It's a Public Health Issue

From 1920 through 1989, an average of 21.7 people died in U.S. traffic accidents per 100,000 of population.

From 1990 through the first 9 months of 2012, the average was 15.9.

Since 2000, the number is 13.4. For the last three years (counting the partial year 2012), the number has remained below 11.

This decline has been the result of a number of factors, but the overarching reason that encompasses all of them is that the nation began looking at traffic fatalities as a serious public health issue that needed to be addressed.

Part of the improved safety record resulted from technological improvements, safer cars, some mandated and some not. I'm not a car enthusiast, but off the top of my head, I can think of seat belts, air bags, strategic reinforcements of the car so as to reduce the effects of various types of collisions, and no doubt many more important design improvements I know nothing about.

Another part of the effort involved successful educational efforts that brought about behavioral changes in the population. Anyone my age remembers people who refused to let the government tell them they had to wear seat belts, by gawd. These people didn't want to know anything about statistics; they had their opinion. But they came around, or died off. As evidence that automobile and driver safety was considered a public health issue, people my generation will remember when doctors began asking if you used your seat belt.

Another important result of the educational efforts has been a seismic change in the national attitude toward drinking and driving, much of it due to the educational work of MADD.

The decline in smoking in the U.S. has perhaps been less dramatic, perhaps not. Smoking rates in the U.S. are about half of what they were in the mid-1960s, and I don't know what the current data shows, but the last I saw, the rate of teens taking up smoking was decreasing. Not much of this improvement can be said to result from technological changes, government-mandated or otherwise, although there may have been some mandates regarding the levels of tar and nicotine. Mostly it has resulted from government-enforced behavioral changes (limiting smoking in public places) and educational efforts. Once again, as with seat belts, behavioral changes that result from government mandates don't come without some resistance. We all knew people who thought their god-given right to smoke superseded everyone else's right to breathe smoke-free air. Perhaps there are a few of them still around, but they're rare these days.

The current elephant in the room as regards public health issue, is gun violence. A friend, in a recent blog post, cited Justice Department data which shows that gun violence and the number of gun-related homicides has actually gone down in the last 20 years, even though, if you are murdered, odds are it will be by someone using a gun. While that reduction may surprise many people, what should alarm us is that we have no idea why it has happened.

Part of the answer may involve the aging of the population. Another part probably relates to policing procedures which have contributed to a decrease in crime overall, and not just violent crime. A recent New Yorker article that I'm not going to hunt for at the moment looked at the reduction in crime in New York City since the 1980s. One of the biggest factors identified was the police application of the broken-window theory.

But the point is that we don't have any idea why gun violence is down over the last two decades beyond the fact that it mirrors a general decrease in crime. The CDC began treating gun violence as a public health issue sometime in the 1980s, at least to the point of collecting research data. In the mid 1990s, the NRA used its political leverage to see to it that the CDC's budget was cut by exactly the amount of money it was spending on gun violence research.

Apparently for the following few years, some private foundations stepped up to fill the funding gap, but that has almost all fallen away. One of the principle researchers in the field now discourages his graduate students from doing gun research, because it is a dead end that will only lead to frustrations.

One supreme irony, or example of chutzpah, is that when anyone cites research findings from the time when the CDC was still involved, the gun lobby routinely dismisses it derisively as “old data” and, therefore, worthless. (Or to use one of my favorite Archie Bunker-isms, ipso fatso worthless.)

I'm just thankful the founding fathers didn't write cars and tobacco into the Bill of Rights.