Preventable deaths in U.S. traffic crashes from 1970–2024

Objective Traffic safety in the U.S. lagged 14 other countries with increasing gaps since the 1990s. This study quantified the annual and cumulative number of preventable deaths if the U.S. matched the average safety record of other countries.Methods Traffic fatality data was obtained from OECD for 1970–2024. Fourteen countries with total fatalities similar to the U.S. were used to compare traffic fatalities. The fatality data was normalized by the number of deaths in each country in 1970 (ratio = 1.00), giving a ratio of traffic deaths over time. The ratios for the 14 countries were compared to the U.S. ratio each year. A t-test with paired fatality ratios compared the 14 countries to the U.S. The difference was significant if p < 0.05. The annual difference was determined between the U.S. traffic deaths and the deaths, if the U.S. matched the average fatality ratio of the 14 countries. A positive difference represented preventable deaths if the U.S. matched the average of the 14 countries that year. The sum of annual preventable deaths was determined. The societal cost for the preventable deaths was determined by multiplying the number of preventable deaths by the economic cost of a fatality and the value of a statistical life (VSL) each year. The cumulative cost for the preventable deaths was determined.Results The fatality ratio in the U.S. diverged from the average of 14 countries starting in 1992 with the U.S. lagging in traffic safety. The gap has steadily increased. In 2024, the fatality ratio was 0.748 in the U.S. It was 0.219 ± 0.104 (sd) in the 14 countries. The ratio was 3.42-times greater in the U.S. than the 14-county average. The difference in the ratios was statistically significant starting in 2001 (t = 3.08, p < 0.01) and has steadily increased in significance through 2024 (t = 17.12, p < 0.0001). The annual number of preventable deaths in the U.S. peaked at 31,865 ± 1,057 (se) in 2021 and has been more than 15,000 since 2003. From 1977–2024, the cumulative number of preventable deaths was 660,176 ± 20,331 with 80% occurring the past 25 years. The cumulative economic cost of the preventable deaths was $813 B with 93% occurring the past 25 years. The cumulative VSL was $4.52 T ($4,517.5 B) with 95% occurring the past 25 years.Conclusions From 2000–2024, there were 528,245 ± 9,042 preventable deaths in U.S. traffic crashes at an economic cost of $754 B and VSL of $4.30 T. These amounts could have been avoided or reduced if the U.S. matched the average safety record of 14 countries, which have increasingly used automated enforcement, speed controls, sobriety checkpoints, impairment detection, behavioral interventions, road changes, and best practices the past 25 years.