title: Use and misuse of motor-vehicle crash death rates in assessing highway-safety performance.
abstract: OBJECTIVE
  The objectives of the article are to assess the extent to which comparisons of motor-vehicle crash death rates can be used to determine the effectiveness of highway-safety policies over time in a country or to compare policy effectiveness across countries.
  
  
  METHODS
  Motor-vehicle crash death rates per mile traveled in the 50 U.S. states from 1980 to 2003 are used to show the influence on these rates of factors independent of highway-safety interventions. Multiple regression models relating state death rates to various measures related to urbanization and demographics are used.
  
  
  RESULTS
  The analyses demonstrate strong relationships between state death rates and urbanization and demographics. Almost 60% of the variability among the state death rates can be explained by the independent variables in the multiple regression models. When the death rates for passenger vehicle occupants (i.e., excluding motorcycle, pedestrian, and other deaths) are used in the regression models, almost 70% of the variability in the rates can be explained by urbanization and demographics.
  
  
  CONCLUSIONS
  The analyses presented in the article demonstrate that motor-vehicle crash death rates are strongly influenced by factors unrelated to highway-safety countermeasures. Overall death rates should not be used as a basis for judging the effectiveness (or ineffectiveness) of specific highway-safety countermeasures or to assess overall highway-safety policies, especially across jurisdictions. There can be no substitute for the use of carefully designed scientific evaluations of highway-safety interventions that use outcome measures directly related to the intervention; e.g., motorcyclist deaths should be used to assess the effectiveness of motorcycle helmet laws. While this may seem obvious, there are numerous examples in the literature of death rates from all crashes being used to assess the effectiveness of interventions aimed at specific subsets of crashes.
authors.affiliation: Insurance Institute for Highway Safety, Arlington, Virginia 22201, USA. brianoneill@cox.net
authors.forename: Brian
authors.initials: B
authors.lastname: O'Neill
authors.forename: Sergey Y
authors.initials: SY
authors.lastname: Kyrychenko
mesh_terms: D000063:Accidents, Traffic / Q000401:mortality* / Q000517:prevention & control; D006801:Humans; D008137:Longitudinal Studies; D011640:Public Policy; D012044:Regression Analysis; D012307:Risk Factors; D012449:Safety; D014481:United States / Q000453:epidemiology