It is a great honor to have been invited to give the inaugural Patricia F Waller memorial lecture. Certainly any reflections on this field would have to note Pat’s many significant contributions over several decades. I will mention several, as I tell you what I think about the status of the highway safety field, based on my own 30+ years of experience.

Pat and I served together on various committees. The most recent was a National Academy of Sciences committee assembled to assess the status of the injury control field. Motor vehicle injury control was determined to be the “show horse” of the field, as evidenced by this quote from the committee report: “Over the past three decades, dramatic progress has been made in reducing motor vehicle injuries by understanding the factors that increase the risk of injury, designing interventions to reduce these risks, and implementing and evaluating a wide array of interventions”.¹

I am going to darken this rosy assessment somewhat because not all is well with the highway safety situation in the United States. To some extent this is because of factors that have always been with us, and to some extent it is because of more recent developments.

First, the field is held back by woeful underfunding. We don’t pay very much attention to the highway safety problem, which is evident when you “follow the money”. In 2004 the United States federal research budget for the National Cancer Institute was $3 billion, for the National Heart, Lung, and Blood Institute $2.3 billion, and for highway safety research (the National Highway Traffic Safety Administration and the Federal Highway Administration) $164 million. These are huge differentials, even though in terms of adjusted years of life lost …