July 3, 2024 BY Tiffany Smithin News

BIG Cost Savings & Equity Benefits Highlighted in New Vision Zero Study

The next time someone tries to challenge your investment in proven Vision Zero strategies for being too expensive, share these jaw-dropping findings with them: New York City saved $90 million in healthcare costs over the first five years of its Vision Zero changes.

This comes from a recent study in the American Journal of Public Health, which used New York State Medicaid data to assess the impact of NYC’s Vision Zero program and accompanying upstream safety interventions on low-income residents and residents of color. Researchers compared injuries in New York City to surrounding counties without a Vision Zero policy, between 2014 and 2019. They found that, following Vision Zero implementation, the NYC areas studied observed 77.5 fewer traffic-related injuries per 100,000 person-years. Person-years is a way to measure the time people are exposed to something. Within the context of roadway safety, it is used to measure the amount of time people are exposed to traffic. For example, if 50,000 people were exposed to traffic for two years, that would amount to 100,000 person-years of traffic exposure.

Vision Zero can yield significant financial savings

In addition to decreasing the rate of severe injuries, Vision Zero amounted to substantial healthcare cost savings! One concern with traffic policies is that they affect only the low-hanging fruit (e.g., fender-benders) while having little influence on severe crashes. However, the data suggest this was not the case; NYC residents saw reductions in severe injuries, including traumatic brain injuries or hospitalization. This decline in serious injuries and hospitalizations amounted to more than $90 million in savings for reimbursements for treatment of crash-related injuries. 

Hospitalizations per 100,000 Person Years in NYC compared to surrounding counties

The study also found that low-income residents suffered fewer crash-related injuries following Vision Zero implementation, with the greatest decrease observed among Black New Yorkers. According to the authors, “Given that low-income and Black Americans are more likely to live and work in places with unsafe roadways and face injuries, these findings suggest that Vision Zero–style reforms are promising for reducing disparities.” The findings of this monumental research can support conversations around comprehensive roadway safety reform as a strategy for enhancing health equity by reducing injuries among groups who are particularly vulnerable and at risk for being overlooked in citywide, non-targeted interventions.

Medicaid data offers greater insights 

Most Vision Zero analyses have relied on police reports and data gleaned from transportation departments to quantify changes in crashes, deaths and serious injuries. However, police data does not capture injury severity, nor the long-term effects and associated costs of crashes, and undercounts injuries for marginalized populations. Notably, Medicaid, a government health insurance program for low-income individuals, and its data capture injuries of varying severity and longer-term consequences, including follow-up care such as physical therapy, medications, along with medical expenditures.

Most importantly, it can also be used to create a comparison group for analysis, which is unprecedented in Vision Zero safety research. In this study, the authors used New York State Medicaid data to construct a similar comparison group of low-income individuals living in nearby areas without a Vision Zero policy, allowing for a more thorough assessment of how Vision Zero impacts these communities. 

Vision Zero progress stalled with Covid-19

The study shows that gains observed from Vision Zero between 2014 and 2019 reversed after the onset of the pandemic, as the city’s injury rate slowly rose back to that of surrounding counties analyzed in 2020 and 2021. This is not unique to NYC, as the country experienced a 40-year high in deaths and serious injuries in 2021. However, it does underscore the pandemic’s role in destabilizing transportation safety, emphasizing a need for a continued focus on proactive design-based safety interventions that will remain effective and far-reaching in times of instability. 

Thus, as communities continue to recover from the aftermath of the Covid-19 and face record levels of roadway safety risk, these findings pose significant national and local implications. Not only do they underscore the role of Vision Zero in improving health outcomes and in offering substantial protection for socioeconomically disadvantaged populations, but they demonstrate Vision Zero’s impact beyond preventing minor collisions. They bolster Vision Zero as a tool to reduce the most serious and life-threatening incidents, which place significant financial strain on our medical system. Given Vision Zero’s ability to impact more than just deaths and serious injuries, the findings also emphasize a need for performance measures that go beyond measuring deaths and serious injuries alone. There are still of course other lessons to be learned from the public health sector, but Vision Zero's role in public health and equity, offers a promising path forward for more effective and equitable safety planning across the U.S. 

>> Many thanks to the study authors, Kacie L. Dragan MPH and Sherry A. Glied, PhD, along with NYC’s Vision Zero team and many advocates who shared with policymakers and the public the sheer number of deaths and serious injuries that could be prevented with proven safety interventions.

The next time someone tries to challenge your investment in proven Vision Zero strategies for being too expensive, share these jaw-dropping findings with them: New York City saved $90 million in healthcare costs over the first five years of its Vision Zero changes.

This comes from a recent study in the American Journal of Public Health, which used New York State Medicaid data to assess the impact of NYC’s Vision Zero program and accompanying upstream safety interventions on low-income residents and residents of color. Researchers compared injuries in New York City to surrounding counties without a Vision Zero policy, between 2014 and 2019. They found that, following Vision Zero implementation, the NYC areas studied observed 77.5 fewer traffic-related injuries per 100,000 person-years. Person-years is a way to measure the time people are exposed to something. Within the context of roadway safety, it is used to measure the amount of time people are exposed to traffic. For example, if 50,000 people were exposed to traffic for two years, that would amount to 100,000 person-years of traffic exposure.

Vision Zero can yield significant financial savings

In addition to decreasing the rate of severe injuries, Vision Zero amounted to substantial healthcare cost savings! One concern with traffic policies is that they affect only the low-hanging fruit (e.g., fender-benders) while having little influence on severe crashes. However, the data suggest this was not the case; NYC residents saw reductions in severe injuries, including traumatic brain injuries or hospitalization. This decline in serious injuries and hospitalizations amounted to more than $90 million in savings for reimbursements for treatment of crash-related injuries. 

Hospitalizations per 100,000 Person Years in NYC compared to surrounding counties

The study also found that low-income residents suffered fewer crash-related injuries following Vision Zero implementation, with the greatest decrease observed among Black New Yorkers. According to the authors, “Given that low-income and Black Americans are more likely to live and work in places with unsafe roadways and face injuries, these findings suggest that Vision Zero–style reforms are promising for reducing disparities.” The findings of this monumental research can support conversations around comprehensive roadway safety reform as a strategy for enhancing health equity by reducing injuries among groups who are particularly vulnerable and at risk for being overlooked in citywide, non-targeted interventions.

Medicaid data offers greater insights 

Most Vision Zero analyses have relied on police reports and data gleaned from transportation departments to quantify changes in crashes, deaths and serious injuries. However, police data does not capture injury severity, nor the long-term effects and associated costs of crashes, and undercounts injuries for marginalized populations. Notably, Medicaid, a government health insurance program for low-income individuals, and its data capture injuries of varying severity and longer-term consequences, including follow-up care such as physical therapy, medications, along with medical expenditures.

Most importantly, it can also be used to create a comparison group for analysis, which is unprecedented in Vision Zero safety research. In this study, the authors used New York State Medicaid data to construct a similar comparison group of low-income individuals living in nearby areas without a Vision Zero policy, allowing for a more thorough assessment of how Vision Zero impacts these communities. 

Vision Zero progress stalled with Covid-19

The study shows that gains observed from Vision Zero between 2014 and 2019 reversed after the onset of the pandemic, as the city’s injury rate slowly rose back to that of surrounding counties analyzed in 2020 and 2021. This is not unique to NYC, as the country experienced a 40-year high in deaths and serious injuries in 2021. However, it does underscore the pandemic’s role in destabilizing transportation safety, emphasizing a need for a continued focus on proactive design-based safety interventions that will remain effective and far-reaching in times of instability. 

Thus, as communities continue to recover from the aftermath of the Covid-19 and face record levels of roadway safety risk, these findings pose significant national and local implications. Not only do they underscore the role of Vision Zero in improving health outcomes and in offering substantial protection for socioeconomically disadvantaged populations, but they demonstrate Vision Zero’s impact beyond preventing minor collisions. They bolster Vision Zero as a tool to reduce the most serious and life-threatening incidents, which place significant financial strain on our medical system. Given Vision Zero’s ability to impact more than just deaths and serious injuries, the findings also emphasize a need for performance measures that go beyond measuring deaths and serious injuries alone. There are still of course other lessons to be learned from the public health sector, but Vision Zero's role in public health and equity, offers a promising path forward for more effective and equitable safety planning across the U.S. 

>> Many thanks to the study authors, Kacie L. Dragan MPH and Sherry A. Glied, PhD, along with NYC’s Vision Zero team and many advocates who shared with policymakers and the public the sheer number of deaths and serious injuries that could be prevented with proven safety interventions.




Newsletter Sign Up

Fields with a * are required.


Scroll to Top