Why the U.S. lags other countries in reducing traffic fatalities the past 25 years

OBJECTIVE: Since 1979, traffic fatalities dropped 16.0% in the U.S. compared to 77.4 ± 5.9% for 14 other countries. The gap to other countries has grown and has been statistically significant since 1996. This study describes reasons for the gap in traffic fatality reductions in the U.S. METHODS: NHTSA's research, programs and activities were analyzed to identify causes for the lack of traffic fatality reductions in the U.S. This includes policy decisions, selection of research projects, meaningfulness of NCAP and other tests, and errors in field accident data on serious injury and death. RESULTS: There were three primary and nine secondary reasons identified. NHTSA has: 1) not set targets focusing activities on fatality reductions, 2) not pursued research with measurable reductions in fatalities, 3) no meaningful engagement with industry, IIHS and others on research, NCAP, and safety priorities, 4) not conducted critical analysis of projects, programs and research, 5) inherent problems managing research, regulations, investigations, and enforcement under one leadership, 6) not verified assumptions for field accident data collection, 7) not used correct sampling frequencies or case weights in NASS-CDS and CISS, 8) not terminated testing that does not measurably reduce fatalities, 9) not followed-up on useful research, 10) not pursued crash tests with relevance to traffic fatalities and wrongheaded focus on MAIS 2 injuries, 11) not required timely engineering reports on internal and external projects, and 12) inaccessible archives of many reports and findings. Fatalities in the U.S. would have increased the past 25 years if safety technologies had not been voluntarily introduced by automotive manufacturers, including ESC (electronic stability control), AEB (automatic emergency braking) and high retention seats. NHTSA's budget has increased 459% over 25 years, a 14.4% increase each year. NHTSA has little to show for the extremely large budget, except "we could do better with more money." CONCLUSION: NHTSA must set priorities and targets for research, programs, and activities that reduce traffic deaths. They must change their leadership, because the Agency has failed its core mission to reduce traffic deaths the past 25+ years. NHTSA focuses on new car technologies in crash tests with no relevance to fatal accidents. Most fatalities are in 10+ year old vehicles, where risky driver behavior is the main cause with no seatbelt use, alcohol-drug use, and aggressive, risk-taking speeding. NHTSA must prioritize risky driver behavior and align State activities to reduce traffic fatalities.