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Public health principles to inform testing and build trust in automated vehicles
  1. Johnathon P Ehsani1,
  2. Jeffrey Michael1,
  3. Takeru Igusa2
  1. 1 Center for Injury Research and Policy, Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
  2. 2 Civil Engineering, Johns Hopkins University Whiting School of Engineering, Baltimore, Maryland, USA
  1. Correspondence to Dr Johnathon P Ehsani, Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland 21205, USA; johnathon.ehsani{at}


Highly publicised crashes involving self-driving or autonomous vehicles (AVs) have raised questions about safety and eroded public trust in the technology. In this State of the Art Review, we draw on previous successes in injury prevention and public health to focus attention on three strategies to reduce risk and build public confidence as AVs are being tested on public roads. Data pooling, a graduated approach to risk exposure, and harm reduction principles each offer practical lessons for AV testing. The review points out how the eventual deployment of AV technology could have a substantial impact on public health. In this regard, inclusive testing, public education and smart policy could extend the social value of AVs by improving access to mobility and by directing deployments towards scenarios with the greatest population health impact. The application of these strategies does not imply slowing down progress; rather, their implementation could accelerate adoption and result in realising the benefits of AVs more quickly and comprehensively while minimising risks.

  • Public health
  • Motor vehicle crashes
  • Safety
  • Equity
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  • Contributors JPE and JM made the main argument and drafted the manuscript. TI did a critical review and made revisions. All authors approved the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; externally peer reviewed.

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