When
we hear the word epidemic, we typically think of diseases, often
communicable diseases but maybe we shouldn't, at least not always. An
epidemic that isn't so much potential but real has been with us for at
least a century and is only increasing in importance, namely, road injuries. Also important to remember that one doesn't need to be a driver to fall victim to road injuries. Victims include cyclists, motorcyclists, passengers and pedestrians as well.
Rubbernecking
was one of the first phrases I added to my vocabulary when I came to
the US. Needless to say I learned it in the context in which it is
perhaps most often used, drivers slowing down to see what happened in a
road accident. A 2014 report reckoned 1.2 billon vehicles that were
expected to increase to 2 billion by 2035 (1).
The
thing about hidden epidemics is we somehow learn to internalize certain
costs, get habituated to them and keep on moving. Dangers inherent to
an automobile in motion are precisely the type of costs our brains seem
wired to discount. I hear or read an all too familiar regurgitation
every time there's a plane crash, a statistical accounting of how much
safer, despite that particular crash, plane travel is compared to
automobiles. Numbers aren't apparently enough to leave an impression
though. As prosperity increases around the world, increasing numbers of
the newly affluent are taking to the roads in their new cars the world
over, and inevitably, increasing numbers are dying or injured. After
all, the driving habit is taking off in those places just as electronic
distractions proliferate as well.
In my time
behind the wheel, I've seen it all. From a seemingly endless stream of
drivers with their eyes glued to their phones to someone looking in
their vanity mirror, carefully applying mascara, another wielding an
eyelash curler, someone else mouthing a spoonful, the other hand holding
a bowl, drivers all. Wait a minute. That last one, did I really see
that? I had to make sure I really did see it. Yes, no doubt about it, a
driver behind the wheel eating their breakfast using a bowl and spoon,
hands-free driving as far as I could tell. Rubbernecking. Did any of
them or even me for that matter seriously consider we would rubberneck
or be the object of someone else's rubbernecking that day as we got in
our cars and started driving? Of course not. If we'd done that, how
could we overcome our fear-induced paralysis to start driving? Sheer
habituation and following inevitably in its wake, a hidden in plain
sight epidemic of road injuries and deaths. The fact remains that
in the US, the lifetime chances of dying in a car accident are
apparently 1 in 606 compared to 1 in 174, 426 by lightning (2).
So
let's look at some more numbers to better understand the contours of
this particular epidemic. In 2015, the Lancet helpfully published a
massive report by the Bill and Melinda Gates Foundation-funded Institute for Health Metrics and Evaluation on global causes of mortality (3).
First
off the bat, they include road injuries as one of the top ten causes of
global death in a list that includes the likes of heart disease,
respiratory infections and stroke (see below from 3).
Their analysis further concludes road injuries jumped up the list from #10 in 1990 to #5 in 2013 (see below from 3).
While adding more granularity to road injury data, the WHO 's 2015 Global status report on road safety is the typical Curate's egg, some good bits but mostly bad (4).
According to them, though road traffic fatalities plateaued between
2007 and 2013, they're increasing in middle- and low-income countries
(see figure below from 4).
Unfortunately, middle-income countries are where most of the world lives (see figure below from 4).
While Africa leads the world road injury fatalities per 100000 (see figure below from 4).
So
what can be done? Can anything be done? The WHO data suggests it's
going to be something we've seen before, a long, hard slog to enact and
enforce safe driving practices. This includes traffic partitioning to
protect those most vulnerable, tough drink-driving and helmet laws,
strictly enforced speed limits and vehicles that meet not just basic
safety standards, which shockingly most of them don't right now, but
those that meet preferably the most stringent safety standards (see
figure below from 4).
Bibliography
3.
Naghavi, Mohsen, et al. "Global, regional, and national age-sex
specific all-cause and cause-specific mortality for 240 causes of death,
1990-2013: a systematic analysis for the Global Burden of Disease Study
2013." Lancet 385.9963 (2015): 117-171. http://www.thelancet.com/pdfs/jo...
4. The WHO 's Global status report on road safety 2015 http://www.who.int/violence_inju...
https://www.quora.com/What-are-some-potential-epidemics-that-nobody-is-talking-about-as-of-2016/answer/Tirumalai-Kamala