Relative risk perception and public investment

 Motor vehicles are not quite in the top 10 causes of death in the U.S. The way the CDC categorizes causes of death, unintentional injuries are number 3, about 173,000 deaths per year, and motor vehicle-related injuries constitute about 1/3 of those. If you were to extract those 40,000+ motor vehicle deaths they would probably be at about #11. (This data is from 2019, and for 2020 Covid has undoubtedly bumped up cause number 9, "influenza and pneumonia, from 9 to 3 making unintentional injuries number 4, but we can hope this is temporary.) 

However, unlike the other leading causes of death, which disproportionately affect old people and hence result in fewer years of life lot, motor vehicle deaths affect people of all ages, including children. And, obviously, serious injuries are much more prevalent than deaths, and may result in permanent disability including traumatic brain injury. This otherwise good discussion of motor vehicle safety by Marina Bolotnikova ignores the important issue of non-fatal injuries, and the age of victims, so I'll fill in the blanks with this CDC page. The data here ends in 2015 so the number for fatalities is lower than the past two years, but in that year motor vehicle injuries resulted in 2.3 million emergency department visits and $44 billion in costs for health care and work loss. And yes, they were the leading cause of death for people in the first three decades of life.

The CDC considered motor vehicle injuries a "winnable battle" when it posted the 2015 data, but in fact the numbers have gotten worse since then. Longer term, safer vehicles including seat belts, air bags and crush proof passenger compartments have brought down deaths per miles driven, but they haven't done anything to help pedestrians, bicyclists or motorcyclists; and vehicles are actually less safe for them, with many people driving trucks and SUVs with high front ends. 

As Bolotnikova compellingly explains, the most important factors in motor vehicle safety are road design, and speed. It's one thing to go 70 MPH on a controlled access highway, but urban sprawl and the logic of capitalism have filled the U.S. with "throads," roadways that double as through routes between the suburbs and the city, and miles-long strip malls. I have the great displeasure of traveling on one of these on my own commute, Route 6 in Johnston, Rhode Island. 

 

I was an eyewitness to a fatal crash that is the epitome of the problem Bolotnikova describes. The traffic consists of two kinds: people who are in a hurry to get from point A to point B, probably home and work or some other business; and people whose destination is on the throad and are stopping to turn left or right, or pulling back into traffic when their business is done. What I saw was a driver traveling east at a high rate of speed clipping the front of a car in the westbound lane waiting to turn left, and spinning out into a gas station, striking a car at the pump and causing the pump to explode. Two people died, both of them recent high school graduates. 

 

There are several measures that have been shown to reduce risk, including road design features that slow traffic and lower speed limits. Of course in the incident I saw the driver was well over the speed limit. Here's a fun anecdote about Silicon Valley venture capitalist and Ayn Rand Asshole Peter Thiel, who was pulled over by a California for speeding on Route 17:

Thiel addressed the statie coolly in his usual uninflected baritone. “Well,” he said, “I’m not sure if the concept of a speed limit makes sense. It may be unconstitutional. And it’s definitely an infringement on liberty.”

Unbelievably, the trooper seemed to accept this. He told Thiel to slow down and have a nice day. Even more unbelievably: As soon as he drove out of sight, Thiel hit the gas pedal again, just as hard as before. To his astonished passengers, it was as if he believed that not only did the laws of California not apply to him — but that the laws of physics didn’t either. “I don’t remember any of the games we played,” said the teammate who was riding shotgun, a man who is now in his 50s. “But I will never forget that drive.

These are the same people who oppose vaccine and mask mandates, based on essentially the same principles and logic, or lack thereof. Think about it. 

BTW this is where the crash happened, and this was more or less my view of it. Usually the road is far more congested.