptation (ISA) systems. One way to achieve this is to include ISA in the New Car Assessment Program. Notably, ISA became mandatory in July 2022 for all new models of vehicles introduced in the European Union.
• Develop a common standard of practice for drug toxicology testing by state officials.

Remember. Support. Act.

Even as we advocate for our safety recommendations, more crashes are occurring daily — which means more investigations. The work continues.

And yet, we cannot let the magnitude of the road safety crisis deter us.

We must keep fighting for zero, which is only possible through a Safe System Approach. 

We must fight for road users around the world who deserve to be safe.

We must fight for those whose lives are forever changed by traffic violence.

We must fight for those who are no longer here to fight for themselves.

For all these people and more, the NTSB will keep fighting. And so will I.