[sustran] FW: WHO report on Road Traffic Injury Prevention

Todd Alexander Litman litman at vtpi.org
Fri Apr 16 01:20:04 JST 2004


I was a member of the expert team which helped write the "World Report on 
Road Traffic Injury Prevention" 
(http://www.who.int/world-health-day/2004/en). I was mainly involved in 
developing Chapter 4, which identifies interventions.

There was considerable internal debate concerning motorization as a risk 
factor, and the role of mobility management as a safety strategy. Our 
original draft emphasized the importance of strategies that reduce 
automobile travel volumes and speeds, but this was weakened considerably 
during the review process. The good news is that some of it was 
incorporated in the report. The bad news is that it is not as prominent or 
as detailed as I would have preferred.

An issue of considerable debate was how to handle the relative accident 
rates of different modes. Motorized travel tends to have fewer user deaths 
per passenger-kilometer than non-motorized travel, and so it is easy to 
conclude that increased motorization reduces risk. This is implied in Table 
3.1 (p. 75) which does not take into account the risk to other road users, 
or the tendency of motorization to increase total travel. This issue is 
mentioned on page 111, but is not highlighted or linked to the previous 
section. There is also little discussion of the health benefits of 
increased walking and cycling which may offset some or all of the accident 
risks, particularly in industrialized countries.

The WHO report also fails to discuss "offsetting behavior", the tendency of 
people to take greater risks when they feel safer, a critical issue when 
evaluating many of the solutions presented, such as safer roads and vehicles.

Chapter 4 includes the basic concept that risk can be reduced by reducing 
total vehicle traffic volumes and speeds, and by restricting motor vehicle 
use, and it emphasizes the safety benefits of improving and encouraging 
transit rather than private automobile travel. It also includes information 
on strategies such as improved walking and cycling facilities and traffic 
calming. It relies considerably on my report "If Health Matters: 
Integrating Public Health Objectives Into Transportation Planning" 
(http://www.vtpi.org/health.pdf), which discusses these issues in more detail.

The report indicates that per capita crash rates decline with increased 
motorization (see the third paragraph of page 40). Figure 2.2 shows Africa 
to have the highest per-capita crash rates, although this is based on 
limited and highly aggregate data, and Table 2.5 indicates a much lower 
traffic fatality rate for Sub-Saharan Africa. Much of the data is at the 
regional level, which hides differences between different countries and 
cities which may indicate how factors such as motorization affect crash rates.

Regardless of the exact death rate, traffic accidents are a terrible 
problem in developing countries, and the evidence is that this risk 
declines with increased motorization, as vehicle and road quality improve, 
people (drivers and other road users) take more precautions, and emergency 
medical services improve. However, the ultimate level of traffic safety in 
a particular country or city is affected by per-capita vehicle ownership 
and use, and other transportation and land use policies. This explains, for 
example, why the U.S. has a much higher per capita traffic fatality rate 
than most other developed countries (more than twice the rate in the U.K.), 
despite having modern vehicles, well designed roads and numerous safety 
programs; and why U.S. cities with more balanced transportation systems 
have a fifth of the traffic fatality rate as automobile-dependent, Smart 
Growth cities (see "If Health Matters" for information). Unfortunately, the 
WHO report provides no information on these issues, and so supports the 
conclusion that per capita vehicle ownership and mileage do not affect risk.


The Conclusions and Recommendations (Chapter 5) includes many good ideas. 
For example,

Box 5.1 recommends encouraging walking and cycling and improving walking 
and cycling conditions.

On page 158, level of motorization, modes of travel, the volume of 
unnecessary trips and land use planning practices are all listed as risk 
exposure factors.

On page 162, recommended safety strategies include safer cycling and 
pedestrian facilities, and convenient, safe and affordable public transit.


The European WHO report "Preventing Road Traffic Injury: A Public Health 
Perspective For Europe" (www.euro.who.int/document/E82659.pdf) similarly 
contains a lot of good information, such as the first of "Highly effective 
measures for road safety" listed in Appendix 1:

"Incorporating as a long-term goal, safety features into land-use and 
transport planning – such as the
provision of shorter and safer pedestrian and bicycle routes and 
convenient, safe and affordable public
transport – and road design, including controlled crossings for 
pedestrians, rumble strips and street
lighting"


Please let me know if you have questions or comments. I am interested in 
hearing how these issues are perceived in developing countries. Also, 
please let me know if you have any specific suggestions for improving my 
paper "If Health Matters".


Best wishes,
-Todd Litman



At 11:02 AM 4/14/2004 +0800, Barter, Paul wrote:


>-----Original Message-----
>From: Rural transport and development mailing list
>[mailto:RURAL-TRANSPORT-DEVELOPMENT at JISCMAIL.AC.UK] On Behalf Of
>Priyanthi Fernando
>Sent: Tuesday, 13 April 2004 8:45 PM
>To: RURAL-TRANSPORT-DEVELOPMENT at JISCMAIL.AC.UK
>Subject: WHO report on Road Traffic Injury Prevention
>
>
>Dear colleagues
>
>The WHO has just put out its World Report on Road Traffic Injury
>Prevention (see links at the end of this email).  I have just skimmed
>the introductory chapters.  The statistics speak for themselves - 1.2
>million people killed per year begs that resources are channelled to a
>War Against Traffic Accidents!
>
>At the IFRTD Executive Committee meeting in November 2003 we
>had a considered discussion on road safety.   It would seem to me
>that road traffic injuries are correlated with  the increase in high
>speed road networks and increased motorisation.  The 'vulnerable road
>users' (pedestrians, cyclists, and motorcyclists - and perhaps other
>non-motorised transport users ) are the most at risk but perhaps also
>the least likely to benefit from motorisation and highways. So, from the
>perspective of reducing vulnerability of poor people, do we not also
>need a road traffic injury prevention strategy that questions the
>dominant paradigm of high speed motorisation?
>
>The following xtract from a contribution to the sustran email network
>shows that the World Bank (a co-author with WHO of the publication)
>finds it difficult to 'walk the talk':
>
>"  Providing uninterrupted speed to vehicles results in higher accidents
>yet the authorites plan for super highways within cities and expressways
>cutting through rural areas..... The World Bank bemoans high road
>accident rate in Mumbai, a city of  12 million plus residents yet has
>extended liberal loan for Mumbai Urban Transport Project. in which
>construction of expressways and flyovers predominate. Now six lane
>carriageways are increased to eight with no pavements.  The Bank further
>records that pedestrians form  95% of accident victims and turned down
>citizen request for construction of pavements.  Is this how the poverty
>is reduced........ "
>
>I hope this will spark some discussion on this issue of road safety...
>
>Priyanthi Fernando
>IFRTD
>
>
>LINKS
>
>To download the report:
>
>http://www.who.int/world-health- day/2004/infomaterials/world_report/en/
>
>Developing country organisations can order a hard copy from the WHO
>bookshop for 15 Swiss francs which is about 13.50 USD
>
>http://www.who.int/bookorders/anglais/detart1.jsp?sesslan=1&codlan
>=1&codcol=15&codcch=572
>
>
>Priyanthi Fernando
>Executive Secretary, IFRTD
>113-114Spitfire Studios,
>  63-71 Collier Street
>London N1 9BE. United Kingdom
>Tel: +44 20 7713 6699
>Fax: +44 20 7713 8290
>Email:  priyanthi.fernando at ifrtd.org OR ifrtd at ifrtd.org
>Web: www.ifrtd.org
>
>IFRTD provides a framework for collaboration between individuals and
>organisations interested in issues of access & mobility as they affect
>the lives of rural people in developing countries.


Sincerely,
Todd Litman, Director
Victoria Transport Policy Institute
"Efficiency - Equity - Clarity"
1250 Rudlin Street
Victoria, BC, V8V 3R7, Canada
Phone & Fax: 250-360-1560
Email: litman at vtpi.org
Website: http://www.vtpi.org




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