Federalism and safety on americas highways

Safety on Americas highways has long been an important state policy issue, but since the 1960s Congress has used incentive grants, crossover sanctions that threaten to withhold federal highway funds, and diversionary sanctions that force states to use highway funds for safety purposes as a means of compelling states to adopt traffic safety policies. In an effort to promote public health, Congress has, at times, pushed states to adopt lower speed limits, mandatory motorcycle helmet laws, occupant protection laws, and laws designed to deter impaired driving. This article examines which fiscal tools have been effective in getting states to adopt traffic safety policies, how states have responded to changes in federal priorities on public health goals, and the implications of these policy efforts for public health.