Celebrating Advances in Health, Safety, and Well Being

In the Monday, November 23, Wall Street Journal , reporter Melinda Beck recounts a number of our successes in improving public health in an article entitled “20 Advances to be Thankful For.” Among the advances she highlights are:

• The fact that we had the same number of traffic fatalities in 2008 as we had in 1961, which is remarkable considering the significant increase in the driving population, the number of cars on the road, and the number of miles driven;
• The 50% decline in trans fats in packaged foods since 2006;
• The fact that 71% of our population lives under either a state or local ban on smoking in workplaces and/or restaurants and bars; and
• The fact that the percentage of secondary school that no longer sell soda, candy, or high-fat snacks have each risen to 64%.

I zeroed in on this article for two reasons:

• It reminds us that we are doing many things well as a society, even though the media often choose to focus on things that are going wrong.
• More importantly, there are multiple success stories from which we can learn how to improve overall population health. Government intervention was a factor in every one of these cases, but it was not the only factor. There were many forces, including private sector advocacy groups, that influenced human behavior for the better.

Let’s just take the first of these accomplishments, the reduction in the ratio of traffic fatalities to miles driven. Beck notes that one contributing factor for reduced fatalities is that 84% of Americans now wear seat belts, which resulted from laws mandating seat belt usage and from increased compliance with those laws.

But there are many other factors as well, some of which are related to laws and some of which are the result of private sector initiatives:

• Clearly, the stronger enforcement of laws prohibiting driving while under the influence of alcohol has helped.
• Laws which delay the granting of drivers licenses to younger people until they have completed both classroom and road-based drivers training has put better younger drivers on the road.
• The cars built and driven today are far safer with better transmissions, braking systems, and acceleration than cars on the road in the past.
• Trucks also are far safer in their design than was the case a generation ago.
• Traffic engineers are far smarter in designing road systems to reduce accidents.
• Customs and practices in many communities are less conducive to late-night driving. For example, in my community, both of our older boys who have gone to proms have shared the cost of a limousine, rather than having each of them drive separately to the prom.

However, much more could be done. For example, many communities are deploying cameras to catch those who speed or commit other moving violations. Those communities see significant drops in accident rates and fatalities after they deploy these systems. Too many lawmakers are too timid in standing up to bogus privacy arguments and back off putting in these systems. There are well-established ways to protect citizen privacy, while protecting public safety.

We need to have more properly-equipped rest stops for long-haul truckers, since fatigue on the part of truckers is a major cause of horrific accidents, particularly late at night. We also need to enforce laws against truckers who exceed maximum-hour daily driving limits. The technology is available to track compliance with these laws. We should use it.

Finally, we need to reduce the overall number of miles driven by changing our zoning patterns to enable people to walk to stores and to avoid the opportunity to get into accidents. My sister and her family got into a near-fatal accident in 1966 on a residential street close to their home because a drunken driver failed to observe a stop sign and hit their car at a relatively high speed on the drivers side of the vehicle. Many accidents happen within a few miles of home, just like this one, often when people are doing driving that, in a differently designed community, would not be needed.

Nevertheless, these are cautionary notes relative to something which we should celebrate. When our country and our citizens decide that they want to improve health and well being outside of the health care system, they have proven time and time again that they can be successful.