IMPEDIMENTS TO THE PREVENTION OF TRAVEL-RELATED INJURY: SOCIETAL AS WELL AS INDIVIDUALISTIC
Hemenway (1) describes three beliefs which may jeopardize injury- avoidance: optimistic ("it will never happen to me"), fatalistic ("accidents happen") and materialistic ("you probably deserved it"). Such a scheme parallels well-known trait theories regarding the individual's general personality (2); given the value of those endeavours,Hemenway's scheme deserves serious consideration.
Nonetheless, it may be incomplete. In this note, I argue for the inclusion of values that I label as societal - that is, they are best understood in terms of major societal groups. Evidence supporting this proposal resides in a comparison of road-travel and rail-travel; this suggests that society expects higher standards of safety for rail than for road. Two examples follow:
A. SAFETY AND VEHICLE DESIGN: Traditionally, Britain's railway carriages were equipped with slam-doors, which could be opened by passengers even when the train was moving. During the mid-2000s, such stock - even if relatively new - was mostly replaced by carriages using less reliable sliding-doors under electronic control of guard and driver. The saving in injuries and deaths has almost certainly been miniscule: I see no evidence against this assertion in Britain's transport data (3). Society deemed that the relevant legislation should be enacted, despite the heavy costs involved.
Cost can have different implications on the road: SUVs - large and powerful four-wheel-drive automobiles - are more dangerous than smaller, cheaper-to-buy and cheaper-to-run automobiles (4). One might suppose that governments would seek to reduce the prevalence of SUVs, since the choice of SUV ownership appears to be little more than an issue of perceived prestige.
B. ATTENTION TO THE TASK: Society has long expected that train drivers pay undivided attention to their job. Indeed, the use of a "dead- man's-handle" or its modern developments entails the train automatically coming to a stand if the driver diverts attention (5).
In contrast, values concerning the road imply that drivers can safely carry out other tasks during driving. A notably transparent example concerns the common media device of televising an inverview while the interviewee is driving. This presents an extraordinarily inept message to the motoring community. Inattention on the road is supposedly discouraged, although specific legislation is limited. The banning of mobile-phone use is a rare case, but its effectiveness must be seriously doubted (6).
CONCLUSION: Hemenway offers a useful scheme for investigating injury prevention. I argue here that - at least regarding travel - the problems are not simply to be understood by reference to the individual's beliefs. The problems are also societal. The two examples above indicate greater threat on road than on rail. There are other examples that can be developed: the use of psychoactive drugs (7,8) and failure to observe speed-limits (9). Paradoxically, the latter may have been exacerbated by the legally-required use of seatbelts (10).
The imbalance in societal values is consistent with casualty statistics (3). Until society is prepared to recognise and implement the lessons from rail-travel, an important conduit for injury prevention in road-travel will remain under-exploited.
1. Hemenway D. Three common beliefs that are impdiments to injury prevention. Inj Prev 2012; 00:1-4. doi:10.1136/injuryprev-2012-040507
2. Hewstone M, Fincham F, Foster J. Psychology. 2005. Leicester UK: BPS.
3. Department for Transport 2011. Transport statistics GB: 2010 Annual report. London: TSO.
4. Simms S, O'Neill D. Sports utility vehicles and older pedestrians. BMJ 2005;331:787-8.
5. Harris M. Dead man's handle. In Simmons J, Biddle G (eds). The Oxford campanion to British railway history. 2002. Oxford:OUP (p 125).
6. McEvoy SP, Stevenson MR, McCartt AT, Woodward M, Haworth C, Palmara P, Cercarelli R. Role of mobile phones in motor vehicle crashes resulting in hospital attendance: a case-crossover study. BMJ 2005;331:428 -430.
7. Perkins A. Red Queen: the authorized biography of Barbara Castle. 2003. London: Macmillan.
8. Hall W. Driving while under the influence of cannabis. BMJ 2012;344:e595 doi: 10.1136/bmj.e595.
9.Reinhardt-Rutland AH, Roadside speed-cameras: arguments for covert siting. Police J 2001;74:312-315.
10. Reinhardt-Rutland AH, Seat-belts and behavioural adaptation: the loss of looming as a negative reinforcer. Safety Sci 2001;39:145-155.
Conflict of Interest: