Injuries and deaths related to motor vehicle accidents constitute a major public health problem that continues to take a significant toll upon the nation's citizenry. It is estimated that approximately 50,000 fatalities and 2 million serious injuries per year are attributable to motor vehicle accidents (National Highway Traffic Safety Administration, 1983; Sleet, 1984). This yearly death toll rivals that of all American fatalities that occurred during the entire Vietnam conflict. Financially, it is estimated that the costs associated with these deaths and injuries range from $48 to $70 billion annually. It is ironic that the above-described deaths, injuries, and financial costs are largely preventable through a few simple actions on the part of the drivers and passengers of motor vehicles. It is estimated, for example, that the consistent use of lap and shoulder safety belts, which are now standard equipment on motor vehicles sold in the United States, would reduce the incidence of deaths and serious injuries by over 50% (Evans, 1987, 1988; U.S. Department of Transportation, 1983). It seems that few other major public health problems are so potentially amenable to remediation as those related to motor vehicle accidents. Other types of so-called life-style disorders such as obesity, lung cancer, hypertension, or Acquired Immune Deficiency Syndrome also contain a large behavioural element in both their genesis and their alleviation. But they require relatively complex changes in an individual's comportment. For example, overweight persons may be asked to engage in a regular exercise program and change the quality and quantity of foods consumed. The hypertension sufferer may also be asked to lose weight, exercise, reduce salt and fat intake, and take a variety of medications. The prevention of AIDS requires the consistent use of condoms or other alterations in sexual practices and/or the use of sterile needles by drug abusers. The process of stopping smoking is complicated by the addictive properties of nicotine and the complex pharmacological reinforcement history most users of tobacco have experienced. Compared with the above problems, the act of consistently buckling one's safety belt when riding as a driver or passenger in a motor vehicle would seem to involve a relatively low response cost in return for a substantial risk reduction benefit. However, noncompliance with consistent safety belt use remains the norm, not the rule, for most people in the United States. Nationwide, observational studies find that about 75% of adults and 50% of children aged 0 to 4 years fail to use a motor vehicle safety belt or child safety seat (Ziegler, 1986). A recent nationwide survey conducted by the Center for Disease Control found that one out of every two adolescents reported that they did not use a safety belt the last time they were in a car (Sternberg, 1989). As it is well established that reports of safety belt use are usually exaggerations of actual safety belt compliance (Waller & Barry, 1969), it is likely that the actual belt use of contemporary teenagers is substantially less than 50%. These figures provide one explanation for the continued carnage on our nation's highways caused by motor vehicle accidents. (Author/publisher)
Samenvatting