Fifty year trends in U.S. societal costs and HARM from motor vehicle crashes

The 50 year trends were determined for societal costs and injury HARM from motor vehicle crashes in the U.S. The injury and fatality HARM provides a basis to set priorities and for cost-benefit analyses in automotive safety. The over- and under-counting of injuries and deaths was analyzed, and the costs for injury fraud, malingering, victim psychology, and product liability were evaluated.

NHTSA published eight studies since 1970 showing societal costs for motor vehicle crashes, including medical costs, property damage, productivity losses, insurance administration, losses to other individuals, employer losses, funeral costs, community service losses, pain and suffering, and miscellaneous accident costs. The trend in costs was determined for: (1) total societal costs, (2) injury HARM, (3) fatalities, (4) nonfatal injuries, (5) MAIS 4 + F, and (6) MAIS 1-3 injuries. The costs were adjusted for inflation to 1971 dollars ('71$) based on the annual CPI (Consumer Price Index). A linear trend line was fit to the various costs with the goodness of fit given by the correlation coefficient (R).

The societal cost (C) of motor vehicle crashes was $339.8B in 2019 up from $46.0B in 1971. This was a 7.39-fold increase, or 13.0%/yr annual increase. The linear fit gave C = $6.19B (yr - 1,967), R = 0.978. The compound increase was 4.14%/yr. The injury HARM cost (H) from fatal and nonfatal injuries was $309.1B in 2019 up from $38.1B in 1971. This was an 8.01-fold increase, or 14.3%/yr annual increase. The linear fit gave H = $5.63B (yr - 1,968), R = 0.972. The compound increase was 4.64%/yr. After adjusting for inflation, the societal cost was '71$52.5B in 2019. This was a 1.142-fold increase or 0.291%/yr annual increase. The linear fit gave C ('71$) = $0.283B (yr - 521), R = 0.554. The '71$ compound increase was 0.200%/yr. HARM cost increased to '71$47.8B in 2019. This was a 1.238-fold increase or 0.486%/yr annual increase. The linear fit gave H ('71$) = $0.333B (yr - 625), R = 0.62. The '71$ compound increase was 0.644%/yr. The greatest increase in injury costs was for MAIS 2-4 injuries with only a modest increase in a fatality cost from $200,700 in 1971 to '71$247,442 in 2019. NHTSA added quality of life costs to the economic costs giving a high value for a statistical life (VSL), increasing the value of life in cost-benefit analyses.

The societal cost and injury HARM from motor vehicle crashes increased above inflation over the past 50 years. NHTSA should set 5-year targets and track long-term trends for fatalities and HARM. Cost-benefit analyses depend on VSL, which is based on a willingness to pay. VSL over-values a life. NHTSA over- and under-counts injuries and deaths. The societal costs do not adequately address criminal and insurance fraud, like the Queens and helpful wave schemes, malingering, manipulation of medical imaging and treatments, victim psychology, Lithuanian experiences, and product liability.