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Lesson from the continuing 21st century motor vehicle success
  1. David Hemenway1,
  2. Lois K. Lee2
  1. 1 Health Policy and Management, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
  2. 2 Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA
  1. Correspondence to Professor David Hemenway, Health Policy and Management, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA; hemenway{at}


In 1999, the Centers for Disease Control and Prevention proclaimed the reduction in motor vehicle fatalities to be one of the great public health achievements of the 20th century. That motor vehicle success story has had enormous intellectual impact on the injury prevention field, providing many guiding lessons. Can we learn any lessons from what has happened to motor vehicle safety in the 21st century? A key lesson may come from the fact that the great injury achievement of reducing the motor vehicle death rate did not stop in 2000—it continued. We believe that is largely due to the 20th century creation of the conditions that promote continuous declines in injury. By contrast, in the firearms area, these conditions do not exist, and rates of death have not fallen, but have increased. As the idea of continuous quality improvement has become a staple in medicine, we should similarly have a focus on how to continuously reduce injuries. An important lesson from the 21st century motor vehicle success story for the injury prevention field is that we should put more strategic emphasis on creating the conditions that will lead to continuous reductions in injuries. But first we need a much better understanding of what those conditions are.

  • Motor vehicle � Occupant
  • Firearm
  • Policy analysis

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  • Contributors DH and LKL had the idea. DH wrote the first draft. LKL edited 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.

  • Provenance and peer review Not commissioned; externally peer reviewed.