The role of the voluntary sector and community campaigning in road injury prevention

Speech by Julie Townsend, deputy chief executive, Brake

For the Brain Injury Prevention Symposium, ISCoS (International Spinal Cord Society) Annual Conference, September 2012

In May last year the UN launched the first ever global Decade of Action for Road Safety. Events in more than 100 countries involving governments, celebrities, sports stars, muppets and NGOs, promoted a shared goal of stabilising and then bringing down numbers of road deaths and injuries through a global plan for road safety, with the aim of saving five million lives and many more injuries by 2020.

The Decade came about following recognition by the World Health Organisation that road injury is set to become the world's fifth biggest killer by 2030, rising from its current position as ninth in the rankings, if more is not done to improve road safety worldwide.

The WHO estimates there are 1.3million road deaths globally each year and some 20-50 million injuries, although we are a long way off having accurate figures for the latter. (Even here in the UK, where the government has collected this data for decades, there is an acknowledgement of a big discrepancy between its published road injury figures, collected by police, and hospital admissions figures.)

Unlike many of the biggest killers in the world, road crashes disproportionately affect the young, meaning many life years lost among those killed, exacerbated trauma for the bereaved, and long-term pain and upheaval for those who suffer debilitating injuries. Looking at these leading causes of death worldwide, road crashes rise to the top three if you look specifically at deaths among five to 44 year-olds, and they take the number one spot for deaths among young people – both globally and in many developed nations, including the UK.

And road crashes, you may note, stand apart from any other cause of death on this list, in that they are entirely man-made and preventable, again adding to the trauma of those affected, but also making it shameful that it should make the list at all, let alone be rising up it.

Or to put a positive spin on it, because crashes are entirely preventable, road safety presents a tremendous opportunity to save a lot of lives, and prevent a great deal of suffering.

Without exception road casualties have a devastating impact on those directly affected, and on society as a whole. Because they are unexpected, violent and man-made, road deaths and injuries inflict particularly acute suffering. Research has shown the long-term, acute psychological impact, and that this can frequently lead to further and ongoing health, financial and social problems.

Those who survive crashes but with catastrophic injuries often need many years of rehabilitation, and may find themselves living a completely different life to the one they led before, unable to do the same work, pastimes, or live in the same house, every aspect of their life affected. Some may need round-the-clock for the rest of their lives.

As well as the upheaval, pain and anguish experienced by injured victims and immediate family of those killed and injured, road casualties often have a terrible ripple affect across whole communities. One person killed or injured may mean scores suffering and traumatised.

Think, for example, of a 12 year-old boy knocked down outside his school during his lunchbreak. He is cradled in the arms of his best friend as he lies dying in the road, the rest of the school's pupils watching on from the playground. The driver is a teenager from the area whose family knows the boy's family. Tragically, this is not a made-up example nor by any means exceptional.

The economic cost to society of road crashes and casualties is also huge. Here in the UK, the government estimates the cost of each fatal crash to be £1.8million, and each serious non-fatal crash to be £200,000. It puts the total annual cost of crashes at up to £32bn, taking into account under-reporting. This includes human costs, as much as they are quantifiable, lost output, police and insurance costs, as well as of course the very significant costs to health services.

And it's crucial for us to also acknowledge the price society pays not just for road casualties, but also for the threat of casualties, for road danger.

We are increasingly realising this threat is one of the biggest barriers we face in developed nations like the UK to promoting and enabling active lifestyles. Parents, children and adults all say the threat from traffic, the lack of safe facilities, is stopping many of them from walking and cycling as a sustainable and healthy transport choice, and simply for their enjoyment and wellbeing. Recent surveys by Brake of adult commuters and parents show that a huge proportion say they would walk and cycle, or do so more, if there was a safer road environment.

And yet despite all of this, road safety is often not regarded and dealt with as a public health issue.

It was therefore a huge break-through in our view to see the World Health Organisation and United Nations launching the Decade of Action, recognising road safety as a hugely important public health issue – but we still have some way to go on this. This is a rare opportunity for me, to be speaking at an event for health professionals – but a very welcome one – as at Brake we are determined over the coming years to do more to engage public health and medical communities to work together on casualty prevention.

____

The challenges we face together in road casualty prevention are huge across all parts of the world. Vehicle ownership continues to rise rapidly, the vast majority of countries don't have adequate laws addressing the major risk factors, and we have an unclear picture of the full extent and nature of road injuries.

But perhaps the biggest challenge facing everyone working in road safety across the globe is the cultural one. Specifically, we might boil this down to firstly the widely-held view that road crashes are inevitable occurrences – hence the use of the term 'accident', which we believe is inappropriate for such catastrophic and preventable events – and secondly the prestige, glory and glamour that surrounds the activity of driving. The fact it's seen as a right, a pleasure, and glamorised through so many media outlets, makes it all the harder to persuade drivers to change their habits, and to persuade governments to implement restrictive or punitive measures that could be seen to unfairly target or penalise drivers.

Chipping away at and dismantling these cultural myths is vital if we are to persuade governments to legislate for safer roads and if we are to persuade people to abandon the behaviours that cause road injury. And this is a key role that NGOs like Brake can play, particularly through campaigning and community engagement and activation.

---

Brake was founded 18 years ago as a UK-wide road safety charity, with two main aims: making roads safer and preventing road death and injury and easing the suffering of people bereaved and injured in road crashes. We've grown to the modest size of 22 members of staff, with a turnover of just under a million pounds, and we're very proud that we make that little bit of money go an awfully long way. Incidentally, very little of our money comes from government: less than 10%, and all of that is for our victim care services. Our road injury prevention work is entirely funded through corporate and community fundraising, much of which runs hand-in-hand with educational and community engagement activities.

I'm focusing in this presentation on the casualty prevention side of our work, but it's important to briefly reference our care work, since the two are closely inter-linked. Our work supporting and assisting people who lives are torn apart by road crashes – including a national helpline and support packs - gives validity and weight to our work preventing these tragedies because we witness first-hand the devastation crashes and casualties cause.

And we find that many families who we support, later on, want to help us fight to stop other families going through what they have been through. Many come forward wanting to speak out in support of our campaigns, and tell their stories, and we are very proud to work with these courageous individuals – including some whose photos I showed a few minutes ago.

__

We use a range of means to campaign as efficiently and effectively as possible given our limited resources, and at the heart of that is media work. We don't have the money for national advertising campaigns, but we do have the expertise and means to deliver high-profile, high impact PR campaigns through engaging traditional media, and making use of social media.

To generate widespread coverage, we use surveys into road user attitudes, behaviours and understanding, such as the examples I gave before on walking and cycling, plus freedom of information requests to police forces, government and local authorities to gauge the state of play in relation to different road safety issues, from morning-after drink driving, to child car seats, to penalties for driving offences. We link our results to constructive, clear and specific educational messages and messages. We often engage families who has been affected by a related type of crash in support of our media work, as I've just mentioned. Sometimes we might run an event or photocall to coincide with the release, and then we work hard to engage our contacts in national, regional and specialist media, and to disseminate the story ourselves via social media.

It's a formula that works incredibly well for us. Just to give a couple of examples, a press release we issued in January using freedom of information request data showed how traffic police numbers have dropped by 12% over four years. We put this out along with calls for traffic policing to be given greater priority and got coverage in five national and 23 regional press outlets, plus three national and 41 regional broadcast interviews. A few months later, we conducted a survey on the extent of mobile phone use at the wheel, which we put out alongside calls for people to drive smart by pledging to never use a phone at the wheel in any way. It was covered in 15 regional and seven national press and web outlets, and through two national and 27 local broadcast interviews.

Alongside this PR activity communicating educational and policy messages, we work hard to lobby government, calling for legislative change and investment in road safety, through direct engagement of government ministers and civil servants, working with MPs to help bring road safety to the fore in parliament, and through responding to new proposals and developments, such as answering consultations and putting out media statements. We are also, more and more, working to activate members of the public in lobbying, such as by enabling people to write to their MP using a bespoke app on our website.

Some of our main UK policy focuses at the moment include:

- calling for a system of graduated driver licensing, to ensure novice drivers develop their skills and experience gradually through a minimum 12-month learning period and then a novice driving period with risk-reducing licence restrictions like a late night driving curfew

- calling for a lower drink drive limit – in line with the fact that even small amounts of alcohol significantly affect driving – and improved drink and drug driving enforcement regime

- and we want lower speed limits and other measures to bring down traffic speeds particularly to make roads safer for people to walk and cycle – specifically we would like our urban default limit lowered to 20mph and lower limits of 50mph or below on rural roads, although with the government's current focus on localism, we're focusing on persuading them to enable and encourage local authorities to implement more lower limits at local level

Policy work is often slow-burning, but we have played a key role in seeing some key legislative change over the years, and in bringing some policies to the fore if not into fruition, yet. We have seen a ban on using hand-held phones at the wheel across the UK, lower drink drive limits have recently been announced for Scotland and Northern Ireland, many major towns and cities have implemented 20mph limits, and we have seen increasing interest in and support for graduated driver licensing – and we'll keep pushing for this.

And as a completely independent charity we are ideally placed to do this lobbying and advising and applying of pressure – especially as an organisation that sees the terrible aftermath of crashes, and that is constantly scanning international road safety research and best practice to inform both our policy work and our information services for road safety professionals.

We are also able to galvanise action across a variety of partner organisations, and are increasingly working to speak out alongside and in partnership with other transport safety, environmental and health NGOs. This is a recent example of that: earlier this year we built a coalition of organisations opposed to the UK government's proposal to increase motorway speed limits to 80mph, under the banner 'No to 80'. Together we drew on a range of evidence to highlight that 80mph limits would increase casualties, carbon emissions, and costs for taxpayers and drivers – so employing social, environmental and economic arguments. I can't yet tell you the outcome of this campaign, but since the government has gone rather quiet on the issue, and no formal proposals have materialised for consultation, we are hoping it was another success.

---

The other side to our campaigning and awareness-raising work to prevent casualties is at grassroots level: working to engage, empower and enable communities to take action on road safety in their area.

We offer a range of guidance and resources to communities to help them bring about change locally and make roads in their area safer. We have an online community campaign kit that tells you how to set up a campaign and build support and awareness – such as through petitions, social networking sites, local events, noticeboards, and engagement of local authorities. We also deploy our Zak the Zebra mascot, and carry out publicity around Zak-led campaign events, to help these communities gain publicity and attract interest in their campaigns.

It can take many years, but often these campaigns are successful, bringing about important road safety engineering measures like 20mph limits, crossings and paths, and helping to develop real passion and commitment for road safety within these communities.

Brake also coordinates initiatives specifically aimed at empowering pre-schools, schools, colleges and youth clubs to take action on and promote road safety locally:

Beep Beep! Day is an activity nurseries and pre-schools can run for under-8s. It's about teaching tots the road safety basics. But more than this, it's about getting the school or playgroup engaged in road safety, and promoting road safety to parents and the wider community. Brake provides resources, and carries out publicity around the events, promoting the message that by slowing down and looking out, drivers can help local families walk and cycle safely.

Our Walking Bus event, which takes place each June, involves hundreds of thousands of primary school kids marching for road safety. Again, it's an opportunity for schools to teach children about safe walking, but it's also about schools saying to their local community: we care deeply about children's safety, and we need drivers to help protect them. Through the publicity Brake does around the event, we are demonstrating support within communities for safer roads.

In a similar way, our 2young2die initiative is about young people speaking out to peers on the importance of road safety. We ask young people to develop road safety campaigns as part of a competition, and publicise the results. Again, we're engaging young people in road safety at the same time as demonstrating support for road safety in the community, rather than preaching to young people.

The same applies to our flagship event, Road Safety Week, which is now in its 16th year in the UK. Each year it involves thousands of partners, professionals, schools and groups running local road safety activities, alongside a national and regional media campaign by Brake.

The way we coordinate Road Safety Week neatly reflects our wider role as an independent NGO campaigning on road safety. We develop the overarching theme and messages, we promote involvement to communities and professionals, we provide information, resources and advice on getting involved (through our website and email action packs). We make a big splash during the week itself by coordinating a comprehensive media campaign – using research and case studies, again, to generate coverage nationally, regionally and online.

But the essence of the event is community engagement, and that comes from members of the public, community leaders, educators and professionals running activities locally, demonstrating that safer roads are vitally important to ordinary people everywhere.

So it is very much a partnership project that works because of the commitment and engagement of professionals and volunteers across the UK, many of whom get involved year in year out. It's a model we think is extremely effective, which we're starting to roll out internationally. Our first Road Safety Week New Zealand, coordinated by the newly-formed Brake NZ, was a big success in May this year. We are also developing our international Road Safety Week website to share information with practitioners worldwide. And we will be sharing our expertise and supporting the UN's global Road Safety Week in May 2013.

Back in the UK, this year's Road Safety Week kicks off on 19th November and our main theme this year is Slower Speeds = Happy People. So we'll be conducting a nationwide media campaign, and encouraging and helping those getting involved in the Week to shout loud and proud about the vital importance of drivers slowing down, and more authorities implementing lower limits – particularly to enable more people to walk and cycle in safety.

We will be riding the wave of enthusiasm for sport and active lifestyles created by the Olympics and Paralympics, pointing out that safer roads are crucial if we want a legacy of healthy, active communities.

---

Across all our community engagement and campaigning work, as you might have picked up from the last few slides, we are increasing using positive messaging to communicate the enormous benefits of and demand for safer roads, rather than finger-wagging and telling people NOT to do this that and the other.

The topic of speed is a prime example of that. Brake has campaigned vociferously on speed since our inception 18 years ago. What we want to achieve hasn't changed a great deal – lower traffic speeds across all road types, but particularly 20mph or below in communities, through lower limits, improved compliance, and better driver awareness. But the messages we communicate have shifted. We have moved away from simply warning of the consequences of driving too fast, to, more and more, promoting the positives of slowing down – pointing out the relationship between reduced speed and sustainable travel, healthy lifestyles, and the environment.

We have moved away from simply drawing attention to the fact that most drivers drive too fast. We instead focus on the widespread support from families, schools, and society for safer streets through slower speeds. It's a subtle change but an important one: from saying no to going fast, to saying yes to slowing down. From telling drivers off for speeding, to thanking them for braking.

We are striving, through our media work, through Road Safety Week, through engaging and activating schools, nurseries, young people and community groups, to build a sense that driving fast is shameful and anti-social, that slowing down is a compassionate and wonderful thing to do.

We are not moving away entirely from communicating the terrible consequences of risk taking, which remains important. As I have mentioned, engaging families affected by crashes continues to be a vital component in our campaigning. We are in no doubt these stories get people's attention, and make the public and policy-makers sit up and listen. Alongside this, we also use stark, simple facts about stopping distances and the physics of speed, and to draw on international research, to demonstrate how and why slowing down makes such a difference.

So across this broad range of community engagement and campaigning activities, we're chipping away at cultural myths that surround speed. The idea that driving fast is a glorious thing, synonymous with freedom and excitement. The sense that it is a right, a pleasure we should be allowed to indulge. And the myth that everyone likes and wants to drive fast, that this is the norm, and any impingement in this is nannying.

We are also, across all our community engagement and campaigning work, striving to dismantle the other myth I referenced earlier, that road crashes are an inevitable part of getting about, just 'accidents'. You may note this is a term we never use at Brake in relation to crashes, because it undermines work to prevent them in our view, and is offensive to many people bereaved or injured on roads.

We constantly refer to the preventability of crashes, and advocate the Vision Zero approach originally adopted in Sweden: where there is a long-term, ultimate goal of reducing road deaths and serious injuries to zero, in line with the fact these events are devastating and costly, but need not happen at all, so should not be accepted in any number.

We believe convincing people – the public and policy makers – on this point is critical in road injury and death prevention and I can assure you that despite the Decade of Action, despite the huge amount of progress that's been made in road safety in developed nations in recent years, getting this simple point across about the preventability of road casualties is a battle far from won.

So I urge all of you as health professionals, to pick up this mantle alongside the road safety community. We think that a huge amount can be gained by working together to empower communities, to persuade governments to act, to break down the myths surrounding road safety and to tackle road death and injury.

Please do get in touch with us if you would like to work with Brake towards safer roads and zero casualties. And thank you very much for your time.