Picture your morning commute. You're sitting in traffic, shoulders tense. You come to a sudden stop and your coffee spills all over your console. Someone cuts you off. You're fairly sure you're going to be late to work…and grumpy when you get there.
Now picture this: You're cruising along at a steady pace, with no gridlock in sight. You're enjoying breakfast while watching the morning news on your dashboard monitor. All of your coffee is still in your cup because you haven't had to stop short. Sound better?
This is the vision that many hope will come to fruition through the development and introduction of self-driving cars or autonomous vehicles (AVs).
But it's more than the average commuter who should take an interest in how AVs may change daily life. Those who are concerned with the public's health should not only be interested in the development and adoption of these futuristic-seeming vehicles but be playing an active role in shaping the role of AVs in tomorrow's world.
So what is an AV exactly? The term encompasses a variety of technological advancements in which some or all of a vehicle's functions operate without driver input. Those AVs with the most potential to transform American life are those that can operate without the "driver" having to pay attention to the road. Some AVs will be able to function in self-driving mode for the entire trip. Others will be able to operate in self-driving mode for some or most of the time but, when needed, will alert the driver that he or she will need to assume control of the vehicle.
Either way, AVs carry the potential not only to change the way we drive but also to affect public health (i.e. motor vehicle safety, stress, health equity) profoundly. While most observers believe that the benefits of AVs will outweigh the harms, no one knows for sure how AVs will change our lives. We summarize a list of hoped-for benefits and possible unintended negative consequences below.
Health Benefits Of Autonomous Vehicles
Motor vehicle safety
More than 30,000 Americans and more than 1 million people worldwide die each year in motor vehicle crashes. More than 2 million are injured in the U.S. alone. Human error contributes to more than 90 percent of crashes. AV technology has the potential to significantly reduce motor vehicle crashes caused by human error and even prevent crashes that have other causes such as unsafe roadway conditions.
Environment
The adverse health effects of tailpipe emissions are well-documented: higher incidence of respiratory disease, cardiovascular disease, and adverse pregnancy outcomes, to name a few. Through more efficient driving, AVs offer the potential for a cleaner environment and less pollution-related disease.
Land Use And Urban Design
Parking spaces occupy a third of all land area in some cities. With AVs able to drop off their owners and then park themselves at remote locations, much of this space may be repurposed. Cities could become more compact and friendlier for pedestrians and bicyclists.
Stress
Traffic congestion and delays are associated with high blood pressure and decreased job performance. AV "drivers" may experience lower levels of stress due to smoother traffic flow, less stop-and-go driving, and fewer accident-caused traffic jams. They may be able to enjoy their rides and even be productive while in the car.
Mobility
Those who are transportation disadvantaged stand to benefit the most from the introduction of AVs. This includes people who cannot afford a car as well as those who cannot drive, such as many people with disabilities and millions of seniors.
For people in rural areas, transportation challenges can be immense. In many rural counties, public transit is nonexistent, often leading to both physical and social isolation. AVs offer the prospect of lower-cost travel, increased mobility, and ultimately better health for rural populations.
Health Equity
Hopes are high that the many positive benefits that could result from the widespread use of AVs will help to improve health equity. Access to reliable transportation improves economic opportunities and outcomes, which relate directly to good health.
In addition, AVs offer the potential to change the traditional model of private car ownership. Shared ownership or shared use of AVs could be cheaper than having to buy a car for one's own use. Furthermore, government agencies charged with delivering services to vulnerable populations may be able to use AVs to facilitate access to health care, healthy foods, child care, and more.
Potential Negative Health Impacts Of Autonomous Vehicles
Technological changes as potentially transformational as AVs are typically accompanied by a plethora of unintended consequences. For example, "driving" a car may become so easy or pleasurable that it discourages healthy behaviors such as walking or biking. The environmental benefits of AVs could be offset if AVs result in an increase in total vehicle miles traveled. In addition, a reliance on AVs could contribute to the expansion of suburban sprawl, potentially discouraging such activities as walking and biking.
At this early stage of development, no one knows for sure who will reap the greatest benefits from this new technology and, conversely, who will benefit the least. Historically, low-income and underserved populations are the last to benefit from new technologies. It will be important to ensure that attention and resources devoted to AVs do not detract from other services and systems that are disproportionately important to underserved populations and to people who cannot drive. Likewise, policymakers will need to ensure that resources dedicated to promoting AVs do not diminish funding for nonautomotive means of transportation, particularly walking and biking.
Why Should Public Health Engage Now?
The level of activity around AV technology is already frenetic. Nearly every major automobile manufacturer is planning for the emergence of AVs. Several have announced plans to have commercially viable AVs by 2020.
The automobile industry itself is changing in order to speed the development and adoption of AV technologies. General Motors and Lyft have formed a partnership to create a network of on-demand AVs. Google and Ford are widely expected to collaborate in building self-driving cars. Tesla now sends software updates wirelessly to its fleet of cars to add new autonomous features.
Lawmakers and regulators are also taking an interest in AVs. Four states and the District of Columbia have passed laws regulating the testing of AVs. The U.S. Department of Transportation (DoT) recently announced its intent to help accelerate the development of AVs. In the coming months, DoT plans to develop model state policies to promote testing and use of AVs. In addition, President Obama is seeking nearly $4 billion over the next 10 years to support pilot projects to advance the development of AVs.
Yet few public health professionals are focused on the significant impact that AVs may have on public health and the role public health can play. Little attention has been paid to how to assess AVs' impact on such things as pollution-related disease, mobility, health equity, and active transportation modes such as walking and biking. Public health professionals are uniquely situated to develop data systems and conduct research to monitor the public health impact of AVs and to bring high-quality information to the policymaking process.
In fact, identifying the many issues that policymakers will need to address is limited only by one's imagination.
- How can policymakers maximize safety during the transition from human-driven to self-driving vehicles?
- Should legislators amend distracted driving laws to take into account vehicles traveling in self-driving mode?
- Should certain lanes be earmarked for AV use so that AVs can operate without human interference?
- Should unlicensed drivers be allowed to ride in AVs unaccompanied by licensed drivers?
- Should emissions and fuel economy laws be different for AVs than for conventional vehicles?
- How can government promote accessibility to AVs across a broad range of socioeconomic groups?
- How should the likely widespread use of AVs in the future affect planning decisions being made now about such things as transportation infrastructure, urban planning, and land use?
Certainly, AV manufacturers will need to overcome a number of obstacles before AVs are in widespread use. Those obstacles include technological ones (although it appears to just be a matter of time until remaining technological challenges are overcome), consumer acceptance, and various legal and regulatory hurdles. Cost may also be a barrier, since the first commercially available AVs are likely to be expensive. Policies that facilitate AV development and implementation, however, may provide sufficient economies of scale to make AVs more affordable.
Despite the obstacles, strong economic and social forces are moving the nation in the direction of AV technology. Self-driving cars are likely to begin appearing on our roads in just the next couple of years.
For public health professionals, the message is clear. The benefits of AVs are much more likely to be maximized if public health is proactive in shaping state and national policies rather than watching from the sidelines as important decisions are made.
from Health Affairs Blog http://ift.tt/1WZwbv5
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