To your health

Monday March 4, 2013

Given my mild obsession with motorcycles, road safety and health in general, I was happy to stumble upon a report of a major, global, on-going assessment of human health. True, the word motorcycle didn’t appear once in the article, but one of the statistics in the report relates quite directly to motorcyclists and, for that matter, to anyone else who dares to venture out on the open road.

So yes, Science magazine (Dec. 14, 2012) reported on a new effort to evaluate and quantify the state of health of the world’s populace. Centered in Seattle, and run by a guy named Christopher Murry, the project lives at the Institute for Health Metrics and Evaluation. IHME’s work has caught the attention of virtually all public health professionals, the World Health Organization, and just about anyone or anything else concerned with the well being of humanity. As with any effort this new and big (187 countries), the study has its share of critics. At least some of that is a product of Murry’s hefty ego, but the Institute’s methods and, therefore, conclusions have also raised a few eyebrows. Is there enough on-the-ground work? Are the samples big enough? Stuff like that. But let’s just go with some of the findings for a little while.

The overarching outcome of interest here is the categorization and ranking of the causes of human death and disability. Causal agents achieve their rankings because they can kill you, thereby taking years off an average life, or they can disable you for a period of time. Thus, HIV can both kill and disable, while low back pain rarely kills (maybe a few suicides), but disables. And time is the metric of interest -- how many years of time are lost to each causal agent. The use of time allows IHME to compare apples and oranges, something like malaria to clinical depression, and end up with a ranked list of what does us harm. The group has produced a top 12.

In 2010, the leading global health problem was clogged, gasping hearts. It was number four in 1990. Apparently more of us around the globe are eating fatty food and getting less exercise. But then my eye wandered down to number 10 on the list, and guess what? It was road injury. Yep, considering the whole planet, the 10th largest source of disability involved some sort of road trip. Its nearest neighbors were preterm birth (nine), chronic obstructive lung disease (eight), malaria (seven), and major depressive disorders (11).

I can’t say that I was shocked, but I was surprised. "Road kill" was right up there with malaria, an enormous health scourge in most of the tropics. In fact, road injury was the only form of injury to make the top 12. Guns didn’t make the list (maybe because only the U.S. has a gun under every pillow). In 2010, for example, in the U.S. alone, more than 30,000 people died in auto crashes. If you add the mortality for pedestrians and all kinds of cyclists, you get a grand total of almost 40,000 deaths. To get the total injuries from all of this, some of which can have lifelong effects, you multiply the mortality figures by anywhere from 10 to 20!

OK, so where do we go with this? There are a number of avenues, but I think I might like to comment on just one agent that I think is causal to the persistent and even increasing carnage on the road. Recently I saw a video of people driving in and around Moscow. A guy with a camera in his car just cruised around and recorded stupid crash after stupid crash. It was utterly chaotic and hard not to laugh. Some combination of alcohol, lack of training, poorly maintained cars, and complete lack of law enforcement ruled the day. "Drivers" crashed into buildings, other cars and trucks, utility poles, trees, and anything else that occupied space, including a few foolish pedestrians.

Mostly, we don’t do that here. We inspect our cars, we are usually licensed to drive, we frequently don’t drink and drive, and we have cops who do their jobs. So what is our problem (40,000 deaths per year is a problem, I think)? I would like to posit that we are on the road so much that we simply get blasé. We just don’t see the road for the danger it is. So we speed, ignore the road conditions, down some beers, unwrap sandwiches, and phone and text. You know.

In reality, you have about a one in four million chance of dying every time you get out there in a car. That’s about 15 times more likely than your winning the average Powerball lottery. Can you live with that? Over a lifetime in a car, however, the figure gets a lot closer to 1 percent. Still OK?

Here’s a single anecdote to illustrate. A few nights ago, I finally saw the guy. He was dressed in dark colors, without any light, riding a dark bicycle against the traffic on an unlit portion of Putney Road. "What, me worry?" At least he wasn’t talking on a phone.

By the way, the Science piece also listed the 12 top risk factors contributing to the IHME’s disability data. Smoking was second, alcohol third, and -- get ready -- low fruit consumption was fifth. Inactivity came in 10th. Motorcycling didn’t make the list.

Bob Engel lives in Marlboro with his motorcycles, wife and cat.


If you'd like to leave a comment (or a tip or a question) about this story with the editors, please email us. We also welcome letters to the editor for publication; you can do that by filling out our letters form and submitting it to the newsroom.

Powered by Creative Circle Media Solutions