Motor Vehicle Crash Prevention

Klauer, Sheila G. Ph.D.
Doerzaph, Zachary R. Ph.D.

¹Virginia Tech Transportation Institute, Blacksburg

Dr. Klauer can be contacted at [email protected] or at the Virginia Tech Transportation Institute, 3500 Transportation Research Plaza, Blacksburg, VA 24060.

Disclosure forms provided by the authors are available with the full text of this article at NEJM.org.

New England Journal of Medicine 393(5):p 479-486, July 31, 2025. | DOI: 10.1056/NEJMra2216360

Key Points

Motor Vehicle Crash Prevention

More than 40,000 people died on U.S. roadways in 2021, a figure that represents a per capita rate that is much higher than those in many other high-income nations.
The evidence-based Safe System Approach to reducing the incidence of traffic fatalities encompasses the following principles: roadway injuries are unacceptable, humans make mistakes and are vulnerable, safety is a shared responsibility and must be proactive, and redundancy is crucial.
The responsibility for roadway safety is shared by users, designers, operators, policymakers, administrators, and health care professionals.
Measures to improve safety include interventions to prevent high-risk behavior by drivers and passengers, road design to reduce the risk of crashes and to physically separate vehicles from pedestrians and cyclists, manufacture of vehicles with enhanced preventive features and crashworthiness, enforcement of safer traffic speeds, and improvements to postcrash medical care.