Walking Away--Safe: Pushed by personal tragedies and heartbroken constituents and sometimes by the federal government, legislatures are working to prevent motor vehicle injuries.

Just about every American adult knows what they should be doing to fend off such things as cancer and heart disease. Eat broccoli, exercise aerobically, stay out of the sun. But there's something else they should be doing to live longer, something simple and easy that can dramatically reduce the chances of an early death.

Buckle up!

Every 13 seconds, someone in America dies in a car accident and 52 people are disabled. Motor vehicle wrecks take about 41,000 lives and account for 2.2 million disabling injuries every year. About half of those killed are under the age of 35. Many survivors are seriously disabled by traumatic brain and spinal cord injuries.

Most people believe that injuries happen by chance and cannot be prevented. But the truth is that most crash injuries and deaths are caused by behaviors that are predictable and preventable, such as not wearing seat belts or driving drunk. The U.S. Department of Health and Human Services says motor-vehicle related deaths and injuries are as much a public health problem as cancer and heart disease. In its recently issued Healthy People 2010 initiative, the department says the overall health of the country can be improved by reducing the number of unintentional injuries, specifically those caused in crashes. How? By getting people to use seat belts and child safety seats, by creating stricter licensing for older and teen drivers and by increasing penalties for drunk drivers.

TRAFFIC SAFETY BIG IN LEGISLATURES

Nudged by personal tragedies or heartbroken constituents and often by the federal government, state lawmakers have considered more than 5,000 bills regarding traffic safety in the last five years. They've tried to increase seat belt use, deter drunk driving, protect child passengers and safeguard pedestrians. States considered nearly 1,300 bills in 18 key traffic safety areas this year alone.

Of interest to many lawmakers is the economic side of motor vehicle crashes. The National Highway Traffic Safety Administration (NHTSA) estimates it costs the country $181.5 billion a year in the form of property damage, lost productivity and medical expenses. These numbers do not include the cost of pain and suffering or the nonmonetary value of life. Each death costs society $970,000, while each disabling injury costs $35,300 according to figures from the National Safety Council. If a measure of the value of lost quality of life is factored in, each death costs society $3.1 million, and each incapacitating injury $153,000.

SEAT BELT USE PAYS DIVIDENDS

If everyone just used a seat belt, an estimated 9,550 lives would be saved and 50,000 disabling injuries each year would be avoided. A combination of legislation, police efforts and public awareness campaigns have resulted in a growth of seat belt use from only 11 percent in 1980 to 49 percent by 1990 to 73 percent in 2001. An estimated 80,000 lives have been saved between 1982 and 1999.

But should it be against the law not to wear a seat belt? Today, lawmakers are trying to decide if drivers should be stopped and ticketed if they aren't buckled up. It's called "primary" enforcement and it is much more intrusive on a citizen's personal rights than the first seatbelt laws passed some 20 years ago. Then, lawmakers were hesitant to penalize drivers for not wearing seatbelts because they weren't sure they should be meddling in their constituents' private lives. Seat belt violations became secondary offenses, and drivers were ticketed only when they committed another offense.

But statistics--as well as safety groups, victims and the law enforcement community--are pushing states to adopt more stringent laws. Seventeen states now enforce primary seat belt laws, and they are paying off. Citizens in those states are more apt to use their seat belts than they used to be. Several states with new laws showed dramatic improvement in 2000, including Alabama, which jumped from 58 percent to 71 percent seat belt use; New Jersey, 63 percent to 74 percent; and Michigan, 70 percent to 84 percent.

PERSONAL CHOICE VS. GOVERNMENT INTRUSION

But these aren't easy laws to pass because they smack of government intrusion. Many constituents look at seat belt use as a personal choice, and they believe the government has no business mandating it. Representative Irv Slosberg, a Florida legislator whose 14-year-old daughter died in a traffic crash because she wasn't wearing a seat belt, tried this year to upgrade his state's law. His bill also would have required that the number of passengers in a motor vehicle could not exceed the number of seat belts.

"More than 1,500 people died in crashes in Florida unbelted last year," he says. "The only proven way to stop these senseless deaths is to strengthen our seat belt law and motivate people to buckle up. It can be the difference between life and death in a crash. No father should ever have to face the kind of pain I did when Don was killed."

But his bill died on the floor because his fellow lawmakers weren't ready to create more government at a time when most believe less government is better.

The National Safety Council, a nonprofit research and advocacy group, says the issue isn't about government intrusion, but about saving lives. They expect legislators to be leaders in this area. A recent report card issued by the council gives 19 states Ds and Fs for driver and passenger safety. Eight states receive a C-, 11 get Bs. New Mexico, the District of Columbia and California are the only As. (The Golden State has an aggressive enforcement program that has motivated 89 percent of its citizens to buckle up.)

The council's efforts include a public awareness campaign, as well as encouraging law enforcement to step up ticketing. It also is pressing states to enact primary belt laws and remove loopholes so that all passengers are protected by seat belts.

KEEPING CHILDREN SAFE

Car crashes are the leading cause of death for children ages 5 through 12, claiming the lives of 2,027 children in 1998 (the most recent statistics available). More than 274,000 children are injured each year in wrecks. Kids are put at the greatest risk by riding unrestrained. Nearly half of all children ages of 4 to 7 who die in car accidents are not buckled in at all.

Most people--97 percent--buckle up their babies. The rate drops to 91 percent between the ages of 1 and 4. From ages 5 to 15, the rate drops to 68.7 percent. All 50 states have some form of child safety restraint law, but they don't cover all children in all situations. In some states, passengers 4 and older are not required to buckle up in rear seats. Other states do not require out-of-state drivers to comply with their laws.

The National SAFE KIDS Campaign says 24 states are utter failures when it comes to protecting kids. Seventeen others and the District of Columbia have laws that barely protect them, and seven are rated mediocre. Only laws in California and Florida come close to meeting the model laws established by the group.

A big problem, according to NHTSA, is that only a little more than 6 percent of children who should be in a booster seat--according to age and weight guidelines--actually are. It recommends that all children under 12 ride in the back seat, properly buckled into age-appropriate safety seats.

Most children outgrow their safety seats when they reach 40 pounds. The new recommendation is that they should be moved to a booster seat until they are at least 4 feet, 9 inches tall. This is the step many parents are missing.

ANTON'S LAW

In 1996, while visiting family in Yakima, Wash., Autumn Alexander Skeen and her 4-year-old son Anton were both buckled up using standard lap/shoulder belts. Autumn became distracted, lost control of her sport utility vehicle, and crashed. Anton slipped out from under the seat belt and was thrown from the vehicle. He died instantly. Skeen made a common mistake, following the common recommendation of that time, thinking that Anton was big enough to fit in the vehicle seat without a child safety seat. During the 2000 legislative session, the Washington Legislature passed Anton's Law, which requires children between ages 4 and 5 and between 40 pounds and 60 pounds to ride secured in a booster seat.

During the 2001 legislative sessions, 18 states considered bills to establish similar provisions. Seven state legislatures--Florida, Hawaii, New Jersey, South Carolina, Tennessee, Oregon and Rhode Island--passed booster seat laws. The laws in Florida and Hawaii were vetoed. Florida Governor Jeb Bush vetoed the bill citing, among other reasons, that requiring purchase of booster seats presented a financial hardship for needy families.

Representative Richard Devlin, sponsor of the Oregon bill, says that booster seat laws are important regardless of cost. The price is relatively small compared to the loss of a child or the expense of long-term disabilities that could have been prevented by using a booster seat, he says.

Air bags are another problem for young passengers. Combined with seat belts, air bags successfully save lives and prevent injuries. But they deploy rapidly--sometimes up to 200 miles per hour. The impact can cause injuries and death, especially to small adults and young children. A simple solution to this potential danger is to have everyone buckle up and make children ride in the back seat. Delaware is one of the few states with a law to that effect. Children under 65 inches and under 12 are required to ride in the back seat of vehicles equipped with passenger-side air bags.

REDUCING DRUNK DRIVING

There is one alcohol-related fatality every 33 minutes in the United States. A contributing factor to injuries and deaths is that seat belts are less likely to be used by an intoxicated driver or passenger.

About 1.4 million people are arrested for driving under the influence each year, but this is only a small number of the actual impaired drivers on the road. The Centers for Disease Control estimate that there were more than 126 million episodes of impaired driving. Because drivers younger than 18 were not included, this figure is probably an underestimate.

Alcohol-related crashes are not only tragic, but expensive. These crashes cost taxpayers $29 billion in 1997 in direct costs and lost earnings.

Drunk drivers killed 16,653 people during 2000. That is 40 percent of all traffic fatalities--up from the historic low of 38 percent in 1999. Proposals to combat drunk driving violations continue to be considered partly because of funding incentives and sanctions passed by Congress in 1998 in the Transportation Equity Act for the 21st Century (TEA-21) and in 2000 in the highway appropriations bill.

TEA-21 gives states incentives (mainly cash for state highway safety programs) to enact strong drunk driving provisions--including harsher punishments for drunk drivers convicted of having a high blood alcohol content and repeat offenders, establishment of a .08 BAC, and passage of open container laws. States that do not enact these laws by 2004 will have federal highway funds moved from construction accounts to safety programs.

Arizona Representative Linda Gray targeted repeat drunk drivers with her 2001 law that requires the use of ignition interlock devices for chronic repeat offenders. Then, the legislature passed a .08 BAC law that is now in effect. "Arizona has done all it can to prevent drunk drivers from being on the streets," Gray says. In addition to these new drunk driving laws, the Arizona Governor's Office of Highway Safety is training judges and prosecutors to help them understand drunk driving laws. The goal is for the judicial officials to have an understanding of the laws so they are comfortable enforcing them.

WORKING TOGETHER

Over the last four decades, the United States has made remarkable progress in reducing the number of people seriously injured and killed in traffic crashes. The rate of motor vehicle deaths per 100 million miles has dropped from 15.6 in 1930 to 1.54 in 1999, the lowest ever recorded. At the same time, miles traveled have skyrocketed from about 900 billion in 1965 to 2.7 trillion in 1999.

State legislatures play an important role in reducing injuries and deaths, whether introducing traffic safety legislation or promoting public education. Car crashes occur so frequently that nearly every person has either been in one or had a loved one involved. As Wisconsin Representative Jeff Stone, the former chair of the Highway Safety Committee, says, "Many of us come so close to being injured or killed in crashes, we need to do what we can to improve the odds."

Melissa A. Savage specializes in traffic safety issues at NCSL. James B. Reed, who directs NCSL's transportation program, also contributed to this story.

TRAFFIC SAFETY BILLS INTRODUCED IN 2001


.08 BAC                 52

Aggressive Driving      32

Revoking Licenses       39

Booster Seats           24

Cell Phones in Cars    125

Child Passengers       131

Elderly                 12

High BAC                27

Motorcycle Helmets      42

Open Containers         22

Pedestrians            147

Pickup Bed Riders       10

Red Light Running       65

Repeat Offenders        73

School Buses           191

Seat Belts              87

Speed Limits            87

Teen Drivers           128

Total                1,294

RELATED ARTICLE: CUTTING DOWN ON ACCIDENTS BY TEEN DRIVERS

Teenagers can be dangerous drivers. Their inexperience, the willingness to take risks and frequent driving with friends at night increases their vulnerability. They make up only 7 percent of the driving population, yet are involve in 14 percent of all traffic deaths.

Graduated licensing is one Way to reduce teen injuries and deaths. Through this system, teen drivers gradually earn full driving privileges through a series of stages. In the first stage, teens are usually required to hold a learner's permit and drive a certain number of hours accompanied by a parent or guardian. The goal of the learner's stage is to give the teens the opportunity to gain as much driving experience as possible in lower risk situations.

After the learner's permit, teen drivers 'graduate' to the intermediate stage and are allowed to drive without parent or guardian, but still with some restrictions. Some states place passenger restrictions, meaning teens can have only a certain number of people in the vehicle while they are driving. In some states, since nighttime driving leads to more teen crashes, curfews are used to remove this risk.

Once the teen has completed the learner's and intermediate stages, he or she is eligible to apply for a full license--in other words, one without restrictions.

Over the past few years, most states have passed some kind of graduated licensing. Many states are amending their laws by adding new restrictions, like curfews and placing limits on the age and number of passengers.

HOW MUCH ACCIDENTS COST

The National Safety Council determines how much accidents cost society by figuring out the actual economic costs: wage and productivity losses; medical expenses; insurance, police and legal costs; motor-vehicle damage; and employer costs, then adds the value of lost quality of life. The values of lost quality of life are obtained through empirical studies of what people actually pay to reduce their safety risks, such as buying safety features like air bags. The figures they come up with show the average costs per death or per injury for a certain year.

In 1999, the average economic cost was:

Per Death--$970,000

Per Disabling Injury--$35,300

By adding the value of lost quality of life, you get the comprehensive cost, for 1999:

Per Death--$3,100,150

Per Serious Injury--$153,453

MONEY FOR THOSE WITH BRAIN OR SPINAL CORD INJURIES

Through additional fines on traffic violations or surcharges on court convictions, at least 12 states (Alabama, California, Florida, Georgia, Illinois, Kentucky, Louisiana, New Jersey, New Mexico, New York, Mississippi and Tennessee) have established brain or spinal cord injury trust funds to provide the help needed for survivors to return to the community.

Louisiana's trust, created by the Legislature in 1993, currently serves 250 citizens, although 400 are on the waiting list. The fund relies entirely on additional fees imposed for driving offenses to provide medicine, rehabilitation and equipment necessary for daily living. So far, just under $11 million has been collected. Expenditures are capped at $15,000 for any 12-month period and $50,000 in total expenditures per individual. On average, the fund collects $1.5 million annually.

Reed Morris, NCSL