Ellen's Take

Driving the Future

The rise of autonomous vehicles needs the public health perspective now—not later.

By Ellen J. MacKenzie, PhD ’79, ScM ’75

Following decades of success in road traffic safety, motor vehicle fatalities are on the rise—a troubling increase of 14% since 2011.

The next great revolution in transportation—the autonomous vehicle—has the potential to stop that trend and reduce the 40,000 annual traffic deaths in the U.S. The only question is, how soon can we make that happen? Not only are autonomous vehicles poised to make our roads safer, they can also improve mobility for those in vulnerable and underserved communities.

To realize these goals, attention to safety and equity are essential as autonomous vehicles continue to roll out. Self-driving cars have already racked up millions of miles of travel on our roads and attracted billions of dollars of investment. Just recently, Ford Motor Company joined other leading companies in announcing it will produce cars with driverless technology by 2021. 

It’s clear that self-driving cars are in our future, but so far we’ve focused too much on the technology and not enough on their effects on our society. 

We need only look back at the history of the automobile to see what happens when technology gets ahead of safety. Following the car’s introduction in the early 20th century, thousands of Americans were seriously injured or killed on the roads. Decades passed before attention turned to safety in meaningful ways. Requiring seatbelts, airbags, collapsible steering columns, shatterproof glass and other lifesaving technologies as standard equipment on all cars was game-changing.

In 1923, there were an estimated 18.7 deaths for every 100 million miles driven. By 2017, that number had fallen to 1.25 deaths—a 93% reduction, according to the National Safety Council.

From the 1960s onward, public health experts worked with policymakers and car manufacturers to develop safety standards that prevented 600,000 motor vehicle deaths—a great success. But there was an obvious problem: Too many people died before critical safety interventions could be put in place.

New approaches and new standards are needed to ensure public safety as increasing numbers of self-driving cars are being tested on American streets.  Careful thought needs to be given to how automated vehicles can be deployed to help the underserved and reduce health disparities.

We learned something from that experience. This time, we need to do things in the right order. 

Today, the development of self-driving cars is largely controlled by market forces and entrepreneurs. I would argue that we need stronger government oversight and more participation from public health experts who can act as trusted advisers to the public, policymakers, local officials, engineers and corporate leaders. The public health perspective should be an essential part—not an afterthought—in preparing for this massive change to our society. 

New approaches and new standards are needed to ensure public safety as increasing numbers of self-driving cars are being tested on America’s streets. Careful thought needs to be given to how automated vehicles can be deployed to help the underserved and reduce health disparities. 

Industry has a great incentive to work with public health. A recent American Automobile Association survey found that seven in 10 Americans say they would not get in a self-driving car. With billions of dollars on the line, manufacturers should embrace a safety-first approach and demonstrate how the new technology will improve community health and well-being. 

Over the past several years, government and technology leaders have convened dozens of meetings around the world to discuss the performance of automated vehicles and how they will eventually fit into existing mobility systems. These are important steps toward advancing the technology and ensuring that autonomous vehicles are safe for our streets. 

But more needs to be done. 

Deployed thoughtfully, autonomous vehicles could unlock the benefits of increased mobility for everyone. Our ability to move around determines the quality of the food we eat, our employment opportunities, our access to health care and our ability to socialize with family and friends. With equitable access, autonomous vehicles could help reduce longstanding health disparities affecting underserved populations. Electric autonomous vehicles would also reduce air pollution generated by internal combustion engines. 

Public health experts have decades of experience in saving lives by gathering evidence and developing policy recommendations to reduce motor vehicle injuries. The field’s deep commitment to social justice can also ensure that the new technology benefits everyone. And public health leaders are well-positioned to convene manufacturers, government leaders, community officials and others in dialogue that leads to progress in transportation. 

Our own Center for Injury Research and Policy—with more than three decades of success in making transportation safer—is working with industry groups and policymakers to help inform decisions about how and where autonomous vehicles should be introduced. Their work is shaping policies for testing and deployment that reach from the city level to the U.N. They are analyzing crash data and traffic volume to inform autonomous vehicle route guidance and selection. They are developing graduated testing strategies that phase in increasingly demanding driving environments. They also are creating innovative policy models that will reduce health disparities by providing a “dose” of mobility to underserved areas. These efforts, bolstered by collaborations with the Whiting School of Engineering and beyond, are making a distinctive contribution to the conversation on self-driving cars to emphasize both safety and equity.

The latest mobility revolution is underway, and its impact on our communities is not predetermined. Public health experts can help shape the new paradigm, setting the bar high to ensure that automated mobility is more than a convenience for those who can afford it. We can make self-driving cars a win for everyone. 

Let’s get it right the first time.