Centers for Damage Control

fox guarding henhouse This week’s howler comes from Gwen Bergen, PhD, MPH, MS, behavioral scientist in the Division of Unintentional Injury Prevention of the National Center for Injury Prevention and Control [the DUIPNCIPC!] at the Centers for Disease Control:

“Motor vehicle crashes and related injuries are preventable.”

That of course, is not only official doctrine, but complete malarkey. No amount of safety technology is going to stop large subsets of 200,000,000+ independently steered (or remotely commanded) metals boxes traveling at high speeds on intersecting and undulating paths from colliding with one another and thereby injuring their occupants.

But even those whose careers stem from genuine worry over the appalling, undiscussed carnage of cars-first transportation can’t summon the chutzpah to face and state the plain truth that automotive travel is remarkably dangerous to the human person. Admitting this technological fact is simply and deeply verboten in our market-totalitarian society.

Instead, you get apparently sincere professional hopes pinned to utterly unexamined strings of reassuring presumptions:

“Although much has been done to help keep people safe on the road, no state has fully implemented all the interventions proven to increase the use of car seats, booster seats, and seat belts; reduce drinking and driving; and improve teen driver safety.”

News flash: Not only are no states going to do everything possible (which would include criminalizing cell phone use inside cars), but TCT says it again: Even if some state did everything on Dr. Bergen’s list, it would still be home to huge surpluses of preventable, inexcusable injuries and premature deaths.

The Unmentionable Ossuary

Despite their centrality to actual lives, the costs and dangers of cars-first transportation remain entirely “off the table” in our corporate capitalist, market-totalitarian society.

ossuary My great friend Douglas Pressman, who once escorted me into an ossuary located in the Czech Republic, conveyed this news item from the mighty USA Today:

Road accidents — not terrorism, plane crashes or crime — are the No. 1 killer of healthy Americans traveling abroad, a USA TODAY analysis of the past 7½ years of State Department data shows.

About 1,820 Americans, almost a third of all Americans who died of non-natural causes while abroad, have been reported killed in road accidents in foreign countries from Jan. 1, 2003, through June 2010. On average, one American traveler dies on a foreign road every 36 hours.

This, of course, is peanuts compared to the number of people killed here and around the world by cars when not on vacations or buying or spying junkets.

But it highlights the fact that our overclass simply suppresses rational public discussion of automotive death and dismemberment.

There were 2,996 people killed by the 911 terrorist attack. That is one-eleventh the number of people killed in U.S. car crashes in 2009, a year hailed by NHTSA officials and even Ralph Nader as a wondrously safe annum automobilis.

Despite their centrality to our transportation order and to ordinary people’s actual lives, the costs and dangers of cars-first transportation remain entirely “off the table” in our corporate capitalist, market-totalitarian society. Some deaths sell, and some don’t.

Do Cars Cause 100,000 U.S. Deaths a Year?

carskullIt would be hard to invent another everyday transportation order as wasteful of human well-being as the cars-first arrangement that has long prevailed in the United States.  In this, the initial post here on Death by Car, I review the most basic facts in this area from recent sources:

► In the year 2008, automotive collisions killed 37,261 people in the United States.  That’s 102 a day; 717 a week; 3,105 a month. And 2008 was no anomaly: Since World War II, more than 2 million individuals have perished in U.S. car crashes.

► In a nation that likes the sound of “no child left behind,” car crashes have long ranked as the #1 cause of death for every single age-year from 3 through 21.

► In typical years, the number of people “severely or critically” injured, but not killed, in U.S. car crashes surpasses the number killed.  In the Maximum Abbreviated Injury Scale (MAIS), a standard international system for ranking and tracking traumatic injuries, “severe or critical” injuries are those that surpass “serious” ones.v Injuries classified as merely “serious” (and hence not bad enough to be ranked “severe” or “critical”) only involve things like open leg fractures, amputated arms, and major nerve lacerations. To be classified “severe” or “critical,” a non-fatal collision must involve something like a severed spinal cord or a head injury with an extended period of unconsciousness and lasting brain damage.  In the words of the U.S. Centers for Disease Control, “For MAIS 4-5 [i.e. “severe” and “critical” injuries], the predominant [monetary] costs [of the crash] are related to lifetime medical care.”  Of course, as the authors of one study explain, “Persons injured in these crashes often suffer physical pain and emotional anguish that is beyond any economic recompense. The permanent disability of spinal cord damage, loss of mobility, loss of eyesight, and serious brain injury can profoundly limit a person’s life, and can result in dependence on others for routine physical care.”

► If the United States has a national odor, it is automotive exhaust. The smell, of course, is but the tip of the iceberg. “Automobile emissions are the main cause of urban air pollution and contain thousands of chemicals, several of which are recognized as mutagenic or carcinogenic.”  In addition, as a glance at the roadside after an urban snowstorm will confirm, both by fuel combustion and the normal wear of tires and roadbeds, automobiles –- especially those with diesel engines — also create large amounts of “particulate matter.” Breathing particulate matter is most dangerous for children, the sick, and the elderly, and exposure to it is heaviest among the poor, who are disproportionately non-white, and who disproportionately live near major urban highways.

► Because air-pollution damage to the human body accumulates over time and complicates several complex multiple-cause diseases, at present, we can only guesstimate the exact amount of suffering and death caused by automotive air pollution. A recent special report in the Journal of the American Medical Association estimated that the overall annual “airborne toxics” death toll in the United States is now running somewhere between 22,000 and 52,000 a year.  Even if the bottom of this range is right, and even if cars account for only a quarter of all U.S. air pollution exposure, that would mean autos-űber-alles causes over 5,000 more premature U.S. deaths each year, on top of its collision toll. Meanwhile, some medical researchers suspect that we may be radically under-estimating air pollution’s impact on human health.

► Either way, it’s certain that automotive air pollution also produces a mountain of non-lethal health costs. San Jose’s The Mercury-News, one of the few major U.S. newspapers to attend to the topic at all, reports:

The death toll due to air pollution only begins to touch the vast magnitude of human suffering caused by breathing our dirty air — for every 75 deaths per year due to air pollution in the U.S., health scientists have estimated that there are 505 hospital admissions for asthma and other respiratory diseases, 3,500 respiratory emergency doctor visits, 180,000 asthma attacks, 930,000 restricted activity days, and 2,000,000 acute respiratory symptom days.

► Autos-über-alles’ biggest health impact may lie in its discouragement of walking and bicycling. Studies confirm that the United States has by far the lowest percentage of miles traveled by foot or bike in the world.  Meanwhile, a rapidly worsening obesity epidemic plagues the nation, with health consequences for Americans that may soon surpass those caused by cigarettes. According to the Journal of the American Medical Association, “poor diet and physical inactivity” are now causing 400,000 deaths a year in the United States.  Even if car dependency explains only 10 percent of the society’s deepening food-exercise imbalance, that would mean another 40,000 American lives being sacrificed to the automobile every year.

Detailed sources for all the above factual claims will be published in my forthcoming book, Automobiles-Über-Alles: Capitalism and Transportation in the United States (Monthly Review Press).