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Contact: APHA Media Relations
There exists a considerable disparity in unintentional injuries and resulting fatalities between individuals of high-income and low-income across the globe. The likelihood of crashes in residential areas also differs markedly between these demographic groups. Notably, low-income Black Americans are particularly prone to inhabiting areas with high rates of crashes.
New York City's Vision Zero policy aimed to protect these more vulnerable members of our society by introducing a range of traffic reforms, including reduced speed limits, enhanced roadway infrastructure such as protected bike lanes, and new mandates for vehicles such as trailer sideguards. In addition, Vision Zero utilized educational campaigns for better implementation and intensified traffic law enforcement.
In a recent study published in the June 2024 issue of the American Journal of Public Health, researchers Kacie L. Dragan and Sherry A. Glied, have found that for six years following the implementation of New York City's 'Vision Zero' traffic reforms, enrollees in NYC Medicaid, comprising low-income people, reported 77.5 fewer injuries per 100,000 people annually.
"We found evidence that…the rate of traffic-related injuries among low-income New Yorkers, and low-income Black New Yorkers in particular, fell relative to trends in surrounding counties," explains Dr. Dragan.
The researchers also found that the reduced number of serious injuries and hospitalization following crashes among Medicaid enrollees due to Vision Zero regulations lead to reduced Medicaid expenditure in New York City. "We observed marked reductions in severe injuries (brain injury, hospitalizations) and savings of $90.8 million in Medicaid expenditures over the first 5 years,” said Dr. Glied. “Effects were largest among Black residents."
Since New York City implemented the Vision Zero policy, nearly a dozen cities, including Boston, Massachusetts; Los Angeles, California; and Seattle, Washington, have adopted similar measures. The study also shows that the reduction in crashes observed over six years since the implementation of Vision Zero reversed during the COVID-19 pandemic, with New York City's traffic-related injury rates becoming comparable to surrounding counties in 2020-2021. Researchers attribute this trend reversal to factors associated with changes in traffic density and law enforcement priorities during the pandemic. They identify the documented increase in unsafe driving behavior and lax enforcement of traffic rules in New York City during this period as possible reasons for the increase in traffic-related Medicaid injuries.
Researchers discovered a decline in NYC Police Department traffic violations tickets despite increased unsafe driving behavior during the pandemic, signaling reduced traffic enforcement. "Using ticketing data, we found a 25% greater reduction in traffic ticketing during the pandemic in NYC relative to the suburbs, lending credibility to our explanation," notes Dr. Dragan.
To regain the benefits of Vision Zero for vulnerable populations post-pandemic, modifications may be necessary. However, implementing a new and improved Vision Zero could require significant effort. "Our analyses demonstrate that Vision Zero was highly effective in the prepandemic world for which it was designed; whether it can be effectively adapted to the post-pandemic era, and what changes are needed to recapture those gains, remain to be seen," concludes Dr. Glied.
The June 2024 issue is currently available online. To request a full copy of a study or for information on scheduling interviews, contact APHA Media Relations.
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