Diabetes

I could just present you with this list, showing accidental deaths surpassing diabetes as a leading cause of death in the US.  But I wouldn't do that to you.  Because the truth behind the chart is that motor vehicle accidents account for 46,000 of the accidental deaths, so diabetes still wins at 71,000 (Congratulations, Insulin Resistance!).

I might show you this chart, in which diabetes doesn't even rank globally, while RTI's are climbing quickly. But you could claim the deaths due to ischemic heart disease are likely being contributed to by diabetes.

....At which point I'll claim both for cars!  I WIN!

How'd I do that?

Research.

We're all pretty aware at this point that diabetes is part of  metabolic syndrome, yes?  And a major risk factor for metabolic syndrome is what now?  Obesity!  And taking public transit is associated with walking 8.3 more minutes per day on average, or an additional 25.7–39.0 kcal. Hill, et al, estimate that an increase in net expenditure of 100 kcal/day can stop the increase in obesity in 90% of the population. Additional walking associated with public transit could save $5500 per person in present value by reducing obesity-related medical costs.

But there's more:   Each additional hour spent in a car per day was associated with a 6% increase in the likelihood of obesity. Conversely, each additional kilometer walked per day was associated with a 4.8% reduction in the likelihood of obesity. As a continuous measure, BMI was significantly associated with urban form for white cohorts. Relationships among urban form, walk distance, and time in a car were stronger among white than black cohorts.

If that's not enough motivation to get out of your car and walk a little, maybe this will be: a recent study conducted at the University at Buffalo and Erie County Medical Center showed that drivers who are moderately obese have a 21% increased risk of death in a crash. Worse yet, the morbidly obese have a 56% increased risk of not surviving a crash.  To account for this, they're proposing changes to the build of crash test dummies.

For heaven's sake all the time we're spending in cars is making the crash test dummies get fatter!

And just to prove RTIs are worse than diabetes without any Jedi mind tricks: 843 disability adjusted life years lost for diabetes, 1081 for RTIs.  That is, RTIs are robbing us of more healthy, productive life years than diabetes, even as we think they are helping us by getting us there faster or more.

Congratulations, cars....?

Murder

Seriously, I can't make this stuff up.

In fact, wish I were making this up. 


Annually, 40,000 people die as a result of injuries acquired in motor vehicle crashes in the US.   According to the CDC motor vehicle crashes are the leading cause of death among those age 5-34 in the U.S.  As Carolyn Hirschman, in her article "Take Control of the Wheel," puts it  "As a nation we are nearly three times more likely to be killed in a car crash than by homicide, and our children face no greater risk of dying from any cause, accidental or disease related.   If we die at work, it is usually in a vehicle; since records started being kept in 1992, crashes are the number-one killer on the job, with professional drivers, salespeople, and farmers especially vulnerable."

The trend holds globally, where the number killed is 1.3 million annually.  Compare that to a global rate of 490,000 intentional homicides in 2004 (Yeah, every-professor-I've-ever-had, I Wikipedia'd it.)  

You are in more danger driving the kids to soccer or to the store for milk than taking a pleasure stroll through Detroit.  So why isn't Dick Wolf making serious syndication dollars off Law and Order: DMV?

Because car murders are a legitimized form of violence. We accept driving fatalities as inevitable.  There are some car crimes that are becoming delegitimized: drunk driving, the most egregious of road rage incidents.  But for the most part, as the authors of Carjacked put it: "Americans on the whole still believe our cars and roads are safe and that it is individual drivers who are responsible for automotive injuries and deaths.  News reports of any crash rarely treat it as a tragedy whose repercussions can last for decades.  They inevitably treat it as a stroke of really bad luck or as inevitable due to poor driving conditions or bad driving behavior, rather than as part of a pattern that can be broken by driving less, using safer modes of transit, regulating car companies and enforcing behavior on the road.  And thus Americans, on the whole, like the car companies we buy from and the government we elect, have resisted regulation and enforcement."

People die in horribly violent ways, at a higher rate than by homicide, but no one's on the news asking "What are the police going to do about this?  This is ruining our suburbs!"  No one worries that the tourists will stop coming to your suburb to see..............(Ok, I can't think of anything...your awesome collection of strip malls?) because of concerns about car violence.  But not only do consumers excuse it, they're accomplices.  


While the automotive manufacturers distract us with the ways they're making cars safer through engineering and design with one hand, they're distracting us in our vehicles with the other.  Each day, according to CDC data, more than 16 people are killed and more than 1,300 people are injured in crashes involving a distracted driver.  While distracted driving is increasingly being legislated against and becoming an enforcement priority, cars are getting computer screens because you''ll buy the cars that have them: "Initially, putting Internet access in the car sounds like a distraction and frivolous but as time passes it will become a part of our lives and we will feel uncomfortable not having access," said Jeff Kagan, an independent telecoms analyst."I think this is going to grow into a vibrant sector."


Here's a hint: your safety is only as good as their bottom line.  No matter how good their ad execs are,  they're still not in it for you, or your kids.  The way to stop this epidemic is by hurting their bottom lines--or even better, voting with your feet. 


Otherwise, it's time for my L&O franchise.  Sure a plushie-lovin', horse-and-rider fetish -havin', sci-fi role-player wielding a compressed gas knife (I may have mixed some Bones in there.  Also, these shows are a little too into fetishes.) is infinitely more sexy than a soccer mom fumbling with her cell phone, but Soccer Mom's way more deadly.  


Hey--people could even watch it on the screens in the car.  Synergy!

Katrina??

Well now they're just doing my job for me...

Which Was Worst, Katrina or Car-Culture?

That was easy.

Kidnappers

I don't have kids.  So I generally try to keep my mouth shut about kid-related issues rather than invite picky-eater, loud-toy, poor-sleeper karma my way.  But what with all the revolutions/earthquakes/tsunamis/nuclear disaster/tornadoes hitting handgun factories (okay, the last one might have only happened on 30 Rock) this week, I'm in a mood to tempt karma.

In the United States, the chances of a child being abducted and killed by a stranger--the kind of kidnapping that people envision happening if they dared let their child walk home from school--are one in 1.5 million.

The chances of a child in the United States dying in a motor vehicle crash are one in 50 thousand.  The chances of injury in a motor vehicle crash: one in 300.  I'll admit my math is slightly imperfect since I used CDC data from 2005 divided by population data from the 2008 census so here's the raw data: in 2005 1,335 children ages 14 years and younger died as occupants in motor vehicle crashes, and approximately 184,000 were injured.  That’s an average of 4 deaths and 504 injuries each day--compared to 0.3 abductions daily.

I was talking to a friend of mine the other day about my niece's walk to school: two blocks--with sidewalks--in a posh neighborhood.  The one street she has to cross has a crossing guard.  By far the greatest danger she faces is avoiding all the parents on cell phones trying to maneuver their SUVs into the driveway once she reaches the school.  My husband and I quickly came to the consensus that we'd allow a theoretical child of ours to do such a walk solo sometime in the 1st-2nd grade year, depending on the maturity of the particular kid.  Before I could tell my friend this, she answered, "Oh, probably around age 13 or 14."  

We can't trust kids to walk alone until 14, but two years later it's no problem to hand them the keys to the two-ton death machine?  How did we get here?

In 1969, 41 percent of children either walked or biked to school; by 2001, only 13 percent still did, according to data from the National Household Travel Survey.  Of kids living within a mile of their school only 1/4 are regular walkers.  Why?  Well, busing, of course, is part of it.  But even those kids that could walk to school don't.  Poor neighborhood design, lack of sidewalks and other infrastructure are surely in play (so let's fix those, too), but the big bugaboo is stranger danger.

We hear about every case of child abduction (ever think about the fact that it is, in part, more notable because it's rarer?) on the news and then repeated ad nauseam on morbid "news"-magazine shows like Dateline or Nancy Grace (*shiver*).  There's no shortage of crime dramas that will give you a case of parental agoraphobia--Without a Trace, CSI, (as much as it pains me to say it) Bones, Law and Order SVU.  Listen, I love me some Elliot Stabler as much as the next girl, but for the two years I lived alone I had to put a moratorium on SVU-watching lest I have to sleep with the light on.  I can only imagine what nightmares it must give parents.  

The decision to let your kid walk is better than any PR the car companies could ever pay for.  It tweaks a nerve with at least 7 of the 10 factors which psychologist Paul Slovic has identified alter risk perception.  Novelty and publicity--fear of the unknown combined with heightened coverage (the same thing that makes us disproportionately scared of terrorist attacks)--dread, trusting the actions of others, and, of course, the fact that it involves children.  The sense of choice and how that plays into the illusion of control means we choose the option of driving--where we control the risk, even if we control it right into a guardrail or the rear end of another car.

But it's not just that the abduction monster is not as big a monster as we fear, it's that the car monster is much bigger. If I let my kid walk to school and that kid got abducted, I'm a negligent parent.  If I drive my kid to school and they get seriously injured or killed while in the car with me, that's unfortunate, but no one's going to condemn me.  It's an "accident."  These things just happen.  Certainly no one's going to charge me with child endangerment.  Yet I'm putting that kid in much greater danger by buckling them in a safety seat than letting them take a bus by themselves.  

So how can we really protect kids?  By encouraging a diversity of options in how to get around.  By making the roads more equitable for bikers and pedestrians.  By driving less.  In order to drive our kids less, we need to embrace density, mixed-use neighborhoods, and traffic-calming measures and regulations that respect all users of our roadways (and yeah, make it more inconvenient to drive).

And speaking of that "loving" act of buckling in them in the child seat they're not nearly as good as they should be.  Turns out they're pretty much another one of those things we do "just in case" because it seems to increase safety without actually questioning if it does.  So even if you can't get behind my car-lite/car-free hippie fanaticism, hopefully you can get behind lobbying for higher standards for the thing that's supposed to save your kid's life.

Better yet, eliminate your need for one altogether.

http://www.planetizen.com/node/71068

AIDS

I’m not trying to downplay HIV.  I’m trying to give you the right idea about road traffic injuries.

According to World Health Organization projections, by 2020 road traffic injuries will surpass HIV in terms of disability-adjusted life years lost globally.  Already the leading cause of injury-related disability, in less than ten years, they will move from the 9^th  leading cause of morbidity and mortality in the world (1998 data) to 3rd, with an annual death rate estimated at 8.4 million. It’s not just a global, “over there” issue, either.  Motor vehicle crashes are the leading cause of death among those age 5-34 in the U.S.  

Perhaps worse than the death toll is the injury burden: 260,000 injuries per year involve complicated fractures, spinal cord damage, or brain damage (Science Serving Society, 2004).  According to authors Catherine Lutz and Anne Lutz Fernandez in their book Carjacked, no reliable data has been collected on how many Americans have been permanently disabled by crashes, but "the National Spinal Cord Center has estimated that approximately 79,500 people are living today with spinal cord injuries from car crashes, with about 4,200 more paralyzed each year."  Likewise unmeasured is the burden of PTSD and major depression among crash survivors as well as loved ones.  Crash morbidity, like HIV, often robs families of a financial provider and can drastically alter family dynamics, leading to family disintegration, interruptions in education, and financial ruin.

If only your minivan were just a paragon of lameness.

Like HIV, this is an epidemic we've seen this coming from a long way off and chosen to do nothing to stop it.  In his 1965 book Unsafe At Any Speed (Read it.  You’ll be fascinated.  And angry), Ralph Nader says "as an environmental trauma, auto casualties have no challenger in this country.  Most of the casualties are countable, visible, and common to the experience of millions of citizens...The tragedy is known.  How it is interpreted is another matter and one which has remained the principal obstacle to a rational selection of safety strategies and their implementation."  Nearly fifty years—half a century—later where are we?

You'd do better to picture emaciation, flies, and orphans.  Hyperbole?  Yes...but no.  Because your minivan--and your SUV, sedan, gull-wing minivan, your truck, and even that stinkin' cute Mini-Cooper--is not a bubble of safety.  The fact that we automatically equate loving your children with these things is a testament to the power of marketing.  Listen, even my stone-cold heart loves those crazy swagger wagon kids, but your cool isn't the only thing your minivan kills.