Category Archives: Transportation
Faces of Public Health is a recurring editorial series on NewPublicHealth featuring individuals working on the front lines of public health and helping keep people healthy and safe.
According to the U.S. Centers for Disease Control and Prevention (CDC), each year 1.3 million people are killed and 20 to 50 million are injured in car crashes around the world. Most of the crashes happen in low- or middle-income countries, and 25,000 of the deaths are among tourists. In fact, nearly half of medical evacuations back to the United States, which can cost $100,000 or more, are the result of a car crash.
According to the CDC, reasons for an increase in crashes in foreign countries include:
- More people driving cars and other motorized vehicles
- Poorly maintained roads
- Insufficient traffic laws and poor enforcement in some countries
- Insufficient emergency response capabilities in some countries
Rochelle Sobel knows the worst possible outcome of these crashes first hand. She founded the Association for Safe International Road Travel (ASIRT) in 1995, after her son, Aron, was killed in a bus crash in Turkey along with 22 other passengers from many countries, just two weeks before his graduation from the University of Maryland Medical School. The bus Aron was traveling on was speeding down the wrong lane of a narrow, poorly maintained road with no guard rail. The bus hit oncoming traffic and plunged down an embankment, landing on its side. Emergency medical crews were slow to respond, likely a factor in at least some of the deaths. After the crash the U.S. Ambassador to Turkey recommended the creation of a road safety organization to protect both American citizens abroad and residents of countries around the world.
NewPublicHealth spoke with Rochelle Sobel about ASIRT.
NewPublicHealth: ASIRT was started out of personal tragedy, the loss of your son Aron, in a bus crash in Turkey. How did you get started?
Rochelle Sobel: The first thing I did was talk to the U.S. embassy in Ankara, and I asked them if they could please tell me when such crashes occur again, and they said, “Mrs. Sobel, we’d be calling you constantly.” That led me to understand that this is indeed a health issue that was not getting the kind of public attention that it deserved. So I started to call different organizations, and unfortunately, it was not yet recognized as a health issue. So we decided to become the organization that would bring attention to the issue. We got help from the embassy; we got a lot of help from the State Department. We asked the State Department to start collecting data on the numbers of Americans who die abroad in road crashes by country, and they discovered that it was the single greatest cause of death for healthy Americans traveling abroad.
NPH: Is that still the case?
According to the National Highway Traffic Safety Administration (NHTSA), at least 33 deaths from vehicular heatstroke—a desperately high body temperature in kids inadvertently left in hot cars—were reported last year for kids under the age of 14. Since 1998, at least 532 children have died from vehicular heatstroke and most of the deaths have occurred in kids 3 years and younger. “As we approach what is the hottest month of the year for most of the country, we’re working to get the message out to families with young children to take basic precautions to ensure a heatstroke tragedy never happens to them,” says Transportation Secretary Ray LaHood.
Recently, officials from NHTSA and Safe Kids Worldwide, who are partnering to reduce vehicular heatstroke deaths, joined the Tennessee Department of Transportation officials and other health professionals for a demonstration on just how quickly the inside of a vehicle can heat up. When outside temperatures are in the low 80s, the temperature inside a vehicle can reach deadly levels in only 10 minutes, even with a window rolled down two inches. According to NHTSA, children’s bodies in particular overheat easily, and infants and children under 4 years old are at the greatest risk for heat-related illness.
In addition to the deaths, each year vehicular heatstrokes causes permanent brain injury, blindness and hearing loss, among other injuries, to an unknown number of children, according to NHTSA. Often heatstroke deaths and injuries occur after a child gets into an unlocked vehicle to play, without their parents’ knowing. Vehicular heatstroke also happens when a parent or caregiver not used to transporting a child as part of their daily routine accidentally forgets a sleeping baby in a rear-facing car seat in the back of the vehicle.
Demonstration programs have been planned for Kentucky, North Carolina, Missouri, Georgia and Arizona. Safety precautions include:
Study Finds Alarming HIV Rates Among Many Young Black Men
A key study conducted in six cities and released yesterday at the International AIDS Conference in Washington, D.C. by the HIV Prevention Trials Network finds alarming rates of new HIV infections occurring among gay and bisexual black men in the United States (who are also known as men who have sex with men, or MSM), especially among young black MSM. The rate of new HIV infections among U.S. black MSM in the study was 2.8 percent per year, nearly fifty percent higher than white MSM. And the infection rate of young black MSM age 30 years and younger was 5.9 percent, which is three times the rate among U.S. white MSM. According to the researchers, the overall infection rate among black MSM in the study is comparable to the rate seen in the general populations of countries in sub-Saharan Africa hardest hit by the HIV epidemic. Read more on AIDS.
Coordinated Campus Strategies to Address Student Drinking to Reduce Self Harm and Injuries to Others
Strategies that address alcohol availability, alcohol policy enforcement and drinking norms can help colleges and their communities protect students from the harms of high-risk drinking, according to a new study funded in part by the National Institutes of Health. The study was published in Alcoholism: Clinical and Experimental Research. The researchers compared five campuses with coordinated approaches to five campuses without the program, finding that on campuses with dedicated efforts to control student drinking the percentage of students reporting severe consequences fell from 18 percent to 16 percent, but stayed the same on the campuses that had not initiated drinking controls. Reports of injuring another person while drinking decreased from 4 percent to 2 percent on dedicated campuses, with only a tiny change at the control colleges. The researchers estimate that on a campus with 11,000 students, drinking control efforts would result in 228 fewer students experiencing at least one severe consequence of drinking over the course of a month and 107 fewer students injuring others due to alcohol use during the year.
“This is the basic principle of public health — small changes at the population level can translate into significant improvements in the health of a population,” says Mark Wolfson, Ph.D., professor in the Department of Social Sciences and Health Policy at Wake Forest Baptist Medical Center, and the lead author of the study. Read more on alcohol.
DOT Announces Nearly $800M in Grants Help Fix the Aging U.S. Transit Infrastructure
The Department of Transportation has announced grants of almost $800 million to modernize and replace aging transit facilities and vehicles in 48 states, the District of Columbia and Puerto Rico.
- New Jersey Transit: $76 million to upgrade the bus fleet, which will help improve commuting times and air quality for state residents.
- Los Angeles County Metropolitan Transportation Authority: $15 million to replace aging buses with new buses that use compressed natural gas. The new buses are expected to improve reliability for riders, leave a smaller environmental footprint and reduce fuel costs.
- Capital Area Transportation Authority in East Lansing, Michigan: $6.3 million to redevelop a former Amtrak station near Michigan State University, which will improve bicycle and pedestrian access and connections to local bus and rail service.
Read more on transportation.
Many older people are not able to cross a street before the automated crosswalk light shifts to red, according to a new study in the journal Age and Ageing. Researchers compared the average walking speed of people in Britain age 65 and older who took part in a British health survey to the average time allowed by crosswalk lights. The study found that 76 percent of men and 85 percent of women in the study had a walking speed slower than the speed required to cross the street before the light turned red. Read more on aging.
Cancer Survivorship Research: Translating Science to Care, a conference held last week, focused on survivorship research. Issues of concern included resilience, obesity and economic issues of survivors, including the cost of follow-up care. Read more on cancer.
In 2004, the United Way of Santa Cruz County, the Children’s Network and several other community based organizations convened over 150 local agencies representing a wide array of sectors to create a comprehensive plan to address the rising rates of childhood overweight in Santa Cruz County.
Go For Health! partners include schools, parents, health care professionals, local media, local markets/businesses, city planners, community based non-profits, and local and state policy-makers—as well as the affected youth themselves—working together to effect long-term change in reducing the rates of obesity by enacting changes in the community such as improving healthy food offerings at restaurants and markets, and increasing transportation options.
NewPublicHealth spoke with Megan Joseph, director of community organizing, and Kymberly Lacrosse, community organizer, both at United Way of Santa Cruz County, as well as Lynn Robinson, Santa Cruz City Council Member and Santa Cruz County Metro Board Member, about the initiative.
NewPublicHealth: How did Go For Health! come about, and how did you come to focus on prevention and creating a healthier community?
Megan Joseph: Go For Health! was convened by the United Way of Santa Cruz County, the Children’s Network and a few other organizations in 2004 who were starting to notice the upward trend in childhood obesity across the county, which wasn’t different from what was happening across the nation. Our community came together to start taking some real steps to address the issue. Representatives from over 150 local agencies gathered in that first year to start looking at best practices and what was really working to address childhood obesity beyond a nutrition education and direct service approach. That’s when they started to learn about a cross-sector approach and the idea of environmental prevention, which takes a unified, big picture strategy to address such a large public health issue that has so many pieces and different causes.
NPH: You were able to convene 150 different agencies and many of which were from different sectors. Why is that so important to think about bringing in different kinds of partners to the table?
Kymberly Lacrosse: When you’re looking at a problem in a community that affects so many different people in so many different areas, it’s really important to have as many perspectives as possible in the collaboration and participating in problem solving. We believe that really helps look at it on a deeper level and you’re more likely to have greater success in long-term sustainable changes. Having schools and local community organizations and community members and county and city government and many, many, many more in collaboration has definitely been important.
Lynn Robinson: From my perspective, and being someone that is on the Santa Cruz City Council, to feel like I have a partnership role in this as an elected official does two things. One, where it’s appropriate or where we can, we can help with resources. But also, partnering across sectors makes a statement about who your community is and that you recognize the issues in your community. So even if it can’t be a monetary contribution, there’s still a lot of different ways that you can be participating.
As these interesting partnerships develop, the work blossoms. It becomes something bigger than you imagined because everyone sees the role that they get to play—as small or as big as it might be. Every one of those roles are integral to success. All the pieces together, as Kymberly described, makes it work. There’s a value in that because you never know how successful the end result can truly be until you plug in that one more partner.
Kymberly Lacrosse: Your partnership can be so powerful when the people that are partnering are really invested and committed, because there’s a deeper commitment and a bigger vision that everybody is participating in and working towards.
NPH: What are some of the lessons that you’ve learned in fostering these kinds of committed, engaged partnerships?
Megan Joseph: A particular example in Watsonville is a youth leadership component there called Jóvenes SANOS [“Healthy Youth” in Spanish]. I just saw a clip from the city council meeting where they passed the restaurant ordinance there and a couple of the council members in that meeting spoke very directly to the power of the youth, who are their constituents and the people that the problemof childhood obesity is affecting the most. The youth brought the problem to these policy-makers and asked them to use their power to help do something about this issue. That really created some champions in the city council because they had real people bringing real stories to them and showing them that they could make a difference. They have been strong partners ever since.
>> Watch a video of Jóvenes SANOS at work.
Lynn Robinson: I can speak to that too, and using that same example. I sat with Jovenes SANOS and asked them a couple of questions and saw how deep their commitment is and how engaged they are. I’m almost tearing up as I sit in my own little office here because it is so inspiring. You recognize if there’s something I can do to help them, they’re going to take this a long way. It’s going to really transform their lives as they see that their action can make a difference, and it will change the lives of the people that really need this in their lives to make healthy choices. To me, there isn’t anything better than that.
NPH: Can you talk a little bit more about the role of the city council and basically what you worked on with the Santa Cruz County Metro Board?
Lynn Robinson: The youth have created a new Healthy Vending policy that they will bring to the metro board that sets reasonable expectations about changes that we could make throughout our transit system for healthy choices for all of our patrons. In theory the policy is focusing on increasing choices for youth, but it really benefits everybody. It’s really exciting because they’re going to make a model policy that’s not been used before in the transit agencies and that will probably go statewide and beyond. That is pretty powerful stuff.
NPH: What were some of their recommendations?
Kymberly Lacrosse: We are following recommendations we’ve made through our Healthy Corner Markets project, where we worked with markets on carrying healthier products and placing them near the register. We also passed the Healthy Restaurant Ordinance in Watsonville last year, which was also one of the first of its kind in the nation. It says that all new and incoming restaurants within the city of Watsonville have to have a certain number of healthy options on their menu. We use a point system to do that and most of them are pretty easy to accomplish, like having a low fat dressing or a whole grain bread and things like that. We have also looked at other Healthy Vending policies where vending machines carry at least 50 percent healthy options. We are looking at carrying some of these best practices and policies over into the Healthy Vending policy with the Metro Board. We’re trying to be very mindful of the economic climate, partnering with vendors and market owners to make this policy work for them, while also working to keep the healthy options affordable.
NPH: Can you talk a little bit about United Way’s role as a convener?
Kymberly Lacrosse: One is building relationships through one on one conversations and meetings with people that we think would be interested in partnering with us on an issue. Initially there’s definitely a time investment in building these relationships and letting people know what the issue is. When you take the time to really sit down that definitely makes a difference.
It’s also about making it personal. We try to connect an abstract problem that maybe people aren’t consciously thinking about to real life. That makes it real.
Megan Joseph: We really see community engagement as being central to our work. We have our three goal areas of financial stability for all families, health and the success of our youth. So many issues in the community cross all three areas so we really see we need to build those relationships to address all of the issues we work on. If we build one relationship in one area, we know that relationship will sustain and be able to be leveraged when we’re trying to do a different project. We really see ourselves as the neutral conveners of the community around issues and rely on the wisdom of the community to then direct how we address those issues.
NPH: How do you see your approach to healthier communities as a way to reduce health disparities?
Megan Joseph: We are currently dealing with a report that just came out today, for example, that showed us childhood obesity statistics by city, which is the first time that’s ever been done. It showed that our childhood obesity rates in Watsonville, which is in Santa Cruz County, is at 49.3 percent and if you look at the rest of the County it’s at about 31 percent. That’s a huge disparity, and it just further concretizes why we focus a lot of our funding dollars and a lot of our attention on Watsonville. It’s a countywide issue but those kinds of numbers are what really tells us that yes, Watsonville needs extra attention. Jovenes SANOS is one way we’re empowering the very youth who are affected by the issue the most, by taking an approach of not “let’s help the people that need it,” but “how can we empower them to take the lead and solve this problem?”
NPH: What have been some of the successes so far?
Megan Joseph: Our Community Assessment Project involves a community survey every other year and really gives us in-depth information about where our community is on a lot of different measures. Something that we saw in the 2011 report was that vegetable and fruit consumption by Latino people in Santa Cruz had increased by 12 percent from the year before, which was a huge testament to the work we’re doing to try to make healthy food more accessible. We aren’t seeing the numbers in the actual obesity rates yet or the diabetes rates yet, but we’re seeing it in some of the other behaviors that could lead that way.
NPH: And what’s next?
Kymberly Lacrosse: We’re continually working on engaging people at the community level to build capacity and create strong leadership, something that we talk about often. When we’re working on a problem, we’re really working on creating momentum and a movement so that it is sustainable and it does continue above and beyond us.
Lynn Robinson: There’s a whole other community piece to that about being with the farmers and being with people that are growing the food. I think that’s another partnership that we should start talking about.
Overall,I look at what is getting accomplished and what is getting done and it’s amazing.
The U.S. Department of Transportation (DOT) has announced new regulations requiring railroads to install signs at rail and train pathway crossings with toll-free phone numbers the public can use to alert railroad companies to unsafe conditions, such as malfunctioning warning signals, vehicles stuck on the tracks or other emergencies. The new rules take effect by 2015. Railroads receiving the calls will contact local law enforcement for immediate action and must take steps to correct any confirmed problems. According to DOT, there are about 200,000 public and private rail crossings in the nation. Read more on safety.
A survey by researchers at the Columbia University Mailman School of Public Health finds that inmates at two New York state prisons regularly misuse common pharmaceutical products such as antibiotic cream as shaving cream, skin lotion and lip balm. The researchers say the misuse of the products can result in antibiotic resistance, especially because methicillin-resistant Staphylococcus aureus (MRSA) has increased at correction facilities and could also pose a risk in the community when prisoners are released. Read more on antibiotic resistance.
The American Public Health Association (APHA) will host a free webinar series this summer on transportation and public health, focusing on key issues including active (non-motorized) transportation and how pediatricians can play critical roles in keeping their patients safe during transport and travel. The first webinar will be held on Wednesday June 13 from 2:00 pm to 3:00 pm EST. Register for the webinars here.
NewPublicHealth spoke with Susan Polan, PhD, associate executive director of APHA, about the upcoming series.
NewPublicHealth: What is the focus of the webinars?
Susan Polan: They are designed to bring real-life, on the ground stories and the most current data on public health and transportation to both public health and transportation professionals. Our research around the country has shown that when a community focuses on these issues and creates an approach to transportation that is not based just on individual car, but is based on the big picture, you have more access for formerly under-served communities, and you’re on a step toward building healthier communities overall.
NPH: What’s your goal with the webinars?
Susan Polan: The goal is for participants to understand how to take some of the beginning steps toward necessary changes in transportation for communities. It's also for them to understand what some of the benefits, seen and unseen, might be. We’ll show data, challenges, obstacles and opportunities so that stakeholders who have an interest in making changes in their own communities are better prepared when they start the planning process.
NPH: The second webinar focuses on the role of pediatricians. Why pediatricians?
Susan Polan: Whenever doctors engage in something which is a little bit outside the normal “how are you feeling?” and “what treatment can we offer?” it does have an impact, and that's true for pediatricians probably most of all. And so, engaging those kinds of opinion leaders and opinion shapers in this debate is critical. This is about helping pediatricians engage in education and policy-making for transportation systems, to help make travel for children and teens, whether they’re the passengers or drivers, much safer. Twenty years ago there were a handful of doctors who were engaged in this and were leading the way, and we are hoping to move this towards the norm rather than the exception.
NPH: And the third webinar looks at health impact assessments (HIAs)?
Susan Polan: Yes, the focus of several health impact assessments recently has been on transportation initiatives, whether it be public transit or safe routes to school or a complete streets approach. The webinar leaders will talk about what we seen in the evaluation when these policies have been put forward, and what the HIAs have shown us are the best practices in potential areas of challenge can make a difference on transportation access inequity.
NPH: Is there a registration deadline for the webinars or can participants sign up until the last minute?
Susan Polan: Depending on where we are in terms of registration, participants can sign in until we no longer have room. And if people are not able to participate in the live webinar, they can access the webinars later on; they will be archived on the APHA site.
The Associated Press is reporting that many former players or their families have filed a master lawsuit against the National Football League, accusing the league of withholding information that linked head injuries during practice and games to permanent brain injuries. Read more on sports-related head injuries.
A new Government Accountability Office (GAO) report on school bullying finds that 20-28% of youths reported being bullied in school, but that federal and some state laws provide only limited protection against bullying since they don’t identify specific groups, such as race or gender. The report recommends that federal agencies investigate legal options for victims of bullying, provide more information on state-level protections and determine whether current protections are adequate. Read more on violence.
A recent survey by the Centers for Disease Control and Prevention (CDC) finds that U.S. high school students have shown significant progress over twenty years in improving many health risk behaviors particularly related to motor vehicle safety, but still engage in some dangerous practices such as cyber bullying, marijuana use and texting and emailing while driving.
Improved behaviors in the report include:
- From 1991 to 2011, the percentage of high school students who never or rarely wore a seatbelt declined from 26 to 8.
- From 1991 to 2011, the percentage of students who rode with a driver who had been drinking alcohol during the past 30 days declined from 40 to 24.
- The percentage of high school students who had driven a car during the past 30 days when they had been drinking alcohol decreased from 17 in 1997 to 8 in 2011.
Concerning behaviors identified in the survey include:
- One in three high school students had texted or e-mailed while driving a car or other vehicle in the thirty days before the survey.
- Current cigarette use did not change significantly between 2009 (19 percent) and 2011 (18 percent).
- Marijuana use increased from 21 percent to 23 percent, although there has been an overall decrease in current marijuana use (from 27 percent in 1999 to 23 percent in 2011).
- Current marijuana use among high school students was more common than current cigarette use (23 percent compared to 18 percent).
Read more on the Centers for Disease Control and Prevention.
The Department of Health and Human Service Office of the Inspector General (OIG) released a report "Vaccines for Children (VFC) Program: Vulnerabilities in Vaccine Management." this week that found that some vaccines stored by health care providers as part of the government’s Vaccines for Children program may have been stored at the wrong temperature, which could make them less effective. In some clinics and offices, expired and unexpired vaccines had been stored together.
In a statement responding to the report, the CDC said that most of the expired vaccines were seasonal flu shots that would not have been administered and that, “While the safety and health of our nation’s children has not been compromised by the issues identified by the OIG, the findings are important and underscore that we must do better at ensuring that all vaccines are stored properly at all times, including removing expired vaccine from units where viable vaccines are stored.” Read more on vaccines.
At the International Making Cities Livable Conference held in Portland, Ore., last month, Lou K. Brewer RN, MPH, director of the Tarrant County Public Health in Fort Worth, Texas, led a session about a toolkit she and a colleague are creating to help communities track health indicators and the progress made on improving them. The toolkit should be available by the fall and is likely to be a very valuable tool for many departments starting to track indicators in their community as both a resource for key measures and an adaptable tool largely ready to use. But Brewer’s experience as part of a Texas team shaping the future of the state around smart growth, community development, land use and transportation is equally valuable as a blueprint for collaboration to bring health to the table as communities across the country look ahead in creating their development plans.
NewPublicHealth: What brought you to the Making Cities Livable conference?
Lou Brewer: The presentation was about a set of indicators that I and a planner in a neighboring region created. We researched existing health indicators and decided to create a useful toolkit for planners and health professionals, using materials that were already available.
NPH: Why is a toolkit necessary?
Lou Brewer: Well, I’ve been part of Vision North Texas classes, run by planners and the Council of Governments to look at what stakeholders—including elected officials, planners, health educators and citizens—want the area to look like in 2030. Our population is supposed to double and that brings with it lots of challenges and opportunities, and so they’ve done an extensive visioning process, including a yearly summit.
We invited ourselves to the table as a public health entity, and we really wanted to be able to also ask the questions of the impact on health of whatever decisions were made. So we developed a health research team with wide representation and one recommendation was for this health indicator set [to measure progress on health impact], and then we decided we probably needed a toolkit as well. I also have a personal interest in all this because I’m a doctoral student in urban planning and policy, and that’s because I really see an incredibly strong connection between the built environment and health.
NPH: Who else was on the team?
Lou Brewer: We had the immediate past State Health Commissioner for Texas and the current Medical Director of Blue Cross Blue Shield. We had the Assistant City Manager of one of our larger municipalities who’s also a planner and the organizer for the Vision North Texas process. We also had two hospital representatives, a CEO and a community planner, someone from the School of Nursing faculty, and from the Texas Health Institute, and, of course, members of our own public health agency.
NPH: What critical steps did you take as you researched the toolkit?
Lou Brewer: We didn’t want to reinvent the wheel if it was already out there, so we really spent a lot of time going through the literature and looking at websites, and we borrowed heavily from the San Francisco Department of Public Health. They’ve done extensive work in health impact assessments and developing indicators. We also looked at materials from the state of Michigan and the National Association of County and City Health Officials and the American Planning Association. The health research team told us to really concentrate on physical activity and access to nutritious foods, and so we reviewed the literature again to pick out indicators that supported those two objectives and so that’s what helped us come up with them.
Indicator examples include: How far do people have to walk to transit, to schools, to grocery stores? We’re looking at vehicle miles traveled. And we’re looking at the ratio of bicycle routes to vehicle routes—lots of different things that all speak to and support physical activity and access to nutritious foods.
NPH: What response did you get when you spoke about the toolkit?
Lou Brewer: I had a lot of people come up to me afterwards wanting to get a copy. It’s in the draft stage, so I told people who asked that I’d send them a copy, but really wanted them to review it and give me feedback. We’ll have a final version to release soon.
NPH: What were some of the lessons learned?
Lou Brewer: We tied our work to the annual summit and that’s a long time to wait to keep people’s attention. We could have expanded the role of the health research team earlier.
And, while we had representation from faculty, which was great, I think I would have also asked for some student involvement and perhaps they would have had some time and interest in helping us develop some of this.
I’m glad we did involve Vision North Texas, and they in turn are some of the decision-makers for the region, so I think we had support early on. I think they were very respectful of the health piece of this, and I think they were also very glad to have another layer on their argument. We were always asked to be part of any funding opportunities and to make our case there, and so that’s been really great, because there is still a group out there that the light bulb hasn’t quite gone off yet for them in terms of why is health at the table.
NPH: What’s next for the toolkit?
Our next step is going to be feedback from this conference. and feedback from a few more people in the region and we’ll either post the toolkit it to our website sometime this summer or wait for the Vision North Texas Fall Summit and introduce it at a workshop. And then we’ll ask people for feedback on usability and modifications at the summit.
Weigh In: Have you been invited, or invited yourself, to key stakeholder conversations that didn’t have health in the title?
- For the past six years, the Memorial Day holiday weekend has averaged 11.5 percent more traffic fatalities than similar non-holiday periods, in part because of increased travel.
- The Council estimates 420 traffic fatalities and another 42,000 accident victims requiring medical attention.
- About 150 people may survive a crash this weekend because they wore a seat belt; another 107 lives could be saved if those car passengers buckle up.
Many corporations and organizations have issued advice to help keep drivers and passengers safer this weekend.
The U.S. Postal Service offers guidance from thousands of its workers who have individually driven more than a million accident-free miles: drive defensively and expect the unexpected; be courteous, use turn signals and obey all laws; have a "what I’ll do if I'm cut off" strategy.