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Safety Regulations, Risk Compensation, and Individual Behavior

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Safety Regulations, Risk Compensation, and Individual Behavior 82 Injury Prevention 2000;6:82–90 HADDON MEMORIAL LECTURE Inj Prev: first published as 10.1136/ip.6.2.82 on 1 June 2000. Downloaded from Risky business: safety regulations, risk compensation, and individual behavior James Hedlund Editors comment: We are Government regulations and industry practices paper, behavioral adaptation describes all be- proud to be able to bring to constrain our behavior in many ways in an havioral change in response to perceived our readers this full text version of the Haddon attempt to reduce injuries. Safety features are changes in risk and risk compensation describes Memorial Lecture delivered designed into products we use: cars now have the special case of behavior change in response at the recent Fifth World airbags; medicine bottles have “childproof” to laws and regulations. The distinction Conference on Injury Pre- vention and Control in caps. Laws require us to act in a safe manner: we becomes murky at times: if a new safety feature New Delhi, India. James must wear seat belts while driving and hard hats appears on all chain saws, any behavioral reac- Hedlund oVers a brilliant in construction areas. But do these measures tion won’t depend on whether the feature is review of one of the most important areas of debate influence our behavior in other ways? Risk com- required by government regulation or adopted in the entire field of injury pensation theory hypothesizes that they do, that voluntarily by all manufacturers. The risk control. This is the most we “use up” the additional safety though more compensation definition adopted here focuses complete, most perceptive, and well balanced apprais- risky actions. on the injury prevention strategies of greatest als of this complex issue I This paper surveys risk compensation by controversy, where government attempts to have ever read. Take the reviewing its history, discussing its theoretical increase safety by law or regulation. time to digest it completely. Our thanks to the Insur- foundations, outlining evidence for and against ance Institute for Highway its claims, and providing the author’s own views. Safety for agreeing to per- It concludes by discussing the relevance of risk A brief history of risk compensation mit us to publish it. We all change our behavior in response to some http://injuryprevention.bmj.com/ compensation for injury prevention workers changes in perceived injury risk. Most obvi- who seek to reduce unintentional injuries. ously, we may take additional precautions if we believe our risk has increased. When roads and The setting: injury prevention strategies sidewalks are icy, we may walk more carefully and risk compensation for fear of falling and we may drive more slowly Injury prevention as a discipline began when to be sure that we can stop safely. But it is not injuries were understood to be both predictable at all obvious that we change our behavior in and preventable. Most injuries are the unin- response to every increase or decrease in risk. tended consequences of individual actions in a The heart of the risk compensation debate lies risky environment; they are not due to fate or to in determining which risk changes will produce problem behavior. This understanding led to compensating behavioral change. three fundamental injury prevention strategies, The early risk compensation literature deals as described in the comprehensive report with road safety, as traYc crashes have been the on September 28, 2021 by guest. Protected copyright. Injury in America1: largest cause of accidental injury and death in x Persuade persons at risk to change their motorized countries and consequently pro- behavior, duced extensive safety regulations. By mid- century behavioral adaptation had been recog- x Require behavior change by law or adminis- 2 trative rule, nized but not seriously studied. x Provide automatic protection through prod- uct and environmental design. RISK COMPENSATION AND ECONOMICS: Injury prevention policymakers and workers PELTZMAN’S EVALUATION OF MOTOR VEHICLE generally agreed on the relative priorities of SAFETY STANDARDS these strategies. As Injury in America again Risk compensation in response to government reports: “Each of these general strategies has a actions became a public issue with University role in any comprehensive injury-control pro- of Chicago economist Sam Peltzman’s 1975 gram; however a basic finding from research is paper “The eVects of automobile safety that the second strategy—requiring behavior regulation”.3 Nine years earlier, in 1966, the change—will generally be more eVective than United States Congress established the Na- the first, and that the third—providing auto- tional Highway TraYc Safety Administration’s 1 Highway Safety North, matic protection—will be the most eVective”. predecessor, appointed William Haddon as its 110 Homestead Road, The favored strategies implicitly assume that first administrator, and directed it to improve Ithaca, NY 14850–6216, people will not react to safety laws or safer motor vehicle safety. By the end of 1968 the USA products in ways that would reduce or agency had issued 29 Federal Motor Vehicle eliminate their eVect. But of course they may. Safety Standards (FMVSS) applying to new Correspondence to: Dr Hedlund (e-mail: This behavioral reaction in response to safety motor vehicles. Some FMVSS sought to [email protected]) measures has been called many things. In this prevent crashes by setting standards for brakes, Haddon Memorial Lecture 83 tires, and mirrors. The majority sought to With his 1982 paper, “The theory Risk Analysis Inj Prev: first published as 10.1136/ip.6.2.82 on 1 June 2000. Downloaded from reduce crash injuries by requiring features such of risk homeostasis: implications for safety and as seat belts, shatterproof windshields, and health”,22 its four accompanying comment- energy-absorbing steering columns. aries,23–26 and Wilde’s response,27 his ideas Peltzman evaluated the eVects of the FMVSS: attracted substantial attention. had they in fact improved safety as anticipated? In Wilde’s view, risk is an inherent part of He began with the assumption that we are our psychological makeup. Not only can we not rational economic consumers who act in our avoid risk, we need risk. Wilde hypothesizes own best interests. If we have more of something that we each have a “target level of risk” and than we want, we will (if we can) exchange it for measure risk on our own “risk thermostat”. If something else that we desire. Peltzman consid- the perceived risk of a situation exceeds our ered safety (or risk) an economic good that we target level, we will act to reduce it. And if the will trade with other goods in the same way. If perceived risk is lower than our target level, we our car is safer than we want it to be, then we will will attempt to increase our risk back to our drive faster, trading safety for time. In his words, target level through more dangerous actions. we will trade safety for “driving intensity”. Wilde’s name for this process is risk Peltzman tested his idea with an econometric homeostasis, by analogy with the self- analysis of FMVSS eVects. He concluded that regulatory and unconscious manner in which the standards were ineVective: they had no we maintain our body’s temperature. Risk eVect on overall traYc fatalities; they may have homeostasis is then an extreme form of behav- saved some auto occupants’ lives while increas- ioral adaptation: not only do we modify our ing pedestrian deaths.3 behavior in response to external changes This conclusion startled the road safety designed to make us more or less safe, but we community and challenged the role of govern- seek to counteract these changes completely ment in attempting to improve safety through and return to our desired risk level. Because the regulation. In Peltzman’s view, government risk in our environment constantly changes, we regulation was useless and perhaps even coun- constantly are forced away from our target risk terproductive. level, but we always move back toward it, Peltzman’s paper prompted a lively debate always countering external influences (such as over the next 20 years. Some papers criticized or injury prevention measures) that attempt to supported Peltzman’s study; others oVered new decrease or increase our risk. analyses.4–19 The debate centered on Peltzman’s Wilde developed a mathematical formula- statistical analyses. Issues included the variable tion of risk homeostasis in road safety: the used to measure FMVSS eVects, the time period “accident rate per time unity of driver exposure http://injuryprevention.bmj.com/ analyzed, the regression equation’s functional is invariant regardless of road geometry” (or, form, what other factors should be included in for that matter, regardless of anything else).22 In the model as controls and how they are best other words, my accident rate per hour of travel measured, and how to account for motorcycles, on a high-speed divided motorway is the same trucks, and other vehicles not regulated in the as my rate per hour on a low-speed neighbor- same way as passenger vehicles. Each choice hood street. Wilde described his theory in may aVect the results substantially. For example, catchy language: “the sum of the sins is Graham and Garber recalculated Peltzman’s constant”. Others called it even more pictur- regression estimates using absolute instead of esquely “the law of conservation of misery”. logarithmic variables. Their estimates suggested Wilde extended risk homeostasis beyond road that regulation prevented roughly 5000 fatalities safety: “Risk homeostasis may thus apply not between 1966 and 1972, rather than causing only to road use, but also to industrial safety, on September 28, 2021 by guest. Protected copyright. about 10 000 deaths as Peltzman concluded.15 sports, making love, smoking, drinking, doing Blomquist reviewed 11 of these studies.20 His home repairs, climbing ladders, physical exer- summary of their aggregate evidence is that the cise, investing money, gambling, and who FMVSS increased safety for passenger car knows how many other activities”.28 occupants, but probably not as much as had Risk homeostasis challenges the foundations been predicted, and reduced safety for non- of injury prevention strategy.
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