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Canadian Public Health Association

Self-driving cars

Jayme Marrotte, Alexandra Dixon

Self-driving cars are quickly moving into the fast lane as a new fleet of Google vehicles are hitting the road for testing in two American states,1 and are poised to enter the market as early as 2020.2 These autonomous vehicles (AVs) eliminate the need for a human driver and operate using a variety of computer mapping and sensory technologies.3 Both Google and Tesla have entered this race, and traditional car manufacturers have begun incorporating AV technology into their current vehicles. While self-driving cars have mainly been developed for personal transportation, current cost projections may make them inaccessible for the majority of users. Google estimates that with the current technology and manufacturing schemes, these vehicles would cost consumers upwards of $150,000 each, but plans are in place to reduce costs through economies of scale.4 AVs could also be employed as replacements for public transportation or other transport services.

With these technological advancements, we should consider the implications of these vehicles, including their possible effects on road safety, the environment, health equity and economic security.

Road safety
Human error has been implicated in 94% of traffic accidents annually.2 AVs have the potential to drastically reduce this incidence as they are programmed to obey speed limits, follow all traffic laws5 and remove risks associated with drunk, distracted or drowsy driving. They also have the potential to reduce driving-related stress and road rage incidents.2 However, the transition period from predominantly traditional vehicles to AVs is predicted to increase the number of traffic accidents due to the coexistence of both vehicle types and the adjustment required by human drivers.2

In 2013, traditional vehicles accounted for 77 injuries and 1.09 deaths per 100 million miles driven in the United States.6 Google’s AVs have now accumulated a total of 1.3 million miles and were involved in 13 accidents over a 6-year span, only one of which was deemed to be the fault of the AV.6 There were, however, 10 instances in which the driver intervened to prevent an AV-initiated accident. There has also been one reported fatality due to an accident resulting from a sensor failure combined with driver error.7 Studies have produced conflicting results on the safety of AVs,8,9 and more definitive data are needed before conclusions or direct comparisons to traditional vehicles can be made. In addition, ethical considerations regarding AVs and road safety need to be addressed in the programming of these vehicles. It is unclear how these decisions will be made.

The environment
This concern is largely focused on improved fuel economy and reduced greenhouse gas emissions. AVs have the potential to reduce car emissions through improvements in traffic efficiency and flow.10 Vehicle to vehicle communication facilitated by these technologies could better coordinate traffic mobility, leading to reductions in idling and overall fuel consumption.5 Car sharing could also reduce traffic congestion and decrease emissions. On the other hand, the ease and accessibility of personal car transport afforded by AVs may increase the number of vehicles on the road and dissuade individuals from using current public transit infrastructure.10

Health equity
It is difficult to predict how the introduction of AVs will affect health equity. If social resources are reallocated to AVs from other forms of public transit, then individuals with low socio-economic status may be negatively affected.2 Alternatively, if car-sharing programs predominate, then multiple families could share a single vehicle.11 In addition, the elimination of labour costs associated with human drivers could make AVs a low-cost taxi alternative.12 As such, AVs may extend personal transport opportunities to low-income individuals or those without the physical or cognitive abilities to operate a vehicle. This scenario could provide lower cost access to health care services or social gatherings, and greater independence.2

Economic security
The use of AVs poses both challenges and opportunities to industries focused on the movement of people and consumer goods. Those engaged in the trucking, taxi, delivery, and bus driving fields will be affected, as well as peripheral industries such as vehicle repair and insurance.13 Automation of the trucking industry could put thousands out of work, eliminating one of the few remaining middle-class jobs not requiring a post-secondary education.14 The resulting reduced workforce would likely consist of employees with higher levels of education, with skills related to research, development, programming and installation.15 However, the reduction of labour costs in the trucking and transport industry can provide considerable savings to producers and downstream consumers.13 The removal of a human driver during long-haul trucking, for example, can increase the speed of transport as AVs will no longer need to adhere to a driver’s sleep or continuous work hour regulations.16

Many questions remain to be answered regarding the introduction of AVs; including, whether the individual in the AV would need to hold a valid driver’s license or whether distracted driving rules would continue. It is also unknown whether their introduction would have more advantages or disadvantages to public health. Potential advantages include reduction in traffic accidents, improved road safety, potential positive effects on health equity, and decreased fuel emissions. On the disadvantages side, job security for those in transportation services could be at risk, and the price point and availability of these vehicles could further increase the gap between those with and those without the means to afford a vehicle. One thing is for certain: the introduction of AVs will affect how we live and work, so buckle up for the ride!

  1. Epstein, Z. Google’s self-driving cars will hit public roads this month. BGR, 2017 Available at: (Accessed January 11, 2017).
  2. Richland, J., Lee, J., & Butto, E. D.  Steering Autonomous Vehicle Policy: The Role of Public Health. Altarum Institute, 2016. Available at: (Accessed January 11, 2017).
  3. Surden, H., & Williams, M. A. Technological Opacity, Predictability, and Self-Driving Cars. Cardozo Law Review, 2016. 38(121).
  4. Google. Google’s autonomous vehicle. Weebly, n.d. Available at: (Accessed January 20, 2017).
  5. Pettigrew, S. Why public health should embrace the autonomous car. Australian and New Zealand Journal of Public Health 2016; 41(1).
  6. Kalra, N., & Paddock, S. M. Driving to Safety. How many miles of driving would it take to demonstrate autonomous vehicle reliability? RAND Corporation, 2016. Available at: (Accessed January 11, 2017).
  7. Solon, O. Why self-driving cars aren’t safe yet: rain, roadworks and other obstacles. The Guardian, 2016. Available at: (Accessed January 11, 2017).
  8. Blanco, M., Atwood, J., Russell, S., Trimble, T., McClafferty, J., & Perez, M. Automated vehicle crash rate comparison using naturalistic data. Virginia Tech Transportation Institute, 2016. Available at: (Accessed January 11, 2017).
  9. Schoettle., B, & Sivak, M. A preliminary analysis of real-world crashes involving self-driving vehicles. University of Michigan Transportation Research Institute, 2015. Available at: (Accessed January 11, 2017).
  10. Wadud, Z. Will self-driving cars reduce energy use and make travel better for the environment? The conversation, 2016. Available at: (Accessed January 11, 2017).
  11. Schulman., E. Experts discuss self-driving cars and public health implications at injury symposium. Johns Hopkins Bloomberg School of Public Health, 2016. Available at: & (Accessed January 11, 2017).
  12. Simmons, T. Driverless cars: how will they impact Toronto in 2020? CBC News, 2016. Available at: (Accessed January 11, 2017).
  13. Tracy, S. Autonomous vehicles will replace taxi drivers, but that’s just the beginning. The Huffington Post, 2015. Available at: (Accessed January 11, 2017).
  14. Kitroeff, N. Robots could replace 1.7 million American truckers in the next decade. Los Angeles Times, 2016. Available at: (Accessed January 11, 2017).
  15. Brynjolfsson, E., & McAfee, A. Race against the machine: How the digital revolution is accelerating innovation, driving productivity, and irreversibly transforming employment and the economy. The MIT Centre for Digital Business, 2012. Available at: (Accessed January 11, 2017).
  16. Solon, O. Self-driving trucks: what’s the future for America’s 3.5 million truckers? The Guardian, 2016. Available at: (Accessed January 11, 2017).

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