Photo by Diana Beideman on Flickr.

Traffic is the leading cause of death among children worldwide and the leading cause of death among 1-34 year olds in the United States. So, why isn’t traffic considered the top threat to public health by the CDC, WHO and federal, state and local governments?

Why don’t officials approach traffic reduction with the same urgency that they approach, say, tobacco or malnutrition? The answer can be found in the CDC’s publications on injury prevention.

CDC’s research and prevention efforts target this serious public health problem. We focus on improving car and booster seat and seat belt use and reducing impaired driving, and helping groups at risk: child passengers, teen drivers, and older adult drivers.

The CDC, NIH and other agencies focus on traffic safety as the preventable cause of death, not traffic itself. WHO’s recommendations for addressing traffic fatalities are “speed, alcohol, seat-belts and child restraints, helmets, and visibility.”

The flaw in this exclusive focus on traffic safety is that increased safety only matters when vehicle miles traveled (VMT) are kept static or reduced. Instead, safety improvements that reduce fatalities per VMT have been offset by rising VMT.

Investments in traffic safety finally began to matter in 2004. According to the Brookings Institution, “driving, as measured by national VMT, began to plateau as far back as 2004 and dropped in 2007 for the first time since 1980,” obviously due to rising gas prices. As a result, the rate of traffic fatalities per 100,000 population finally began a much steeper decline in 2004 compared to earlier periods when safety improvements had been largely undermined by VMT increases.

But did this demonstrate the urgency of reducing traffic? Not according to NHTSA Administrator David Strickland, who said the following in a press release celebrating the decline:

This continuing decline in highway deaths is encouraging, but our work is far from over. We want to see those numbers drop further. We will not stop as long as there are still lives lost on our nation’s highways. We must continue our efforts to ensure seat belts are always used and stay focused on reducing distracted and impaired driving.

Attributing the recent decline in traffic fatalities solely or primarily to safety improvements is not only sloppy statistics given that safety improvements have lead to steady declines in fatalities per VMT for decades. It also sends the wrong message — people can feel safe driving, as driving itself is not part of the problem — a message which will only increase VMT further and bring a halt to reductions in traffic fatalities.

Attributing the declining fatality rate to safety improvements also allows the myth to perpetuate that moving to the suburbs is safer than living in the city, a myth that, left unchallenged, increases VMT and undermines safety improvements. This myth was exposed by the New York City Department of Health, which recently revealed that their low VMT per child made NYC a much safer place for children than the rest of the country.

So why does the CDC, WHO, NIH, NHTSA and probably every other public health agency treat poor traffic safety as the preventable cause of the top killer of children worldwide, and not traffic as well? And how many children will have to die for this to change? Are we serious about public health? The sooner we start demanding honesty about the causes of the top killer of children here and abroad the better, because during the 2 minutes you spent reading this article, another child died in a traffic collision.