Promoting Active Communities in a Culture of Distracted Driving
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Promoting Active Communities in a Culture of Distracted Driving
Matthew Lee Smith, PhD, MPH, CHES; Mark E. Benden, PhD, CPE; Chanam Lee, PhD, MLA
Suggested citation for this article: Smith ML, Benden ME, Lee C. Promoting active communities in a culture of distracted driving. Prev Chronic Dis 2012;9:110212. DOI: http://dx.doi.org/10.5888/pcd9.110212.
Efforts to improve health outcomes through behavioral modification are often
complicated by external factors that may thwart success and introduce potential
harm. Factors associated with traffic safety present a contemporary challenge to
efforts to promote physical activity. One example is the difficulty of encouraging pedestrian-based physical activity because of the growing prevalence of distracted driving.
Promoting Active Communities
Increasing physical activity is associated with reduced risk for chronic
diseases, including obesity, diabetes, cardiovascular disease, certain cancers,
and depression (1). In addition to personal and social factors, many elements
and features of the built environment (ie, the physical infrastructure related
to transportation in a given community) have been linked with physical activity
behaviors, particularly walking and bicycling (2). A growing number of
municipalities have adopted policies to improve their built environments to
support physical activity and active living (eg, more sidewalks, bicycle lanes
on roadways) (3).
Many policies and interventions target streets as multifunctional settings
for active transportation and physical activity because they are modifiable
public infrastructures that most residents use daily. Examples include the
Complete Streets initiative (4) and Safe Routes to School (SRTS) program
(5). SRTS was allocated federal funds to improve street-related infrastructure
involving sidewalks, bicycle lanes, and crosswalks around schools (6). The
Complete Streets initiative has been adopted by various local and
state governments, and 70 such policies were enacted in 2010. Complete Streets
is geared toward modifying communities to become more pedestrian-friendly
through integrated transportation systems that support all modes of travel (4).
The Complete Streets and SRTS initiatives seek to improve safety among all road users and to promote walking and bicycling. Healthy People 2020 promotes physical activity as a primary objective and specifies active transportation (walking and bicycling),
and community- and street-scale environmental policies to enhance access to physical activity opportunities (7). Development and modification of streets and adjacent structures is convenient and shows promise in furthering Healthy People 2020 objectives.
Roadway Safety and Distracted Driving
Although streets have become safer for drivers, pedestrians and bicyclists
are especially vulnerable to acute injury and death on roadways. Despite
overall decreases in roadway-related deaths, the reduction rate for pedestrian
deaths (14%) is only half the rate for vehicular deaths (27%) (8). Evidence
suggests that street design features such as traffic-calming devices, raised
medians, sidewalks, and crosswalks can enhance safety for pedestrians and
bicyclists (9); however, only a small proportion of US streets incorporate such
safety features, and roadway design accounts for only a portion of overall
roadway safety. Road users’ behaviors, especially those of drivers, are key
determinants of roadway safety.
In 2009, the National Highway Traffic Safety Association reported that 5,474
people were killed and 448,000 people were injured as a result of distracted
driving (10). Distracted driving is engaging in activities while operating a
motor vehicle that detract from the attention given to driving. Examples of
distracted driving include, but are not limited to, changing the radio station,
programming global positioning system devices, consuming food or beverages,
grooming, reading, and using a cellular telephone. Research indicates that
distracted driving is a growing trend (11). Among distracted driving–related
crashes attributed to cellular telephone use, 18% resulted in death while only
4% resulted in injury in 2009. Furthermore,
portable technology device use among pedestrians and bicyclists has been
associated with automobile-related fatalities in situations in which the
pedestrian or bicyclist was determined to be at fault (10).
Cellular Telephone Saturation: Driving With
Technology
The availability and affordability of mobile communication technology is
increasing. The Highway Loss Data Institute (HLDI) Bulletin estimated that
approximately 90% of the American population owns a cellular telephone, and
approximately 30% of these people are smartphone users (12). Furthermore, the
HLDI Bulletin estimates that the number of monthly text messages sent has risen
from approximately 14 million in 2000 to more than 150 billion in 2010, and
could increase 50-fold by the year 2020 (12). Today’s cellular telephones enable
drivers and pedestrians alike to instantly access the Internet for various
activities including online shopping, social networking, and e-mailing. These
same devices allow us to simultaneously listen to music, have a conversation
with a family member, and read e-mail while driving, walking, or bicycling
between destinations. Although at least 30 states have now made it illegal to
use hand-held devices for any purpose while driving, those laws have not
resulted in reduced collision claims or crash reductions (12). So, what happens
when distracted pedestrians and bicyclists meet motorists driving in the same
condition?
Health professionals continue to promote physical activity and the
development of active communities, which include environmental modifications
such as SRTS that encourage residents to become pedestrians and bicyclists. Such
efforts have been successful, are gaining popularity, and are receiving support
by governmental agencies (via funding streams), community-based entities, and
constituents. In the future, we can also anticipate growing pedestrian traffic
in previously unused and underutilized areas. Simultaneously, rising trends of
distracted driving must be acknowledged. These independently rising growth
curves are on a trajectory to intersect, with implications for markedly
increased injuries and deaths associated with automobile-pedestrian
interactions.
Questions Without Definitive Answers
The ongoing public health movement encouraging people to walk and bicycle is
complicated by technological movements to provide Americans with more
technological distractions. When attempting to protect the public and deter
automobile-pedestrian interactions, the following questions arise about where to focus
efforts (ie, which discipline or health sector) and about which evidence-based
strategies to use: Should the public continue to be encouraged to
walk/bicycle in unsafe environments? Should funding and efforts to improve
roadway design be increased? Should environmental modifications be made in areas
with heavy traffic and crash histories? Should laws restricting cellular
telephone use including “cell-free zones” for drivers and pedestrians be
enforced more rigidly? How should behavioral limits on individual smartphone use
while driving motor vehicles be fostered?
Success Via Legislative Controls
According to the US Department of Transportation, 34 states have
enacted legal bans against text messaging while driving, 9 of which have placed
overall bans on hand-held cellular telephone use (13). Additionally, states and
local municipalities have sanctioned legislation to enable pedestrians,
bicyclists, and motorists to more safely share roadways. For example, many
states have enacted laws regulating the distance in which motorists pass or
follow bicyclists. Although these laws primarily regulate the actions of
motorists, legislative actions also exist to ensure that bicyclists use hand signals,
protective equipment (eg, helmets), and reflectors or lights at night.
A Multidisciplinary Approach
As roadways become increasingly unsafe for pedestrians, bicyclists, and
motorists due to distracted driving, active communities and physical activity
promotion continue to bring about the intended health benefits needed for
healthy living. Potential dangers and risks involved in physical activity on
roadways should be discussed by experts in various agencies and community
sectors. Multidisciplinary collaboration should be emphasized among public
health, urban development and planning, traffic safety, and representatives of
other related fields, including the communications technology sector and
commercial automotive industry. Immediate efforts are needed to educate both the
pedestrian and the driver, with the intent to modify unsafe behaviors and to
continue improving unsafe street environments. Secondary to these efforts,
proper technological solutions should be pursued and supported with expertise,
data, and translational research. Empirical studies and funding supports are
needed to explore and identify innovative approaches to curb distracted driving,
enabling pedestrians to engage in physical activity to reduce risks for obesity
and associated chronic conditions while also safely reaching their destinations.
Acknowledgments
We received no specific grant from any funding agency in the public,
commercial, or nonprofit sectors.
Author Information
Corresponding Author: Matthew Lee Smith, PhD, MPH, CHES, Department of Health
Promotion and Behavior, College of Public Health, University of Georgia, Athens,
GA 30602. Telephone: 706-542-0483. E-mail: health@uga.edu.
Dr. Smith is also affiliated with the Texas A&M Health Science Center School of
Rural Public Health in College Station, Texas.
Author Affiliations: Mark E. Benden, Department of Environmental and
Occupational Health, Texas A&M Health Science Center School of Rural Public
Health, College Station, Texas; Chanam Lee, Department of Landscape Architecture
and Urban Planning, Texas A&M University, College Station, Texas.
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