Public health professionals have a moral obligation to advocate for innovative traffic safety programs that integrate solid research methodologies instead of ad hoc programs rooted in common sense. The first step in re-engineering the communication roadmap between transportation-public health professionals must begin on common ground. Applying an accepted theory from the medical field; the Biopsychosocial model (BPS), an ecological framework based in part on the Social Cognitive Theory developed by Bandura can be used to cross the communication abyss. Using discipline specific terminology and building on existing knowledge from both fields, a cross correlation of the Venn diagram defines each corresponding circle represented in Figure 1. For example, the biology (structure and function) of an individual can be applied to the engineering (structure and function) of a particular road segment. The fundamental principles of this relationship matrix are similar to the Federal Highway Administration perspective of Context Sensitive Solutions; defined as “a collaborative, interdisciplinary approach involving all stakeholders to develop a transportation facility that fits its physical setting, preserves scenic, aesthetic, historic and environmental resources, while maintaining safety and mobility.” The only difference between the BPS and CSS is seen in the concept titles. However, the models are not distinct, but synergistic. It is this interconnection that influences the overall health of an individual. Public health and transportation professionals have a similar goal, “a culture of safety”, we just don't understand what the other is saying!
- APHA Graduate Poster Session Submission, June 11, 2010
The public health problem of traffic-related crashes and the impact on a community is devastating: “In 2006, 42,642 persons died in traffic crashes in the United States. That statistic breaks down to 116 every day, about 5 every hour and 1 every 12 minutes. Looking at it another way, each traffic fatality results in about 60 injuries: more than 7,000 every day, 300 every hour and 1 every 12 seconds.”1
These incidents are not random events. Rather, they are predictable and preventable. Traffic crashes adversely affect persons of all ages; there is no discrimination based on socioeconomic status, season or hour of the day.1 Each person who drives or rides in a motor vehicle, walks, bicycles on or across a road is at risk of death and injury.1 Unfortunately when it comes to traffic safety, we as a society possess a perspective of complacency in which traffic-related crashes and injuries are an accepted outcome.
As public health professionals, we have a moral obligation to advocate for innovative traffic safety programs that integrate solid research methodologies instead of ad hoc programs rooted in common sense. An efficient traffic safety program includes driver behavior and education, law enforcement, roadway engineering, traffic patterns and environmental attributes all working together to affect the overall health of the public. Historically the focus has been on building a safe roadway, but there is an error in this thinking. Roads were built to serve the needs of people. When the human element is left out of the engineering concept, it is the behavior of the individual driver who will ultimately determine the level of safety on a particular roadway.
What is needed is a multidisciplinary collaboration to create a “culture of safety.” According to Robert Foss, “the first step is to set a new direction to re-engineer the existing infrastructure and modify the current values and beliefs within the traffic safety profession.” This is not an easy task. In working to achieve this goal, it will be vital to include public health professionals as part of the transportation team. Advocating for change will require that all disciplines involved in a transportation project are communicating with a similar language to avoid misunderstandings.
In an effort to bridge the transportation-public health communication abyss, one can apply an accepted theory from the medical field. The biopsychosocial model (BPS) is a general ecological framework based in part on the Social Cognitive Theory developed by Bandura. Using discipline specific terminology and building on existing knowledge from both fields, the biology (structure and function) of an individual can be applied to the engineering (structure and function) of a particular road segment. This cross correlation is applicable for each corresponding circle represented in Figure 1.
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| Figure 1: Biopyschosocial Model (BPS) and the Biopysychocial Transportation Model. Diagram developed and adapted by Karyn M. Warsow, MPH, MS. |
The fundamental principles of this relationship matrix are similar to the Federal Highway Administration perspective of Context Sensitive Solutions (CSS), defined as “a collaborative, interdisciplinary approach that involves all stakeholders to develop a transportation facility that fits its physical setting and preserves scenic, aesthetic, historic and environmental resources, while maintaining safety and mobility.”2 The only difference between the BPS and the CSS or BPST is seen in the concept titles (Figure 1). However, the models are not distinct, but synergistic. It is this interconnection that influences the overall health of an individual.
In reality, public health and transportation professionals have a similar goal -- “a culture of safety” -- we just don’t understand what the other is saying! This is an opportunity for creative and well versed public health professionals with knowledge of both disciplines to bridge the communication gap.
- Karyn M. Warsow, MPH, MS, Representative to the Policy and Resolutions Student Committee, and DrPH Student , Johns Hopkins Bloomberg School of Public Health, Department of Health Policy
References
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Improving Traffic Safety Culture in the United States:The Journey Forward (May 24, 2010). Retrieved From: www.aaafoundation.org
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