Montana has been working for years to try to reduce the number of people who die there on the road.
It was one of the first states, says national automobile club AAA's safety chief Jacob Nelson, to pull together state agencies, safety advocates and industry groups to tackle the problem.
The state's latest plan lists a dozen ways to cut the number of people road fatalities. It wants to work with Native Americans, teens and seniors to curb risky drivers; improve ambulance response times in rural areas; and push all people to use their seat belts.
The results so far have been promising. By 2010, the number of traffic deaths in Montana dropped to 189 and set an all-time low for deaths per miles driven.
But Montana's rate was still the highest number of deaths per mile driven of any state in the country. It was nearly three times more deadly than Massachusetts.
Montana shares several characteristics with states that have high traffic deaths rates: a large network of rural roads, low rates of seat belt use, a high percentage of deaths caused by drunk drivers and a high number of fatal accidents involving speed. Many of those are related.
These factors go a long way in explaining how safe or deadly a state's roads are. The most dangerous states in 2010, the last year for which complete federal data is available, were Montana, Arkansas, South Carolina, West Virginia and Wyoming, according to the National Highway Traffic Safety Administration. The safest states were Massachusetts, the District of Columbia, Minnesota, New Jersey, Rhode Island and Washington state.
States play a big role in preventing fatal road accidents by passing or repealing safety laws and by spending money to enforce and publicize those laws. They can also make roadways safer.
But in the meantime, traffic safety remains a major concern. On an average day, road accidents kill 90 people in the United States. There are twice as many deaths on the road a year as homicides.
The number of roadway deaths increased in 2012, after declining for the previous six years. It is still too early to explain why that number jumped last year, but advocates point to the increase as they make the case for stepping up safety efforts.
Rural roads are generally more dangerous than urban roads for a number of reasons, and states with more country routes tend to have higher fatality rates. Only 19 percent of Americans live in rural areas, but 55 percent of all road fatalities happened in the country. Traffic fatality rates have decreased twice as fast in rural areas as urban areas since 2000, but city and suburban roads are still safer.
AAA's Nelson says people drive faster in rural areas, and the crashes are more deadly. Head-on collisions, for example, are more common in country areas, because opposite-direction traffic is rarely separated on two-lane roads. Other safety features, like guard rails, are also less common.
Another challenge in rural areas is that there are fewer people to call for help after an accident, and help is likely to be farther away, Nelson says. The hospitals are also often farther away and may not have the capacity to handle severe traumas. All of that makes it less likely that crash victims will get the medical care they need as crucial minutes tick by.
Drivers in rural areas also tend to be older and therefore more vulnerable to injury. And they are more likely to have been drinking, adds Nelson, an epidemiologist. Finally, fewer police officers spread out across rural areas are less likely to catch drivers for driving drunk, speeding or not wearing a seat belt.
Many safety advocates say strict state safety laws can lead to a drop in highway deaths, especially when it comes to seat belts.
People who did not wear their seat belts made up nearly half of U.S. roadway deaths in 2010, although the federal government estimates 85 percent of people traveling on the road that year wore seat belts.
New York state passed the country's first law in 1984 to let police pull over drivers and front-seat passengers for not wearing seat belts.
Eighteen states do not have “primary enforcement” seat belt laws like New York's that allow traffic stops just for seat beat enforcement. New Hampshire has no seat belt law at all. In the other 17 states, police can issue a ticket for not wearing a seat belt only when they stop a vehicle for another reason.
Advocates for Highway and Auto Safety, a group that pushes for stricter road safety laws, goes a step farther. It argues that states should let police pull over vehicles if anyone in the car is not wearing a seat belt, not just occupants in the front seat. Only 16 states and the District of Columbia already have that law on the books.
Cathy Chase, a senior director for government affairs for Advocates, says stricter state laws save lives. Kansas, Minnesota and Wisconsin all recently passed primary enforcement seat belt laws and then saw a quick increase in seat belt use. In Minnesota, she points out, seat belt use went from 86 percent to 93 percent in three years, while the number of people who died not wearing a seat belt declined from 150 to 120.
Chase's group encourages states to pass 15 safety laws, covering seat belts, motorcycle helmets, booster seats, text messaging, teen drivers and drunken driving. States see very quick results when they make changes, she says. Motorcycle deaths increased after California, Florida, Louisiana, Pennsylvania and Texas weakened mandatory helmet laws. Teen deaths decreased after states, such as Connecticut, rolled out graduated driver's licenses, which phase in young drivers to full privileges.
But state laws do not completely explain how often people die on roads. Massachusetts, which had the lowest rate of traffic deaths, also had the second-lowest seat belt use, trailing only neighboring New Hampshire. Fewer than three out of four Bay State drivers and passengers buckled up.
Stricter laws also come with a cost, says John Bowman, a spokesman for the National Motorists Association, a group originally formed to get rid of what was then a national 55-mph speed limit. “There are also social costs in government intrusion and government intervention into these types of personal decisions (such as) taking away liberty and freedom,” Bowman says.
The group encourages motorists to use seat belts, but it argues against more stringent laws. It also pushes back against lower speed limits. Utah officials recently raised the speed limit of a remote stretch of Interstate 15 to 80 mph, after finding that the higher speed limit had a minimal effect on vehicles' average speed but cut down on accidents, Bowman notes.
The keys to successful highway safety efforts, though, are clear, says Barbara Harsha, executive director of the Governors Highway Safety Association, an organization of state transportation offices. Officials need to pass strong rules, those rules have to be enforced and both the law and its enforcement have to be well-publicized, Harsha says.
In Arkansas, seat belt use increased slightly the year after legislators passed a primary enforcement seat belt law in 2009 and then leveled off, according to state police. But the agency is now targeting public awareness of the new law using a “Click It or Ticket” campaign sponsored by the federal government. A survey conducted last summer after the publicity push showed the Arkansans had recently started to buckle up because they said they were more concerned about safety and because of the new law.
Drunk driving also has been a persistent factor in traffic fatalities, especially in South Carolina. In 2010, 44 percent of road deaths involved a drunken driver, the second-highest rate of any state, behind North Dakota. It is one reason South Carolina had the third-highest rate of traffic deaths that year.
The state's Highway Patrol is trying to combat the problem through enforcement and education, says Sergeant Bob Beres, a spokesman. Police in the state arrested nearly 16,000 people for drunken driving in 2011 and have stepped up enforcement in high-crash areas. The agency rolled out a program to let the public report intoxicated drivers by dialing *HP on their phones to get a trooper to the scene.
The patrol tells the public about its enforcement efforts through ads on billboards, radio and television, plus in-person presentations. Drunk drivers can be sentenced to 25 years in prison for every person they kill.
Beres says those efforts led to a reduction in deaths caused by drunk drivers in recent years, from 464 in 2007 to 315 four years later.
The Highway Patrol uses similar methods to reduce deaths of drivers and passengers who do not buckle up. Police in South Carolina, where not wearing a seat belt is a primary offense, beefed up night patrols for seat belt use, because data showed that a significant number of the deaths of people without seat belts occurred after dark.
At the same time, the state Department of Transportation has been working to lower the rate of traffic deaths by improving South Carolina's roads.
Brett Harrelson, state safety engineer, says the department focused largely on reducing accidents in which vehicles left the road. Those were the fourth-most common types of accidents — behind motorists not buckled up, drunk drivers and speeding — that killed people in South Carolina.
First, the agency started installing 480 miles of cable barriers, mostly along its interstates, to prevent vehicles from veering into oncoming traffic. In 2000, the year before the barriers were installed, 27 people died in those types of accidents. Since then, the number has never been higher than 10 a year, and in 2010, there was only one.
The transportation department, which controls nearly two-thirds of the state's roads, also started improving shoulders, making them at least two feet wide. It also added rumble strips to more than 4,000 miles of roads and tapered pavement edges. In the last four years, the number of people who died when their vehicles left the road dropped from 460 to 359.
Now the agency is starting to use a type of pavement on its interstates that reduces the spray of water coming off roads when it rains. State engineers testing it last year found it reduced crashes by 28 percent.
So even though South Carolina has one of the highest rates of traffic deaths in the country, its roads have gotten a lot safer, Harrelson says. It was just in 2008 that South Carolina dropped below a major milestone by recording fewer than 2 deaths per 100 million vehicles miles traveled. By 2010, the rate dropped even further to 1.67. “It's a pretty significant drop,” Harrelson says.