Pedestrian and cyclist mortalities are on the rise, too. Robert Galbraith/Reuters

The U.S. traffic mortality rate far outstrips global peers. Here’s how state legislators could intervene.

More than 37,000 people died on U.S. road crashes in 2016. That was a 5.6 percent increase from the previous year, and the second year in a row traffic fatalities went up, after years of steady decline.

Vehicle-related mortality is an increasingly urgent public health concern. It is the second-leading cause of accidental death in America, after drug overdoses.* Yet state legislatures aren’t keeping pace with necessary measures to curb the toll of deaths and injuries, according to a traffic safety group.

In the 2018 report card of state traffic laws, the Advocates for Highway and Auto Safety finds that only six states are “significantly advanced” towards adopting 16 laws they deem “essential to save lives, prevent injuries, and reduce health care and other costs.”

For example: Roughly half of all vehicle occupants killed in crashes over the past five years weren’t wearing seat belts. Yet 16 states still lack primary enforcement seat belt laws for everyone on board. The rate of drunk-driving deaths is increasing; still, 20 states haven’t passed laws requiring ignition interlocks for previous offenders, and 9 don’t have open container laws. And though some 40 percent of motorcyclists killed on their bikes weren’t wearing helmets, more states are repealing helmet requirements than tightening them.

There is some reason for optimism: 13 “basic safety” laws were passed by states in 2017, according to the report. That’s much better than in 2015 and 2016, when only eight and five such laws were passed, respectively.

On the other hand, laws are only as good as their enforcement. A good example: drivers with their eyes, hands, and brains preoccupied by buzzing phones or complex car-based navigation and infotainment systems are creating more dangerous road environments. Yet so-called distracted driving deaths have still increased in many states that have passed laws attempting to control it through hand-held device and texting bans. That’s been largely because enforcement has been relatively weak and easy to evade, research has found. (Plus, even though hands-free distraction might be just as dangerous as hand-held, no states have banned the use of cellphones across the board.)

Furthermore, road conditions might be even more dangerous than this report suggests, since it does not assess speed limit laws. The number of states upping their limits has risen in recent years, with Nevada the latest to allow drivers to hit 80 mph on some stretches of highway. Speed is one of the most widely reported causes of deadly crashes, and it might be even more significant of a factor than lawmakers are aware, according to the National Transportation Safety Board. Lower speed limits could save lives, its research shows; France recently reduced speeds on all two-lane highways in response to the country’s own concerning increase in road deaths.

The NTSB urged U.S. states to radically overhaul how they set speed limits: By not only accounting for the average speed of motorists, as an outdated federal study has long encouraged, “but also the conditions of the road, development along the road, parking, the presence of pedestrians and the crash history of the area,” according to Governing. These recommendations are significant, since states rarely take into account local conditions when establishing speeds.

That’s to say nothing of road design. Narrower lanes, road diets, and protected pathways for pedestrians and cyclists—for whom road fatality rates ticked up 9 percent and 1.3 percent respectively in 2016—have all been shown to save lives by slowing motorists and guarding vulnerable road-users. Dozens of U.S. cities, a handful of states, and even the U.S. DOT have adopted or modeled policies after Vision Zero, the international campaign and platform aimed at ending harmful car crashes through ramped-up enforcement, safety education, and intentional engineering. The best outcomes so far seem to be related to that last “E”—although pedestrian and cyclist deaths in New York City have increased overall since the city pledged allegiance to Vision Zero, fatalities at specially redesigned intersections have gone down.

According to the World Health Organization, the U.S. ranks 41 out of 52 high-income nations based on road traffic deaths, outstripped only by the likes of Qatar, Saudi Arabia, and the Russian Federation. The United States is now “the most dangerous of wealthy nations for a child to be born into,” a new report in the journal Health Affairs concluded, based in part on the elevated risk of children dying in vehicle-related crashes. Among American teenagers aged 15 to 19, car crashes are the leading cause of death.

It didn’t used to be this way: Prior to the 1980s, the U.S. was at the vanguard of driving safety, outranking many of its peers. Now, the U.S. traffic fatality rate, per 100,000 people, is roughly double Canada or Australia’s, and about three-and-a-half times that of the United Kingdom. Slovenia, Italy, and Greece all do better, too.

The U.S. drives many more miles than other wealthy countries. But while European countries have dramatically improved road safety by instituting helmet and seat belt mandates, stricter speed limits, lower blood alcohol limits, and national standards for safer street design, the U.S. has fallen behind. Technology may offer the ultimate fix: Many traffic safety advocates are counting on self-driving cars to dramatically reduce road fatalities. But the tools exist to get there sooner.

*CORRECTION: An earlier version of this article characterized vehicle-related deaths as “rivaling” opioid-related deaths. In fact, there were 63,000 accidental drug overdose deaths in 2016, compared to 40,200 traffic fatalities.

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