We tacitly agree to accept a certain level of carnage in order to use the highways in ways we value. At the present time in the US, this tacit agreement says that it is acceptable to sacrifice between 40 000 and 42 000 lives annually.” So said Patricia Waller, then director of the University of Michigan’s Transportation Research Institute, in 2001. 1  

In 2004, the death toll was 42 636. Traffic crashes (see, for example, figure 1) are now the leading cause of death for young people in this country. 2 We rightly congratulate ourselves, our governments, and automobile manufacturers for reducing the danger per vehicle and per vehicle mile. But we can be accused of tolerating the appalling present rate of traffic deaths shown in figure 2. As the figure shows, Germany and Canada, which have more effective programs for reducing traffic injuries, are achieving...

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