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December 15, 1999

Reductions in Motor Vehicle–Related Injuries and Deaths—Reply

Author Affiliations

Phil B.FontanarosaMD, Interim CoeditorIndividualAuthorMargaret A.WinkerMD, Deputy EditorIndividualAuthorStephenLurieMD PhD, Fishbein FellowIndividualAuthor

JAMA. 1999;282(23):2210-2211. doi:10-1001/pubs.JAMA-ISSN-0098-7484-282-23-jbk1215

In Reply: Dr O'Brien raises questions about the contribution of public health in reducing motor-vehicle injuries. He claims that we have done no better than previous generations in preventing motor vehicle–related deaths. In truth, we have done much better.

In our article, we showed motor vehicle death rates from 1966 to the present to illustrate the impressive declines that resulted from aggressive traffic safety and public health measures. What we did not show was that prior to 1966, despite continuous decreases in the traffic safety indicator (deaths per 100 million vehicle miles traveled), the actual number of motor-vehicle deaths increased 242% between 1925 to 1966 (from 21,900 to 53,041, respectively) and the death rate per 100,000 population increased 42% (from 19.1 in 1925 to 27.1 in 1966). The measure used to set public health priorities and to compare health problems—deaths per 100,000 population—increased both before and after World War II. From 1960 to 1966, deaths per 100,000 population increased 28%, prompting federal legislation to curb the problem.1

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