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Suggested Citation:"Chapter 1 - Introduction." National Academies of Sciences, Engineering, and Medicine. 2023. Highway Safety Behavioral Strategies for Rural and Tribal Areas: A Guide. Washington, DC: The National Academies Press. doi: 10.17226/27197.
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Page 1
Page 2
Suggested Citation:"Chapter 1 - Introduction." National Academies of Sciences, Engineering, and Medicine. 2023. Highway Safety Behavioral Strategies for Rural and Tribal Areas: A Guide. Washington, DC: The National Academies Press. doi: 10.17226/27197.
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Page 2
Page 3
Suggested Citation:"Chapter 1 - Introduction." National Academies of Sciences, Engineering, and Medicine. 2023. Highway Safety Behavioral Strategies for Rural and Tribal Areas: A Guide. Washington, DC: The National Academies Press. doi: 10.17226/27197.
×
Page 3
Page 4
Suggested Citation:"Chapter 1 - Introduction." National Academies of Sciences, Engineering, and Medicine. 2023. Highway Safety Behavioral Strategies for Rural and Tribal Areas: A Guide. Washington, DC: The National Academies Press. doi: 10.17226/27197.
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Page 4

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1   Fatalities and serious injuries associated with roadway crashes are a significant public health concern in rural and tribal settings. While about 14% of the U.S. population lives in rural areas, almost half of roadway fatalities occur in rural settings. According to the Fatality Analysis Reporting System in 2018, people who are American Indians and Alaska Natives experienced roadway fatality rates on a mileage basis twice the national rate (https://www.nhtsa.gov/research -data/fatality-analysis-reporting-system-fars). This guide supports the Safe System Approach (https://www.transportation.gov/NRSS /SafeSystem), which recognizes that there is no single solution to eliminate fatalities and serious injuries on our roadways. Instead, multiple strategies are required including safer people, safer roads, safer vehicles, safer speeds, and postcrash care. The Safe System Approach comprises six principles and five elements: Six Principles of the Safe System Approach: • Deaths and serious injuries are unacceptable. A Safe System Approach prioritizes the elimination of crashes that result in death and serious injuries. • Humans make mistakes. People will inevitably make mistakes and decisions that can lead or contribute to crashes, but the transportation system can be designed and operated to accommodate certain types and levels of human mistakes and avoid death and serious injuries when a crash occurs. • Humans are vulnerable. Human bodies have physical limits for tolerating crash forces before death or serious injury occurs; therefore, it is critical to design and operate a transportation system that is human-centric and accommodates physical human vulnerabilities. • Responsibility is shared. All stakeholders—including government at all levels, industry, nonprofit/advocacy groups, researchers, and the general public—are vital to preventing fatalities and serious injuries on our roadways. • Safety is proactive. Proactive tools should be used to identify and address safety issues in the transportation system, rather than waiting for crashes to occur and reacting afterwards. • Redundancy is crucial. Reducing risks requires that all parts of the transportation system be strengthened, so that if one part fails, the other parts still protect people. Five Elements of the Safe System Approach: • Safer people: Encourage safe, responsible behavior by people who use our roads and create conditions that prioritize their ability to reach their destination unharmed. • Safer roads: Design roadway environments to mitigate human mistakes and account for injury tolerances, encourage safer behavior, and facilitate safe travel by the most vulner- able users. C H A P T E R   1 Introduction

2 Highway Safety Behavioral Strategies for Rural and Tribal Areas: A Guide • Safer vehicles: Expand the availability of vehicle systems and features that help to prevent crashes and minimize the impact of crashes on both occupants and nonoccupants. • Safer speeds: Promote safer speeds in all roadway environments through a combination of thoughtful, context-appropriate roadway design; targeted education; outreach campaigns; and enforcement. • Postcrash care: Enhance the survivability of crashes through expedient access to emergency medical care while creating a safe working environment for vital first responders and pre- venting secondary crashes through robust practices for traffic incident management. Because rural and tribal settings often do not have dedicated staff who work only on roadway safety, opportunity often lies with those willing to take it on. This may include law enforcement, local road owners (e.g., counties, towns, or tribal governments), public health educators, emer- gency medical service providers, county and city elected officials, and local citizens. Each of these roles can contribute to improving roadway safety. Creating a coalition of interested individuals (with different roles in the community) is a way to be more effective by sharing the work and being able to reach more people in your community. You may want to share this guide with others and build a multidisciplinary team to engage in the effort. There is a growing recognition that more resources need to be made available for improving roadway safety in rural and tribal settings. Addressing equity in roadway safety is a component of the U.S. National Roadway Safety Strategy (https://www.transportation.gov/NRSS) (Box 1) and may make additional funds available to rural and tribal settings. Box 2 lists sources of funding that you may be able to use. Box 1. Equity and Roadway Safety “Achieving equity requires recognition that communities have been differently impacted by circumstances, structures, and historical contexts and that those who have been disadvantaged require a different allocation of resources and opportunities to eventually reach an equal outcome” (Michael et al. 2021, p. 2). Furthermore, “a Safe System can be implemented in ways that help address structural and institutional racism by correcting for prior under-investments in historically marginalized communities and closing gaps in safety between areas that have been well-served and those that have been underserved” (Center for Injury Research and Policy 2022). The $642 billion total transportation grants funding allocated for FY22 through FY26 by the Bipartisan Infrastructure Law (BIL) contains an unprecedented amount of funds designated to directly benefit rural communities that have been disadvantaged. The Equity Action Plan, released by the U.S. Department of Transportation (DOT) in January 2022, shows the department’s commitment to advancing equity through transportation and use of the BIL funds (U.S. DOT 2022). The Equity Action Plan has information on expanding access, providing technology support to underserved communities, addressing uneven resource distribution, building and activating coalitions, and improving transit deserts and areas of the country where lack of transportation greatly affects quality of life, and even includes a national technical assistance center to help overburdened and underserved communities.

Box 2. Sources of Funding for Improving Roadway Safety in Rural and Tribal Settings Safe Streets and Roads for All (SS4A) Grant Program https://www.transportation.gov/grants/SS4A Transportation Funding Opportunities for Tribal Nations https://highways.dot.gov/federal-lands/programs-tribal/funding-opportunities Indian Health Service https://www.ihs.gov/injuryprevention/tipcap/ Each Indian Health Service district office has specialty grants for specific project such as car seats and observational seatbelt surveys. Tribal Transportation Program https://highways.dot.gov/federal-lands/programs-tribal Rural Opportunities to Use Transportation for Economic Success https://www.transportation.gov/rural/grants/toolkit The Rural Opportunities to Use Transportation for Economic Success (ROUTES) initiative has a rural grants toolkit to assist those seeking funding to address disparities in transportation infrastructure. Reconnecting Communities Pilot Program https://www.transportation.gov/grants/reconnecting-communities Indian Highway Safety Program https://www.bia.gov/bia/ojs/dhs Safe Kids Worldwide https://www.safekids.org/ Safe Kids Worldwide has funding for prevention activities like car seats, bike helmets, etc. Local State Highway Traffic Safety Offices Safe roads grants may be available from local state highway traffic safety offices. Level 1 Trauma Hospitals http://www.maptive.com/ver3/traumacenters These hospitals must have a full-time paid injury prevention coordinator. Hospitals must do research and funding may be available. American Automobile Association Foundation for Traffic Safety https://aaafoundation.org/ The American Automobile Association (AAA) foundation has state offices that award grants for tribal and rural communities for specialty projects. For profit companies may support local efforts to improve roadway safety: • Insurance companies (car seats, bike helmets, etc.) • Chick-fil-A® has supported distracted driving campaigns. • Target® may provide gift cards for communities working on roadway safety- related projects. • Vehicle manufacturers (Chevrolet, Toyota, Volkswagen, etc.) Note: These funding sources may not be available indefinitely, and new ones may become avail- able in the future.

4 Highway Safety Behavioral Strategies for Rural and Tribal Areas: A Guide This guide is for anyone who wants to improve roadway safety in rural and tribal settings. It focuses on countermeasures and strategies to promote safer decisions by road users (often called behavioral countermeasures or strategies) as well as resources for safer roads (often engineering or maintenance practices that improve safety) and safer speeds. The guide includes four chapters in addition to this introduction: • Chapter 2 is a high-level overview of how behavioral countermeasures and strategies work. Understanding how behavioral countermeasures and strategies work will help you be more effective in selecting, adapting, and implementing countermeasures and strategies in your community. Countermeasures and strategies will not be effective in changing behavior unless they are implemented well. • Chapter 3 offers guidance on steps and resources for developing a plan to improve roadway safety. Improving roadway safety takes time. Having a plan will help you be more effective in the long term. It can also help you obtain funding to support your efforts. • Chapter 4 offers guidance on resources to identify, select, and adapt countermeasures and strategies to use in your community. There are several resources available with ideas on how to improve roadway safety. This section will help you identify resources suitable for your community. • Chapter 5 identifies specific actions you can take to be more effective over time. Counter- measures and strategies to improve roadway safety have limited impact if implemented only once. Each time you implement a strategy you can learn what worked and what did not so that you can be more effective the next time. More-detailed information is provided in the following appendices: • Appendix A: Example Logic Models, • Appendix B: Examples of Implementing Countermeasures and Strategies in Rural Settings, • Appendix C: Summary of Countermeasures That Work, and • Appendix D: Proven Engineering Safety Countermeasures.

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Roadway fatalities and serious injuries are a significant public health concern in rural and tribal settings. Creating a coalition of interested individuals is part of the Safe System Approach that addresses the high rates of these fatalities and serious injuries.

BTSCRP Research Report 8: Highway Safety Behavioral Strategies for Rural and Tribal Areas: A Guide, from TRB's Behavioral Transportation Safety Cooperative Research Program, details this approach, which includes strategies for safer people, safer roads, safer vehicles, safer speeds, and post-crash care.

Supplemental to the report are BTSCRP Web-Only Document 4: Highway Safety Behavioral Strategies for Rural Areas and a video that explains how to create a logic model.

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