changes in both vehicle and highway design followed this mandate. Vehicles (agent of injury) were built with new safety features, including head rests, energy-absorbing steering wheels, shatter-resistant windshields, and safety belts Roads (environment) were improved by better delineation of curves (edge and center line stripes and reflectors), use of breakaway sign and utility poles, improved illumination, addition of barriers separating oncoming traffic lanes, and guardrails. The results were rapid. By 1970, motor-vehicle-related death rates were decreasing by both the public health measure (deaths per 100,000 population) and the traffic safety indicator (deaths per VMT). Changes in driver and passenger (host) behavior also have reduced motor-vehicle crashes and injuries. Enactment and enforcement of traffic safety laws, reinforced by public education, have led to safer behavior choices. Examples include enforcement of laws against driving while intoxicated (DWI) and underage drinking, and enforcement of seat belt, child safety seat, and motorcycle helmet use laws. Government and community recognition of the need for motor-vehicle safety prompted initiation of programs by federal and state governments, academic institutions, community-based organizations, and industry. NHTSA and the Federal Highway Administration within the U.S. Department of Transportation have provided national leadership for traffic and highway safety efforts since the 1960s. The National Center for Injury Prevention and Control, established at CDC in 1992, has contributed public health direction. State and local governments have enacted and enforced laws that affect motor-vehicle and highway safety, driver licensing and testing, vehicle inspections, and traffic regulations. Preventing motor-vehicle-related injuries has required collaboration among many professional disciplines (such as biomechanics has been essential to vehicle design and highway safety features). Citizen and community-based advocacy groups have played important prevention roles in areas such as drinking and driving and child-occupant protection. Consistent with the public/ private partnerships that characterize motor-vehicle safety efforts, NHTSA sponsors "Buckle Up America" week, which focuses on the need to secure children in child-safety seats properly at all times. Specific public health concerns High-Risk Populations Alcohol-impaired: From 1982 to 1997, the annual motor-vehicle crash-related fatalities involving alcohol decreased by 39% to approximately 16,000; these deaths accounted for 38.6% of all traffic deaths. Factors that may have contributed to this decline included increased public awareness of the dangers of drinking and driving; new and tougher state laws; stricter law enforcement; an increase in the minimum legal drinking age; prevention programs that offer alternatives such as safe rides (e.g., taxicabs and public transportation),