Yellow May: Worldwide Road Safety Injury Prevention Program

INTRODUCTION

The General Assembly of the United Nations held in March 2010 issued a resolution decreed on May 11, 2011, defining the period from 2011 to 2020 as the “Decade of Action for Road Safety”. The document was prepared on the basis of a World Health Organization (WHO) study which in 2009 accounted for about 1.3 million deaths from traffic collisions in 178 countries.¹ With this, the month of May has become a world reference for the stocktaking of the actions that the world carries out.

Three thousand lives are lost each day on the roads and streets. It is the ninth largest cause of death in the world.² Traffic collisions are the main cause of death in the 15–29 age-group; the third in the range of 30–44 years; and the fourth in the range of 5–14 years.³ These collisions now represent a cost of US$518 billion per year or between 1% and 3% of the gross domestic product of each country.¹

If we are unable to do something about it, the WHO estimates that 1.9 million people are expected to die in traffic in 2020 (rising to the fifth largest cause of death) and 2.4 million in 2030. During this period, between 20 million and 50 million people will survive collisions each year, with injuries and sequelae. The United Nation’s intention with the Decade of Action for Road Safety is to save up to 5 million lives by 2020 through regional, national, and global plans.⁴

The Yellow May Movement was launched in Brazil in 2014 by the National Observatory for Road Safety (ONSV) with only one proposal, i.e., to bring society’s attention to the high rates of deaths and injuries in traffic around the world. The ONSV is a nonprofit organization promoting the technical inputs required for the safe development of traffic in favor of the citizen, through education, research, planning, information, and taking actions that generate efficient solutions with the goal of a harmonious coexistence between people, vehicles, and roads.⁵ In 2015, the Brazilian Trauma Society joined the movement, expanding its dissemination and participation of healthcare professionals and medical students of the trauma leagues in Brazil.^6,7

The yellow symbolizes attention and also the warning signs regarding traffic.⁷ The goal is to put road safety on the agenda and to mobilize society into participating in various educational and prevention programs.

The goal of this movement is a coordinated action between the public authority and civil society. The aim is to raise the awareness toward the issue of road safety and to mobilize the whole society, involving the most diverse segments: government agencies, companies, class entities, associations, federations and organized civil society, to avoid everyday and usual fallacies, to effectively discuss the theme, and to engage in actions and propagate knowledge, addressing the full extent that the issue of traffic requires, in the most different sectors.

MATERIALS AND METHODS

Between the years of 2014 and 2019, data were collected using citations from the Yellow May Campaign. We collected the number of videos hits, campaign website access, Facebook likes, and reach on social media. The number of partners and participating countries was also counted annually. Those kinds of media were also accounted for and also its estimated market value.

The Yellow May has an annual engagement. It begins in January, each year, with the production of materials that are to be available to the public.

The private initiative and nongovernmental organizations unite their logos in the materials and carry out actions aimed at their public. The Yellow May’s coordination identifies the actions carried out; and in June, in a closing event, it recognizes the best practices adopted. During this time, the ONSV encourages social media, companies, entities, and government agencies with issues aimed at the stability of the Yellow May. The intention is to discuss and practice safe traffic throughout the year.

In its first edition, in 2014, Yellow May used the motto “Attention for Life”. In 2015, its motto was “Be the Change”. In 2016, Yellow May engaged the whole society with the motto “I’m +1 for Safer Traffic.” While in 2017, the chosen motto was “My Choice Makes the Difference”. And in 2018, Yellow May had its fifth edition materialized in the motto “We Are the Traffic”. In 2019, it’s “In traffic, the way is life”. These themes are defined by epidemiological data from the previous year, where the largest target audience of the campaign is defined: drinking and driving, children injuries, speed reduction, and respect traffic signal. All the campaign material is done in a way that impacts and shocks the target audience, appealing to emotional and family components.

This article was submitted and approved by the Ethical Research Committee of University of Campinas (UNICAMP), Brazil, under the protocol 215/2018.

RESULTS

In 6 years of Yellow May, the movement has been able to prove the replicability of the project. Nowadays, in Brazil, it is developed annually in our 26 states plus our federal district, which is the whole country engaged, and the Movement also counts with the support of 28 countries, such as Argentina, Austria, Colombia, Spain, United States, the Netherlands, Morocco, Mexico, Portugal, and Uruguay among many others. It is necessary to emphasize that each country is free to create its own material, according to its epidemiological needs (Fig. 1).

Between April 25 and July 16, 2018, the Yellow May Campaign published news 11,855 times, with about 140 news items a day, considering all the press publications, such as radio, newspapers, magazines, TV, websites, and blogs.

Together, all the media accounted for more than 120 million people reached, and in 2019 spontaneous media reached a total value of U$169,000.

By 2018, the movement had more than 5,000 campaign actions in 28 countries, while on 2019 there are more than 3,000 actions. Table 1 shows the evolution of the movement impact data since its inception.

DISCUSSION

Scientific discoveries altered the understanding of how infectious diseases are transmitted and can be prevented, motivating a number of growing efforts to stop the spread of disease. The public health approach was first extended outside the realm of classic disease prevention in the 1980s. What signaled the public health’s entry into the world of preventable injury was seminal work in the application of the public health approach to violence prevention? The public health perspective toward injury was influenced by recognition that injuries are not accidents, but they are predictable and preventable events.⁸

In the area of oncology, prevention campaigns are widespread and have evoked effective participation by the population. One example is the “Pink October”, which started in the USA in the 1990s, spreading the awareness and importance of prevention of breast cancer by encouraging the population to actively participate in various initiatives. This same campaign began in Brazil in 2008, with the support of several medical organizations.

Due to the work of ONSV public relations department and communications consulting, Yellow May has been getting progressively better results, such as the return in spontaneous media in 2018 and 2019. Spontaneous media is considered the positive exposure obtained spontaneously, that is, unpaid, in the media. These data indirectly reflect the attention given to that subject, which has progressively been gaining greater prominence since its start in 2014.

Gielen and Sleet categorized injury prevention strategies into “active or behavioral strategies” and “passive or environmental strategies”.⁹ Active behavioral strategies are designed to encourage people to take measures to protect themselves and others from injury. For example, this may include programs designed to prevent fatalities from motor vehicle collisions associated with alcohol consumption in youth.^10–12 Passive or environmental strategies are designed to change products or environments to prevent injury. In this case, this may include the installation of ignition interlocks in vehicles to reduce alcohol-impaired driving and alcohol-related crashes.^13,14

The Yellow May is a purely behavioral strategy program up to this moment, with annual campaigns with the objective of causing fear to society when approaching them to the risks to which they are exposed. This is a concept imported from psychoanalysis known as the principle of reality, which consists in accounting for the demands of the world and the consequences of the acts themselves.^12,15 Another initiative that follows the same principles is the Prevent Alcohol and Risk-Related Trauma in Youth (P.A.R.T.Y.) Program created in Canada in 1986 and currently present in many countries – one of them being Brazil, since 2008. The program aims to orient teenagers regarding the risks to which they are exposed and how their attitudes might have consequences for the rest of their lives. It has been demonstrated already that the program is successful in reducing the involvement of these young spectators with traumas and helping them stay a longer time away from involvement in traumas related to traffic collisions.^11,12

Cities that have invested in awareness actions since the first edition of the “Yellow May” has already managed to achieve significant falls in the number of collisions computed.

Data from InfoSiga, a system of the São Paulo State Traffic Movement in the State of São Paulo, point to a 14.1% reduction in traffic collisions in the State of São Paulo in May 2018 compared to May 2017.¹⁶ The same database indicates that in some cities the number of deaths related to traffic from 2015 to 2018 is lower in May, when the Yellow May campaign in these cities began to occur. In the city of Petrópolis, in the State of Rio de Janeiro, there was a 29.46% reduction in collisions when comparing 2018 and 2017. In 2016, there were 160 motor vehicle collisions in total; while in 2017, there were 112; and in 2018, the number was reduced to 79. In 2 years, there was a total reduction of 51.9% of traffic collisions in the city.

It may be true that traffic injuries are down in areas of Brazil as the campaign awareness increased, but there is no evidence that the “Yellow May” program of social awareness has directly and causally contributed to this beyond it being a mere association yet. Other cities internationally have had reductions in traffic deaths during this same period without this campaign in effect.

It is no mystery that people across the world know that there are risks navigating our roads. Is merely reminding them of it sufficient to effect change? Does drawing attention to a problem through social media always serve to improve it, that is, unclear but critical. Do social media “hits” imply that we are improving our problems in the world? Social media is aware of climate change, yet climate change initiatives are lagging. More specific to the topic of road safety, the problem of “texting while driving” is known well but has only been worsening hand in hand with the information explosion. “Raising awareness” does not translate into improving an outcome and that the metric we use to measure our injury prevention efforts cannot solely be “awareness”. Raising awareness and changing practice do not always go hand in hand.

On the contrary, by bringing awareness to the problem, new measures are generated by social pressure on government. An example of this is in Campinas, a city in the interior of the State of São Paulo with more than 1 million inhabitants, where the organization responsible for managing the city’s traffic began to map the traumatic events involving pedestrians, motorcyclists, motorcycles, and bicycles, with the objective of creating a risk map and promoting changes in the city’s traffic to generate greater road safety, in addition to having a longitudinal control over these changes. Their reports are published annually and demonstrate a gradual reduction in traffic-related injuries.

Although this is quite different from Vision Zero, this may be an embryo for its Brazilian version, the road traffic safety project, which aimed to eliminate fatalities and serious injuries from traffic collisions. This (now) two-decade old initiative has since grown into a multinational effort and has drawn substantial attention to the problem of traffic deaths internationally.

The concept of Vision Zero first originated in Sweden in 1997, when the Swedish parliament adopted it as the official road policy. Founded on the belief that loss of life is not an acceptable price to pay for mobility, Vision Zero takes a systems approach to enhancing safety. Rather than exclusively faulting drivers and other users of the transportation system, Vision Zero places the core responsibility for accidents on the overall system design, addressing infrastructure design, vehicle technology, and enforcement. The approach has resulted in noteworthy successes – Sweden has one of the lowest annual rates of road deaths in the world (3 out of 100,000 as compared to 12.3 in the United States). Not only that fatalities involving pedestrians have fallen almost 50% in the last 5 years.

In a country such as Brazil, with no tradition of taking public policies involving various sectors of the country, the first step to a program like Vision Zero is to get the attention of its people. Both Yellow May and Vision Zero share the same essence, but different paths must be pursued in countries with different social organizations, so it would be impractical to apply a complex program like Vision Zero without first “preparing the ground” for its implementation in Brazil. Naturally, initiatives that may lead to the Brazilian version of Vision Zero will emerge, as happened in Campinas, but people’s involvement is necessary.

If, on the one hand, Vision Zero is marked by its strong partnership with the government, Yellow May is a program of the Brazilian people, whose initiatives are carried out voluntarily by those who have been sensitized by the message that the program brings.

The next steps are to be taken in the sense of creating environmental strategies - however, to carry this out a public health approach is necessary, which demands government participation. We have already been able to draw a lot of attention: we are a multinational movement with significant results. The only acceptable number of road deaths is zero – that is our goal and must be a public policy too.

Actions in this direction have already been taken by the Yellow May coordinators when presenting results and demanding actions for the trauma issue through political articulations in the federal government. At the same time, P.A.R.T.Y. Brazil, a Yellow May partner prevention program, was incorporated as a public measure in the State of São Paulo.

Meanwhile, toward the international expansion of Yellow May, this year the campaign launch will be held in Montevideo, Uruguay, with the support of the Panamerican Trauma Society and some societies in this country: Sociedad de Cirugía del Uruguay, Academia Nacional de Medicina, Sindicato Médico del Uruguay, Federación Médica del Interior, and Colegio Médico del Uruguay. This effort tries to unlink the campaign from National Observatory for Road Safety, giving it to the people of all countries.

CONCLUSION

The Yellow May is a recent international movement that arouses the attention of society and can be efficient in reducing the number of traffic accident events.

REFERENCES

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