This research report, commissioned by the Appalachian Regional Commission, seeks to define the traffic safety culture in Appalachia and discusses the causes of the common safety problems in the Region. Drivers in Appalachia must contend with environmental concerns, including expansive rural regions, mountainous and curved terrain, and dense forests exposed to extreme weather elements, as well as a number of cultural and health factors that can create unique traffic safety problems within the Region. This report includes a thorough analysis of Appalachian traffic fatalities, an investigation into fatal crash data, and an evaluation of the Appalachian Development Highway System (ADHS) as a potential intervention measure for treating traffic safety problems in the Region.

This report also includes a case study of severe crashes in Appalachian North Carolina. To verify some of the findings of the broader Appalachian results from the fatal crash analysis, the research team investigated fatal and severe injury crash in Appalachian North Carolina using crash data from 2013 to 2017. Key findings include the roles of alcohol involvement, seasonal trends, rurality and ambient lighting, and more.