Challenge: Reducing Motor Vehicle Deaths
Do you have an idea for making our roads safer ?
Imagine if we could end motor vehicle fatalities like the one that killed Niloufar Khanverdizadeh and Atena Arabsalmany on Halloween night. Young, beautiful minds, just 21 – crushed by blunt force trauma after their car lurched into the oncoming traffic lane at 10:30 p.m. in Richmond Hill, Ontario.
Friends have memorialized Atena and Niloufar on Facebook. Those of us who did not know these women (and by all accounts they were exemplary in their kindness and humanity) can all reflect on someone we knew with a likeness to them: a vibrant high-school or university wunderkind – snuffed out by fast cars.
We do not yet know all the facts (the driver survived, and the crash is under investigation). But we do know this: motor vehicle deaths in this country should be eliminated. Nobody should die like this.
According to Transport Canada, there were 2,889 traffic deaths in Canada in 2006, and 15,000 serious collision injuries. An August 2007 Transport Canada study (based on 2004 collision data) put the social cost of motor vehicle collisions at $62.7 billion for Canada (or 4.9 per cent of Canada’s total GDP). The estimate for Ontario was $17.9 billion, or 3.5 per cent of Ontario’s 2004 GDP.
Direct costs include property damage, emergency response teams, hospital care, other non-hospital medical care and insurance administration, out-of-pocket expenses by victims of collisions and traffic delays (lost time, extra fuel, and pollution) and of their families. Indirect costs include what the Transport Canada report called “the human consequences of collisions, such as partial and total disability of victims, activity and workdays lost – as well as the pain and suffering of victims and their families.”
A group of my friends, mostly in finance and private equity, recently put their minds to solving this problem. None of us are experts in motor vehicle injuries. What these friends did know well is the Black Swan. A Black Swan could eliminate road vehicle deaths.
The term "Black Swan" — popularized by scholar Nassim Nicholas Taleb in a 2007 book — originates in nature: Until the discovery of the Australian Black Swan, humans had considered all swans to be white. When ornithologists saw the first Black Swan, this threw into question and contradiction everything we had ever thought we knew about swans.
In policy circles, the Black Swan refers to a rare, extreme idea, or an extreme event (a recent example is the abrupt tightening of the global credit markets following the mortgage meltdown) that is prospectively unpredictable but carries with it enormous positive, or negative, consequences. A Black Swan can refer to an innovation – a disruptive technology innovation, say, like itunes, which changed the entire business model for the music industry overnight. Or it can be negative – like 9/11.
In the health care context, we now face a tsunami of chronic illness. It will take a positive Black Swan to reverse the tide.
Health care’s great challenge is the rapidity with which chronic illnesses (including diabetes, heart disease, asthma, daily pain, and cancer) and the bad habits that abet them (unhealthy eating, stress, alcohol, and physical inactivity) have conspired. Prior to the current recession, these factors had squeezed the necessary financial and human resources to keep humanity healthy and vibrant. The escalating global financial crisis further threatens to unhinge budgets in hospitals and health regions in this country and around the world. How do we find another Black Swan, a positive one, to ease this crisis?
Let us return to motor vehicle deaths – just one of hundreds of extraordinary health policy challenges – to try to answer this question. If we could reduce motor vehicle deaths and serious injuries to zero, or even slash them by one third, we might free up enough resources to pay for the nurses and physicians we all need, and for the information technology systems required to dramatically reduce medical errors.
My friends in my little social entrepreneurship club were intrigued by the fact that some jurisdictions, in Canada and around the world, are making estimable progress in the fight against motor vehicle injuries. This is a good news story that doesn’t make headlines. Traffic fatalities actually fell in 2006, according to Transport Canada data, even though the number of drivers rose. From 1987 to 2006, road traffic deaths declined by 32.5 per cent, an impressive figure by international standards. Our group also noted the historically huge variation in average annual death rates across Canada (from a low of 7.0 per 100,000 in Ontario to a high of 16.4 per 100,000 in the Yukon). (The latter are based on 2004 Statistics Canada data).
The idea behind a social entrepreneurship club such as ours is to collectively land on a good solution and invest in it. But we couldn’t arrive at a consensus investment idea. We did, however, come to agreement that, given the variability in death rates among jurisdictions with comparable populations, policy solutions at the local level must be significant. These solutions might include road, highway and bridge infrastructure; smarter drunk driving legislation; better traffic law enforcement (police deployment, or aerial speed traps); targeted social marketing/ education campaigns aimed at youth to deter dangerous driving; and car safety legislation (including cell phone bans while driving). Some jurisdictions around the world have even found success using strategically deployed fake images of police cars and toddler tricycles at key intersections.
Our group didn’t pretend to know the ultimate answer to this policy challenge. But I suspect that one of you – someone who may very well work in an industry far removed from health care – does.
(This is an edited version of an essay published in Canada's National Post).
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