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Remarks at the Second Global High Level Conference on Road Safety (Brasilia, Brazil) Targets & Indicators Session
T. Bella Dinh-Zarr, PhD, MPH
Brasilia, Brazil

​Good afternoon!  It is an honor to be here today with you.  Each of you is a champion for road safety in your own country and around the world.  Thank you to our conference host, the Government of Brazil, for prioritizing road safety and welcoming us here this week.

When I participated in the First Global Conference on Road Safety in Moscow in 2009, this Second Global High Level Conference was but a distant goal, so I am delighted to be speaking in Brasilia today along with Dr. Margaret Chan, Minister Johannsson, Dr. Wolfe, Dr. Krug, and with my fellow panelists about the importance of developing targets and indicators for road safety.   Back then, we often said that it was a “Time for Action” so it is fitting that now the theme is a “Time for Results” as we ensure we have good processes for identifying indicators and setting targets to achieve those results.

One of our worldwide targets - the target of halving road safety deaths - is within the Health Goal of the SDGs and there are 26 indicators in the Decade of Action, but what does that mean to us as individual nations and regions?  I worked with many of you in my previous non-government position on the Decade of Action but I come to you today as a representative of the U.S. government to talk about how we set our goals, how we identify targets, and how we measure success in the United States.

In the United States, our road safety work is shared primarily by 3 federal agencies.  One is the Department of Health and Human Services (HHS) which includes the CDC and the Office of Global Affairs. Another is the US Department of Transportation (USDOT) which includes the National Highway Traffic Safety Administration (NHTSA).

The third agency is the agency for which I am privileged to serve as Vice Chairman – the National Transportation Safety Board or the NTSB.  I will give you an overview of some of the work that my colleagues at the USDOT and HHS have been doing, and then will describe the role of the NTSB in target setting in the U.S. which you may find unique and, I hope, helpful.

Healthy People 2020 is our national evidence-based target setting framework from the public health perspective. For injury prevention, an effort was made to make the targets multidisciplinary looking at different areas that are complementary such as individual behaviors, physical and social environments, and access to health services.

In addition, working together, the USDOT and CDC developed a Transportation and Health Tool (THT) to provide practitioners with access to data on the health impacts of different transportation systems.  Indicators are available for states, metropolitan areas, and urbanized areas that measure how the transportation environment affects health issues such as safety.  It isn’t always easy to set indicators when working across disciplines but the result is a tool that will help policy makers, practitioners and advocates.

Within the USDOT, NHTSA has a grant funding program for states and requires that each state sets targets in twelve safety areas, such as seat belts, pedestrian safety, and bicycle safety.  This encourages good planning so grant funds are spent effectively.

Now I would like to tell you about our work at the NTSB which might provide a useful model, especially for those countries that are still in the early stages of building your data collection programs.  Good population data is clearly important but it takes time to build the infrastructure to collect even basic death and injury data accurately.  At the NTSB, we conduct very thorough transportation accident investigations and we are agile enough to make – and change – targets as new safety issues emerge, often based on a single representative accident.

Congress mandated our mission to be a noble one – to be an independent agency dedicated to saving lives and preventing injuries in transportation.   As a result, we fiercely protect our values of independence, credibility, and transparency.  We are an independent agency headed by 5 independent Board Members who are appointed by the President and confirmed by the U.S. Senate.  We value scientific and investigative rigor.  And as for transparency, our work and deliberations and votes are done in the public eye in what is known as the Government in the Sunshine Act.

We investigate transportation accidents immediately after they occur – in all modes, land, air, sea – and determine the probable cause of accidents.

We use the results of those investigations to make safety recommendations with criteria for completion – these are essentially targets with measurable indicators.  These recommendations, or targets, have helped States & Territories in the United States make progress such as requiring airbags in vehicles, passing impaired driving laws, passing seat belt laws, improving school bus design, passing motorcycle helmet laws, improving safety barriers in road design, and setting standards for signage, to name a few.

In order to have the information we need to make safety recommendations and set targets from a single investigation, our investigations are extremely thorough in all modes.  For major highway crashes, we have experts who investigate many areas including:

  • human performance
  • survival factors
  • crashworthiness
  • highway factors
  • motor carrier
  • medical issues
  • vehicle factors
  • data recorders
  • and weather and fire

Although we have no regulatory authority, our good reputation has enabled us to successfully set and track targets for the benefit of safety. We have issued over 14,000 safety recommendations and about 80% have been adopted.  And although we have a good track record of having our recommendations adopted, we do not give up on targets that are not achieved.  Some take years or even decades to pass, especially if they must pass in all 50 states in the United States.  In fact, we still have work to do to pass a .05 BAC law which resulted from a 2013 safety recommendation.  So as you can see, we have much to learn from you as well.

As my colleagues at the CDC would say, gathering high quality data on the circumstances of crashes and the associated risk factors is critical to effective programs and policies to prevent crashes before they happen.  I would add that high quality data can take different forms from crash investigations to population-based data.  In addition to collecting high-quality data on deaths, injuries, and risk factors, the data should be widely accessible to governments, NGOs, and the general public. This can help stakeholders remain committed to the issue and hold us accountable for our work.

I'd like to borrow a phrase from our colleagues at the CDC who say road safety is a “winnable battle”.  It's a battle because the number of deaths on our roads is large and it will not be easy to eliminate them.  I also sometimes feel it is a battle when I am on-scene and see the violent aftermath of a crash or when I vote on an investigation in which people were killed and injured.  In fact, just before flying here today, I voted on the results of an investigation where the driver of a commercial truck hit a bus full of student athletes.  But despite these tragic and terrible examples, we cannot forget that this is a winnable battle – we cannot forget that if we apply effective interventions widely, we can save millions of lives.

In closing, there is no doubt that targets must be feasible, they must be measurable, and they must be based on sound science, but that does not mean they cannot also be inspiring and ambitious.  Targets ultimately must allow us to imagine what the world would be like if our work is as effective as it can be.  Targets allow us to imagine a world where no one dies because they were not properly restrained, a world where we know that our cars and our roads will protect us if we make a mistake, a world where no one thinks about getting behind the wheel when impaired by alcohol or drugs, a world where we can send our loved ones to school or work and know that they will come home safely.

Targets must allow us to imagine a better, safer, healthier world for everyone.  That is what public health pioneers did with setting targets to fight the small pox epidemic - and that is what we must do now with our targets for this new epidemic – our epidemic on wheels.  Thank you.