Roads that are designed to kill

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THREE YEARS AGO, I was driving in Atlanta early one morning when I saw a body on the road. It was a young female runner. I called 911 and then ran to her. She had a horrendous head injury but still had a heart beat. I started CPR, but her injuries were too severe. She died in my hands. I wrote a column in the Atlanta Journal-Constitution about what happened to the runner, and a flood of letters came in.

Half blamed the runner, saying she should not have been running in the street at that hour. Half blamed the driver, for not paying close enough attention. Not a single writer blamed the road.

I took a photograph of the scene where I had found the runner. When I showed this picture to friends from Sweden they asked, “This is where you live? This is your neighborhood? Your streets are designed to kill people.’’ They said that the thin painted white lines at the intersection could not be seen at dawn, nor was there a raised bump to or a narrowing of the road to demarcate the intersection and slow down traffic. They said the speed limit should be 30 kilometers per hour (about 18.6 miles per hour) or less if we wanted pedestrians to have much of a chance of surviving. They also said traffic lights increased the number of deaths because people often speed up when the light turns yellow.

When Sweden removed red lights from intersections and replaced them with traffic circles or rotaries, death rates at these intersections fell by 80 to 90 percent.

Sweden has also adopted a philosophy called Vision Zero, believing it can eradicate road traffic deaths.

Vision Zero started about 30 years ago, when traffic safety researcher Claes Tingvall got the idea that we didn’t have to accept road traffic deaths as a fact of life. Tingvall and his colleagues said that these deaths were not “accidents’’ but were predictable and preventable. And they set out to prove it.

One of the ways they began to protect people was to put barriers down the center of two-lane roads. They showed that this could be done cheaply. When Mylar - a strong polyester film - is supported by closely spaced plastic poles, it can keep cars from crossing the median. When the Swedes used this type of center barrier to separate the traffic going in opposite directions, they effectively prevented head-on collisions and the death rate on these roads fell by 70 percent to 80 percent.

Global health research shows more improvements can save lives. For example, Ghana put in rumble strips - small bumps spaced closely together - across all the roads leading into the capital city of Accra, reducing fatalities by 35 percent. Research has shown that speed bumps on roads are one of the “best buys’’ in all of global health.

But as good and as important as these best buys are, we have yet to apply the findings here. When I heard that Dr. Phyllis Jen was killed in a head-on collision in Needham this year, my first reaction was that she did not have to die. But when Jen was killed, no one mentioned the roadway design. No one mentioned that a thin plastic center barrier could have saved her life. (We don’t know whether she was wearing a seatbelt, something so important it would have helped her chances of survival under many different road conditions.) When an elderly driver killed a school crossing guard last week in Boston no one mentioned that a speed bump or a rumble strip might have alerted him to danger. (Major highways do have rumble strips.)

Most people think we are doing all that can be done to keep our roads safe. They are wrong. Road traffic injuries kill more than a million people a year worldwide, including 40,000 a year in the United States. We will continue to have drivers who are too young or too old, too distracted, or too bold, but we can change our roads so they help protect both drivers and pedestrians. Reaching Vision Zero may take us a while but how in the world could we ever justify not starting now?

Mark Rosenberg, a former assistant attorney general, is executive director of The Task Force for Global Health and a research ambassador at the Paul G. Rogers Society for Global Health.