One of the least discussed public health crisis are U.S. road deaths. In fact, when they are discussed, it’s usually along the lines of ‘this year, [bad thing X] surpassed road deaths.’ It never seems to occur to anyone that too many people in the U.S. die due to our transportation system. Well, anyone isn’t fair, since I’ve been beating this drum for a while now. To review:
- Almost one percent of people will die in an automobile accident. Only heart disease, cancer, and complications thereof (infectious disease) kill more people.
- On the economic side, the median household with earnings of $51,939 pays more to respond to and cope with the aftermath of car accidents than it does to Medicare through the payroll tax.
So it’s good to see the New York Times get in on the action (boldface mine):
The federal judge and legal scholar Guido Calabresi likes to pose a conundrum to his law students. He asks them to imagine a deity coming forth to offer society a wondrous invention, one that would make everyday life more pleasant in almost every way.
This invention comes with a cost, however. In exchange, the deity would choose 1,000 young men and women and strike them dead.
Calabresi then asks the students if they accept the deal. In 30 years of giving the lecture at Yale, the answer is almost always no. At which point he delivers the lesson: “What’s the difference between this and the automobile?”
…In the United States, crashes claim 1,000 lives every nine days. Last year, 40,000 Americans died, about as many as from breast cancer and more than twice as many as from murder…
We put up with these costs because we imagine them as unavoidable human imperfection. We are willing to make some changes, like wearing seatbelts and driving sober, which have caused deaths to decline gradually for decades. But we assume there is no cure. We’ve accepted the deity’s offer: modernity in exchange for 1,000 lives, again and again and again.
Leonhardt goes on to talk about the additional surge in deaths due to ‘distracted driving’, which is to say, fucking around on your cellphone while operating dangerous machinery (that would be your car). But let’s not forget the key point–one Leonhardt ends with:
Remember Calabresi’s lesson: Even before distracted driving, cars claimed a toll that would be shocking if it had not become normal. Technology has now given us the choice between making a terrible problem worse and saving a lot of young, healthy lives.
While worrying about cellphones and so forth is fine, this is a structural problem: too many people have to do too much driving to live their lives. Changing that is going to require rethinking how we build our communities–where we live and how we live.
Or we can continue to ‘drive our way’ to breast cancer.
What color do we wear to draw attention that?
mikethemadbiologist
And it’s not just the crashes. Particulate pollution is bad news, all that lead we fumed into the environment decades ago was bad news, even just the noise is bad news. All those things harm health. And from several studies in other countries, it appears that the lack of exercise caused by driving to work raises your annual mortality risk by around 30% (or, in another study, shortens your life by 2-5 years).
I thought of another reason we may accept the human cost of automobile transportation. The social benefits, through increased mobility and consequent economic productivity, have arguably made society in net terms both richer and longer-lived. Thus the thousands of deaths, individually tragic and yet accepted, are implicitly balanced by the millions of extra days lived in additional comfort, compared to the pre-automobile era.
I’d like to see investment in mass transit at the same scale that we invest in roads today. Our interstate highway system is a valuable and efficient means of moving bulk cargo in trucks, but it’s a terrible way to move widely-distributed people to and from densely-concentrated jobs. Saving lives means more metro lines, more stops, more frequent service, more money in the system. If we have to forego a few rounds of road widening, new bypasses, new toll roads, so be it.
Well I am guessing that per capita there aren’t many fewer deaths and disabilities due to auto’s than were due to horses, carriages, etc. So maybe the analogy should be a god came in and said we will keep the same death rate and get rid of a lot of horses**t … then it doesn’t look so bad.
The horse powered economy was even more dangerous. In NYC in 1900, 200 people were killed in horse transportation related accidents. In 2003 345 were killed by automobiles, but the population had gone from maybe 3.6M to over 8M. Even walking around has its risks, and people who die in walking related accidents are just as dead. In fact, there are risks associated with just staying home. There are always going to be risks, and while it makes sense to try to minimize them, they can’t always be reduced to zero.
That choice argument always struck me as rather silly. The actual choice is going anywhere and accepting the risks or never going anywhere and building your society on nobody ever going anywhere. Once you decide that photosynthesis isn’t an option, its all about how to get around as safely as possible.
As if the only alternative was horses, as if we were actually doing a good job at car safety (comparisons with other countries suggest we have ample room for improvement: https://bitre.gov.au/publications/ongoing/files/International_2014_II.pdf ).