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Saving Lives

Ages 5-35

Rating: Level 3


In 1987 the Massachusetts Governor’s Highway Safety Bureau and the Commonwealth Fund of New York launched the Saving Lives program and offered funding for Massachusetts communities to undertake comprehensive, multistrategy programs to reduce alcohol-impaired driving and related problems such as speeding, other moving violations, and failure to wear safety belts. More than 50 communities applied for funding; 11 communities qualified; 6 were selected.

These six Massachusetts communities varied in population size and geographic location. They were selected to be as similar as possible to the remaining five (unfunded) communities. Each program community organized a task force made up of concerned private citizens, organizations, and officials representing various city departments. Each community received approximately $1 per inhabitant annually in program funds. Half of these funds involved payment for a program coordinator, 20 percent was designated for added police enforcement, and the balance went toward program activities and educational material. Voluntary effort was also a key factor in implementing Saving Lives.

The communities—not State or Federal agencies—developed most of the program initiatives. To reduce drunk driving and speeding, communities introduced media campaigns, business information programs, speeding and drunk-driving awareness days, speed-watch telephone hotlines, police training, high school peer-led education, Students Against Drunk Driving chapters, college prevention programs, alcohol-free prom nights, beer keg registration, and increased surveillance of liquor outlets. To increase pedestrian safety and seatbelt use, program communities implemented media campaigns and police checkpoints, posted crosswalk signs warning motorists of fines for failure to yield to pedestrians, added crosswalk guards, and offered preschool education programs and training for hospital and prenatal clinic staff.


A quasi-experimental evaluation compared Saving Lives cities with the rest of Massachusetts. Program cities were also compared with the other five cities that prepared high-quality proposals but were not funded. The evaluation involved fatal injury and crash monitoring, which used data from the U.S. Department of Transportation to examine fatal crashes for the 5 years preceding the program and the 5 years following the start of the program. It made use of direct observation of seatbelt use through annual surveys conducted in both program and comparison areas. It used telephone surveys through four independent, anonymous, cross-sectional, random-digit dialing surveys in program cities and the rest of the State, which assessed program awareness, beliefs about police enforcement, and frequency of driving and drinking. And it used monitoring of traffic citations as reported by the Massachusetts Merit Rating Board.


In Saving Lives cities, fatal crashes declined from a total of 178 during the 5 preprogram years to 120 during the 5 program years. This implies that the program cities experienced a 25 percent fatal crash reduction during the program years. During the same period, fatal crashes that involved alcohol in program cities dropped from 69 to 36, a 48 percent decline. The number of fatally injured drivers with high blood–alcohol levels showed a decline of 51 percent in program cities, from 49 to 24. Furthermore, the number of fatal crashes involving drivers 15 to 25 years of age declined from 98 to 45, a 54 percent drop. The number of fatal crashes that involved speeding drivers dropped from 68 to 33 in program cities, and the number of pedestrian fatalities declined from 45 to 33. The declines were, respectively, 27 percent and 18 percent greater than elsewhere in Massachusetts, but not statistically significant.

During the 5 program years, relative to the previous 4 years, the rate of visible injuries declined from 21.1 to 16.6 per 100 crashes, a 5 percent greater decline than throughout the rest of Massachusetts. Pedestrian injuries per 100 crashes dropped from 2.0 to 1.5. Total injuries per 100 crashes declined from 48.2 to 47.3.

Safety belt use increased in program cities, from 22 percent in 1989 to 29 percent in subsequent years, a rate 17 percent proportionately greater than that of the rest of the State. In contrast, the proportion of vehicles observed traveling at 10 or more miles over the speed limit declined from 19 percent in program cities in 1989 to 9 percent in subsequent years, a 43 percent greater decline than in comparison areas. The proportion of 16- to 19-year-olds who reported driving after drinking in the month prior to the interview declined from 19 percent in 1988 to 9 percent in 1993 in program cities.

During the 5 program years relative to the previous 5 years, the program cities experienced a 33 percent decline in fatal crashes, from 178 to 120. In comparison cities, the number of such crashes increased from 120 to 121. The decline in alcohol-related fatal crashes was 42 percent greater in Saving Lives cities than in comparison cities. These trends were similar to those observed when Saving Lives cities were compared with cities in the rest of the State.

Risk Factors


  • Favorable attitudes toward drug use/Early onset of AOD use/Alcohol and/or drug use


  • Availability of alcohol and other drugs
  • Community crime/High crime neighborhood


  • Peer alcohol, tobacco, and/or other drug use

Protective Factors


  • Healthy / Conventional beliefs and clear standards


  • Clear social norms / Policies with sanctions for violations and rewards for compliance
  • Rewards for prosocial community involvement
  • Safe environment / Low neighborhood crime


Hingson, Ralph, Timothy Heeren, Michael Winter, and Ronald Zakocs. 1996. “Reducing Alcohol-Impaired Driving in Massachusetts: The Saving Lives Program.” American Journal of Public Health 86(6):791–97.


Ralph Hingson, Sc.D.
Director, Division of Epidemiology and Prevention Research
5635 Fishers Lane, Room 2077
National Institute on Alcohol Abuse and Alcoholism
Bethesda, MD 20892–1705
Phone: (301) 443-1274
Fax: (301) 443-7043