Decision-Makers Need to “Follow the Data” Back to Child Passenger Safety

This article originated in the May/June 2010 issue of Safe Ride News.

One of the many benefits of attending a national conference like Lifesavers is the opportunity to hear leading policymakers communicate what they perceive to be our top safety priorities.  One plenary session at Lifesavers this past April featured a panel discussion with leaders in the areas of roadway improvements, vehicle technologies, and occupant behaviors.  During another, the new NHTSA head, David Strickland, took advantage of his first opportunity to address the Lifesavers group to lay out his goals and strategies.

I heard many familiar messages at these sessions:  Driver distraction (in particular, texting) is a major area of concern; motorcycle fatalities are alarmingly high; drunk drivers are still major contributors to crashes, as are teen drivers.  Basic problems like speeding and seat belt use also were mentioned as major areas of focus.

As I nodded in agreement with all of these observations, I noticed one important fact: CPS was missing from the discussion.  As a policy priority, CPS was only mentioned briefly, and that nod — to the need for increased booster seat use — was breezed over far too quickly.  Other than that, the only mention of children was to pat the collective group of attendees on the back for a job well done – child deaths have gone way down over the past 20 years.

Of course, I appreciated the recognition.  After all, reducing child deaths and injuries is what all of us have been working on so diligently.  However, the compliment had an unsettling tone of closure, as if the announcement meant NHTSA now could shut the book on the CPS problem and move on.  “But Mr. Administrator,” I thought, “How do we maintain such levels of success without continued effort and vigilance?   After all, new parents are “born” every day! And what about the needless child deaths that continue to happen? Is there an acceptable level for such tragedy?”

For each bullet-pointed PowerPoint® slide that was used to outline policy priorities, I could imagine a spreadsheet behind the scenes that translated the slide into financial resources.  Based on the slides, very few of those resources seem to be destined for child passenger safety.  Perhaps it is due to our own effectiveness, but there seem to be “squeakier wheels” poised to receive more of the already scarce funds. Although I’m not questioning the worthiness of these other causes, the concern I have is that what we have accomplished for children and families may be allowed to deteriorate while federal attention is shifted elsewhere.

Another NHTSA message I heard frequently was that data is the key to understanding where resources are most needed. This wasn’t a subtle message that required reading between the lines, either, but a mantra that was repeated over and over.  “Look to the data,” “Follow the data,” and “Data-driven decision making” were important points made during each NHTSA presentation.  David Strickland himself said that one of the best pieces of advice he’s ever gotten is “Don’t get ahead of the data.”

This message added to my sense of foreboding, since it has now been two and a half years since the Partners for Child Passenger Safety (PCPS) data collection project ended.  That project, a unique partnership between The Children’s Hospital of Philadelphia (CHOP) and State Farm Insurance, was the only large-scale, child-focused motor vehicle crash surveillance system in the nation, but, after 10 years, funding ended in December 2007.  Over the years, PCPS data was used as the basis for numerous studies that contributed greatly to our understanding of the needs of child passengers, providing the kind of data that policymakers demand.  Even today, studies continue to draw from that database, but soon it will become outdated.

In SRN July/Aug 2008, we ran a guest editorial by Dr. Dennis Durbin of CHOP in which he introduced the CHOP proposal to work with NHTSA to create a child-focused surveillance system that would fill in the void left by the loss of PCPS data collection. He pointed out that the problem with other existing systems is they either provide a healthy sample size but low levels of child-related detail or are rich in details but lack a sufficient quantity of data points. CHOP’s idea was to come up with a way to leverage the system that has tons of data (the National Automotive Sampling System’s General Estimates System, or NASS) and use tools and techniques learned through the PCPS project to enhance the NASS data.  The resultant database, called the National Child Occupant Special Study (NCOSS) Crash Surveillance System, would have both the quantity and the quality of data needed.

At Lifesavers, I had an opportunity to ask Dr. Durbin about the progress on the NCOSS front.  He was happy to report that work is moving forward, and that NHTSA is supportive.  In fact, two important pilot studies are now being initiated.  An industry consortium is financing one to develop methods for contacting and screening potential cases for data collection, and the Insurance Institute for Highway Safety is supporting another that will explore data collection instruments.  These pilot studies will take a year or so to complete. In the meantime, efforts are under way to ensure that the NCOSS Surveillance System becomes a federally funded program by being included in NHTSA’s funding reauthorization, which is currently before Congress.

This update gives some reason for optimism.  Of course, collecting data isn’t a magical solution, but without a collection system there is no data for Administrator Strickland and other policymakers, both today and in the future, to follow.  Without the data, they won’t know the important work that needs to be continued and initiated in the field of CPS, despite our impressive achievements to date.  In fact, they wouldn’t even have a way to recognize if CPS gains begin to deteriorate.

Denise Donaldson—Denise Donaldson

For more information on the NCOSS project, including information on how to support this effort, go to the NCOSS website.