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April 2012 (Vol. 6, No. 1)

Rural Safety News is an electronic newsletter of the Center for Excellence in Rural Safety (CERS) at the University of Minnesota. Rural Safety News brings you the latest research and resources concerning rural safety.

CERS study finds Minnesota primary seat belt law saves lives and money


Minnesota’s primary seat belt law resulted in 68 fewer deaths and 320 fewer severe injuries from 2009 to 2011, according to a new CERS study.

The study, conducted on behalf of the Minnesota Department of Public Safety (DPS) Office of Traffic Safety, also found that the reduction in deaths and injuries has saved $45 million in hospital charges, including nearly $10 million in taxpayer dollars that would have paid for Medicare and Medicaid charges.

“The primary seat belt law has advanced traffic safety in Minnesota by saving lives and preventing serious injuries,” Minnesota Public Safety Commissioner Mona Dohman said. “The findings of this study remind us again how vital it is for Minnesotans to buckle up—every seat, every ride.”

Minnesota’s primary seat belt law went into effect in June 2009. Prior to that, not wearing a seat belt was a secondary offense, which allowed law enforcement officers to ticket for failure to wear seat belts, but only when there was another moving violation. Under the primary seat belt law, officers can ticket drivers for not wearing a seat belt without any other law being broken. Currently, 32 states have primary seat belt laws.


CERS researchers Frank Douma and Nebiyou Tilahun, authors of the report, analyzed the impacts of the new law, examining the changes in roadway crash fatalities through June 2011. The researchers also examined seat belt use data and survey results that measured support for the law and found more Minnesotans are buckling up since the primary law went into effect. Observed seat belt use in the state also has increased from 87 percent in 2008 to 93 percent in 2011. In addition, a survey of Minnesotans shows the support of the law increased from 62 percent just before the law was passed to over 70 percent since it was passed.

“The stronger seat belt law is keeping a lot of Minnesotans out of hospitals and morgues, and it will continue to do so for years to come,” CERS director Lee Munnich said. “But we still have too many Minnesotans injured or killed every year because they are not wearing seat belts, so we have more work to do.”

Related resources:

Collaborations fueling development of national Toward Zero Deaths strategy

Minnesota TZD program provides model for success

Though the number of roadway fatalities has trended downward in recent years, fatal traffic crashes remain one of the nation’s most serious preventable health problems. In 2010, 32,885 people died on U.S. roadways. Most of these crash fatalities occur on rural roads. More children and young adults, ages 15-34, die in roadway crashes than for any other health-related reason.


To address the problem, many organizations that own, operate, enforce, and maintain our nations roadways have joined together to create a national strategy on highway safety—Toward Zero Deaths. As of 2011, 30 states had implemented TZD-type programs to comprehensively reduce traffic crash fatalities.

The Toward Zero Deaths program uses a four “E” collaborative approach, integrating education, emergency medical and trauma services, engineering, and enforcement. Data are used to identify the most critical problems causing traffic fatalities, and multiple state and local government agencies as well as private sector partners are engaged to address those problems. There is no single solution, but together this targeted approach has proven highly successful.

Since most of the costs of the TZD program are borne by reprioritizing and targeting existing federal, state, and local safety funds, the return on investment is very high. State budgets benefit from reduced medical costs, fewer fatalities and serious injuries, and lower unemployment, social security, and welfare costs associated with crash victims’ families. The delay costs imposed on motorists from crashes—many billions of dollars per year—also are reduced.

Improving traffic safety and reducing fatalities and serious injuries on roadways cuts across many agencies within government, including transportation, public safety, health, and education. Minnesota's TZD model shows that interagency cooperation is essential to achieving success in a shorter amount of time.

In 2003, the Minnesota Department of Transportation and the Minnesota Department of Public Safety, in collaboration with Minnesota safety stakeholders and advocates, initiated the Toward Zero Deaths program to systematically reduce road fatalities. Several Minnesota agencies, along with CERS, have joined the effort to expand this TZD approach nationwide.


Since TZD was introduced in Minnesota, traffic fatalities on the state’s roadways have dropped from 655 deaths in 2003 to 365 deaths in 2011, a drop of 44 percent. If Minnesota had followed the U.S. pattern of traffic fatalities—a 23 percent drop from 2003 to 2010—the state would have experienced 91 more fatalities in 2010.

What would 91 more deaths a year mean in Minnesota? Most important, 91 more families and communities each year would have suffered the tragic and unnecessary loss of a family member, friend, or colleague. There also would have been economic and health care costs to the state. A Center for Disease Control (CDC) study has estimated $41 billion in medical and work-loss costs nationwide in 2005 due to motor vehicle crash deaths. In 2005, Minnesota crash deaths cost the state $527 million in medical expenses and lost work according to the CDC, or about $943,000 per crash death. Thus, the 91 fewer crash deaths are saving the state about $86 million per year in medical and work-loss costs.

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Pilot study in Boise, Idaho, demonstrates usefulness of CrashHelp system


In an ongoing effort to facilitate communication and improve patient care following traffic crashes, researchers with CERS and the Intelligent Transportation Systems (ITS) Institute have completed a pilot study of the prototype CrashHelp system. Overall results were positive, indicating that CrashHelp allowed for the efficient collection of usable information.

CrashHelp is a smartphone-based system that enables emergency responders to collect multimedia data about crash victims on-scene and send it directly into emergency rooms, providing hospitals with advance notification of crash severity and related information that can be used to best prepare for a patient’s arrival.

Tom Horan, CERS research director, reviewed the results of the pilot study in a recent CERS webinar. The study—conducted from July through October 2011 in Boise, Idaho—included six hospitals and two ambulance providers.

During the pilot, ambulance crew paramedics and emergency medical technicians used a CrashHelp-equipped smartphone to securely capture pictures, digital audio recordings, video, and basic patient and incident information. The information was then sent to the participating hospital, where an automated phone call informed hospital personnel that new incident information was available for viewing on CrashHelp’s web-based interface. An acknowledgement was sent to the medic after the file had been accessed, and the medic could then send any additional information via text message.

A total of 801 incident transmittals were completed during the study period, including more than 400 images and nearly 450 audio recordings. Horan said the researchers had anticipated images being used most frequently and were surprised by the popularity of the audio recordings. The consistent use of audio could be because emergency responders are most comfortable with this type of reporting since they provide similar verbal reports to emergency departments over the radio.


The researchers also found that use of the system varied widely between more technically savvy personnel and those who didn’t know how to make the best use of the system. “Moving forward, we see the need to do more training in order to get a full range of proficiency,” Horan said.

The researchers also conducted follow-up focus groups with personnel from participating hospitals and ambulance providers, state EMS agencies, and the Idaho Department of Transportation. Medics reported that seeing the information being used in hospitals drove them to make more use of the system, and hospital personnel said the information they received helped them prepare for a patient’s arrival—especially for those coming from further away.

The study also helped the researchers identify future needs, such as protocol on how many and what types of pictures would provide the most value to emergency room personnel. There is also interest in additional notification types, such as an automated phone call that plays the available audio message automatically for hospital personnel.

Idaho has expressed interest in extending the pilot and expanding coverage to a rural area, Horan said. The researchers are also planning a pilot effort in St. Cloud, Minnesota, where they will investigate how CrashHelp could be used as part of a hospital-to-hospital referral system.

Related resources:

Florida’s Marion County uses data-driven approach to prevent rural crashes

crash scene, Marion County, Florida

More than a thousand miles of sylvan, two-lane country roads run through Marion County in north-central Florida. But the peaceful rural landscape had been marred by a serious crash problem, many involving pavement edge drop-offs.

From 2005 to 2008, for example, 120 fatal crashes as well as 800 injury crashes occurred on those roads, according to former deputy Marion County engineer John C. Goodknight. That all changed for the better, however, when the rural county took a new approach to rural road safety. The rural county has since become a leader in stabilizing road shoulders to prevent fatal crashes.

Along one stretch of road with three closely spaced curves near the edge of a forest, two fatal crashes and five serious injury crashes plus a few others occurred over three years. During his CERS webinar presentation in January, Goodknight recounted how authorities eventually discovered that traffic from ATVs and trails connected to the road had caused shoulder erosion to the point where vehicles drifting off the pavement were unable to recover and many overturned.

To correct the problem, the county paved the shoulders along the curves, refreshed markings, and enhanced signs. Two years later, no crashes had been reported. “Without this data,” Goodknight observed, “we wouldn’t have known there was a problem at all.”

crosses mark crash scene, Marion County, Florida

Goodknight determined that shifting emphasis from the miles of shoulders paved to the number of drop-offs eliminated would help reduce the number of crashes on rural county roads. Marion County defines a pavement edge drop-off as a “differential more than 3-inches deep for a continuous 25 inches.”

Goodnight started to record the location and severity of drop-offs while geocoding the crash data. Then, combined with an emphasis on reporting and feedback as well as revised standards and procedures, the new approach began to produce results. The Marion County data helped prioritize the most serious pavement drop-offs to solve the most urgent problems first. The county put together a cost-effective data collection system and database using GPS, free software from the Minnesota Department of Natural Resources for tabulating data, and free custom mapping software from Esri.

“This kind of data helps us identify a serious crash problem on county roads,” Goodknight explained. “Once we put it on a picture, we then begin to see clusters of crashes that suddenly bring a new perspective to some of our problems.”

Comprehensive treatment of shoulders now includes installation of safety edges so vehicles can easily re-enter the road. Semiannual surveys of pavement edge drop-offs continue to help evaluate the effectiveness of the county’s efforts as well as to identify new trouble spots involving pavement edge drop-offs and other dangers, such as pooling rainwater and debris build-up on the shoulders.

Goodknight said that the data systems have gone a long way toward improving the effectiveness of the road safety program in Marion County. “What gets watched,” he concluded, “is what gets done.”

Related resources:

More rural safety news and resources

CERS Best Practices for Rural Traffic Safety Webinar Series: Watch recent webinar

CERS cited in new GHSA report about speeding and aggressive driving

A new report published by the Governors Highway Safety Association, Survey of the States: Speeding and Aggressive Driving (3.1 MB PDF), aims to reduce the loss associated with speed-related crashes. It recommends several strategies to be implemented in states across the country in collaboration with and supported by federal partners. Among the strategies: aggressive driving enforcement, targeted enforcement in school and work zones, and a national high visibility enforcement campaign. CERS research about U.S. automated enforcement strategies is cited in the report (page 12).

Rural Highway Safety Clearinghouse: Selected recent additions


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Center for Excellence in Rural Safety
Director: Lee Munnich
Research Director: Thomas Horan
Program Delivery Director: Gina Baas
Policy Director: Barb Rohde
Administration Director: Frank Douma
Coordinators: Stephanie Malinoff, Kaydee Kirk
Editor: Michael McCarthy
Information Manager: Arlene Mathison
Graphic Designer: Cadie Wright Adhikary
Contributing Writers: Christine Anderson, Nicola Losik
Contributing Writer: Christine Anderson

Center for Excellence in Rural Safety
State and Local Policy Program
Hubert H. Humphrey Institute of Public Affairs
University of Minnesota
301–19th Avenue South
Minneapolis, Minnesota 55455

Center for Excellence in Rural Safety | University of Minnesota | Minneapolis, MN 55455 | Location & Contact Information