Although considerable progress has been made in reducing the highway fatality rate throughout the U.S., the relative risk of a driving fatality varies by more than 1,000-t0-1, depending on the way one chooses to drive. Such factors as alcohol and drugs, failure to use safety belts, excessive speed and aggressive driving substantially increase fatality risk. This is particularly true for young people, as vehicle crashes pose the greatest risk of fatality from all causes for those aged 1-34. Vehicle-related crashes are therefore a major health problem for the nation, and the most significant reason for lost years of productive life.

This paper describes the advances being made by the automotive safety community in the U.S. to further improve the design and performance of motor vehicles to avoid a crash and prevent injury. It also discusses the need for careful evaluation of opportunities for further safety gains. These gains include not only the “hard technologies” of vehicle crashworthiness and crash avoidance hardware, but also the “soft technologies” of modifying driving techniques and risk-taking behavior to avoid crashes. That is, if a person has been taught proper driving techniques, exercises safe driving behavior, and has avoided crashes as a result, these “soft technologies” can take on equal importance in preventing injury as the “hard technologies” of crash avoidance by ABS, head-sup display, or obstacle-detection radar.

As part of national health promotion, HHS Secretary Sullivan has asked the medical profession to encourage the public to take responsibility for their own health. In much the same way, there needs to be a national program by the government and industry to encourage drivers to take responsibility for their own behavior and protection. Perhaps this could be an ancillary program to the current research on causes and control of crash injury to the nation’s citizens. It could help form a national strategy to determine the most effective ways in which driving behavior might be modified, and the principles developed could be employed to reduce risk-taking behavior, particularly in young people.