National Traffic and Motor Vehicle Safety Act
The National Traffic and Motor Vehicle Safety Act was enacted in the United States in 1966 to empower the federal government to set and administer new safety standards for motor vehicles and road traffic safety. The Act was the first mandatory federal safety standards for motor vehicles. The Act created the National Highway Safety Bureau (now National Highway Traffic Safety Administration). The Act was one of a number of initiatives by the government in response to increasing number of cars and associated fatalities and injuries on the road following a period when the number of people killed on the road had increased 6-fold and the number of vehicles was up 11-fold since 1925.
The reduction of the rate of death attributable to motor-vehicle crashes in the United States represents the successful public health response to a great technologic advance of the 20th century—the motorization of America.
Many changes in both vehicle and highway design followed this mandate. Vehicles (agent of injury) were built with new safety features, including head rests, energy-absorbing steering wheels, shatter-resistant windshields, and safety belts Roads (environment) were improved by better delineation of curves (edge and center line stripes and reflectors), use of breakaway sign and utility poles, improved illumination, addition of barriers separating oncoming traffic lanes, and guardrails. The results were rapid. By 1970, motor-vehicle-related death rates were decreasing by both the public health measure (deaths per 100,000 population) and the traffic safety indicator (deaths per VMT).
Changes in driver and passenger (host) behavior also have reduced motor-vehicle crashes and injuries. Enactment and enforcement of traffic safety laws, reinforced by public education, have led to safer behavior choices. Examples include enforcement of laws against driving while intoxicated (DWI) and underage drinking, and enforcement of seat belt, child safety seat, and motorcycle helmet use laws.
Government and community recognition of the need for motor-vehicle safety prompted initiation of programs by federal and state governments, academic institutions, community-based organizations, and industry. NHTSA and the Federal Highway Administration within the U.S. Department of Transportation have provided national leadership for traffic and highway safety efforts since the 1960s. The National Center for Injury Prevention and Control, established at CDC in 1992, has contributed public health direction. State and local governments have enacted and enforced laws that affect motor-vehicle and highway safety, driver licensing and testing, vehicle inspections, and traffic regulations. Preventing motor-vehicle-related injuries has required collaboration among many professional disciplines (such as biomechanics has been essential to vehicle design and highway safety features). Citizen and community-based advocacy groups have played important prevention roles in areas such as drinking and driving and child-occupant protection. Consistent with the public/ private partnerships that characterize motor-vehicle safety efforts, NHTSA sponsors "Buckle Up America" week, which focuses on the need to secure children in child-safety seats properly at all times.
Systematic motor-vehicle safety efforts began during the 1960s. In 1960, unintentional injuries caused 93,803 deaths; 41% were associated with motor-vehicle crashes. In 1966, the enactment of the Highway Safety Act created the National Highway Safety Bureau (NHSB), which later became the National Highway Traffic Safety Administration (NHTSA). The systematic approach to motor-vehicle-related injury prevention began with NHSB's first director, William Haddon. Haddon, a public health physician, recognized that standard public health methods and epidemiology could be applied to preventing motor-vehicle-related and other injuries. He defined interactions between host (human), agent (motor vehicle), and environmental (highway) factors before, during, and after crashes resulting in injuries. Tackling problems identified with each factor during each phase of the crash, NHSB initiated a campaign to prevent motor-vehicle-related injuries.
In 1966, passage of the Highway Safety Act and the National Traffic and Motor Vehicle Safety Act authorized the federal government to set and regulate standards for motor vehicles and highways. The Highway Safety Act resulted in the national adoption of the Manual on Uniform Traffic Control Devices, while the National Traffic and Motor Vehicle Safety Act led to the national adoption of the Federal Motor Vehicle Safety Standards.
Specific public health concerns
- Alcohol-impaired: From 1982 to 1997, the annual motor-vehicle crash-related fatalities involving alcohol decreased by 39% to approximately 16,000; these deaths accounted for 38.6% of all traffic deaths. Factors that may have contributed to this decline included increased public awareness of the dangers of drinking and driving; new and tougher state laws; stricter law enforcement; an increase in the minimum legal drinking age; prevention programs that offer alternatives such as safe rides (e.g., taxicabs and public transportation), designated drivers, responsible alcohol-serving practices and a decrease in per capita alcohol consumption.
- Young drivers and passengers: From 1975 to 1997, motor-vehicle-related fatality rates had decreased 27% for young motor-vehicle occupants (ages 16–20 years). However, in 1997 the death rate was 28.3 per 100,000 population—more than twice that of the U.S. population (13.3 per 100,000 population). Some teenagers are more likely than adult drivers to speed, run red lights, make illegal turns, ride with an intoxicated driver, and drive after drinking alcohol or using drugs. Strategies that had contributed to improved motor-vehicle safety among young drivers included laws restricting purchase of alcohol among underaged youths and some aspects of graduated licensing systems (e.g., nighttime driving restrictions).
- Pedestrians: From 1975 to 1997, pedestrian fatality rates decreased 41%, from 4 per 100,000 population in 1975 to 2.3 in 1997 but still account for 13% of motor-vehicle-related deaths. Factors that may have reduced pedestrian fatalities included more and better sidewalks, pedestrian paths, playgrounds away from streets, one-way traffic flow, and restricted on-street parking.
Safety belts: In response to legislation, highly visible law enforcement, and public education, rates of safety belt use nationwide had increased from approximately 11% in 1981 to 68% in 1997 (8). Safety belt use began to increase following enactment of the first state mandatory-use laws in 1984. In 1997, all states except New Hampshire had safety-belt use laws. Primary laws (which allow police to stop vehicles simply because occupants are not wearing safety belts) are more effective than secondary laws (which require that a vehicle be stopped for some other traffic violation). The prevalence of safety belt use after enactment of primary laws increased 1.5-4.3 times, and motor-vehicle-related fatality rates decreasd 13%-46%.
Child-safety and booster seats: All states had passed child passenger protection laws, but these varied widely in age and size requirements and the penalties imposed for noncompliance. Child-restraint used in 1996 was 85% for children aged less than 1 year and 60% for children aged 1–4 years. From 1975 to 1997, deaths among children aged less than 5 years had decreased 30% to 3.1 per 100,000 population, but rates for age groups 5–15 years had declined by only 11%-13%. Child seats were misused by as many as 80% of users In addition, parents failed to recognize the need for booster seats for children who were too large for child seats but not large enough to be safely restrained in an adult lap-shoulder belt
Reported by: Div of Unintentional Injury Prevention, National Center for Injury Prevention and Control, CDC.
Traffic Injury Prevention 
- Transportation Research Board. Safety research for a changing highway environment. Washington, D.C.: National Research Council, Transportation Research Board, 1990; special report no. 229.
- Rice DP, MacKenzie EJ, Jones AS, et al. The cost of injury in the United States: a report to Congress. San Francisco, California: University of California, Institute of Health and Aging; Johns Hopkins University, Injury Prevention Center, 1989.
- CDC/National Highway Traffic Safety Administration. Position papers from the Third National Injury Control Conference: setting the national agenda for injury control in the 1990s. Washington, D.C.: U.S. Department of Health and Human Services, Public Health Service, CDC, 1992.
- National Safety Council. Accident facts, 1998 edition. Itasca, Illinois: National Safety Council, 1998.
- Graham JD. Injuries from traffic crashes: meeting the challenge. Annu Rev Publ Health 1993;14:515-43.
- Committee on Injury Prevention and Control, Institute of Medicine. Reducing the burden of injury: advancing prevention and treatment. Washington, D.C.: National Academy Press, 1999.
- Sleet DA, Bonzo S, Branche C. An overview of the National Center for Injury Prevention and Control at the Centers for Disease Control and Prevention. Injury Prevention 1998;4:308-12.
- National Center for Injury Prevention and Control, CDC. Prevention of motor vehicle-related injuries: a compendium of articles from the Morbidity and Mortality Weekly Report, 1985-1996. Atlanta, Georgia: U.S. Department of Health and Human Services, CDC, 1997.
- National Highway Traffic Safety Administration. Traffic safety facts, 1997. Washington, D.C.: Department of Transportation, National Highway Traffic Safety Administration, 1998.
- CDC. Alcohol involvement in fatal motor-vehicle crashes--United States, 1996-1997. MMWR 1998;47:1055-6,1063.
- Hingson R, Howland J. Promoting safety in adolescents. In: Millstein SG, Petersen AC, Nightingale EO, eds. Promoting the health of adolescents: new directions for the 21st century. New York, New York: Oxford University Press, 1993.
- Foss RD, Evenson KR. Effectiveness of graduated driver licensing in reducing motor vehicle crashes. Am J Prev Med 1999;16(1 suppl):47-56.
- Rivara FP, Thompson DC, Cummings P. Effectiveness of primary and secondary enforced seat belt laws. Am J Prev Med 1999;16(1 suppl):30-9.
- National Highway Traffic Safety Administration. Research note. National occupant protection use survey, 1996--controlled intersection study. Washington D.C.: U.S. Department of Transportation, National Highway Traffic Safety Administration, August 1997.
- National Highway Traffic Safety Administration. NHTSA traffic tech note no. 133, observed patterns of misuse of child safety seats. Washington D.C.: U.S. Department of Transportation, National Highway Traffic Safety Administration, September 1996.
- CDC. Improper use of child safety seats--Kentucky, 1996. MMWR 1998;47:541-4.
- Taft CH, Mickalide AD, Taft AR. Child passengers at risk in America: a national study of car seat misuse. Washington, D.C.: National Safe Kids Campaign, 1999.
- CDC. National Child Passenger Safety Week--February 14–20, 1999. MMWR 1999;48:83-4.