By Justin Stoltzfus

Certainly, vehicle crashes affect the lives, pocketbooks and auto insurance premiums of millions of Americans each year. But drivers in certain states apparently feel more of the emotional and financial toll than in other states.

The Emergency Nurses Association recently produced its 2010 "scorecard" for evaluating states on their effectiveness in establishing laws to make roads safer. The scorecard looks at 14 criteria, each representing a certain kind of safety law that a state may or may not have passed or proposed.

• Oregon and Washington got the highest marks on the scorecard. These two states got perfect scores of 14, with Washington carrying over its win from the previous study.
• Alaska, California, New York, New Jersey and the District of Columbia were tied, with 12 points each.
• Georgia, Illinois and Massachusetts stayed competitive with 11 points.
• Texas got a mediocre ranking of 10.
• Pennsylvania came in a bit lower with a score of 8.
• Six states, including Florida, Nevada and Ohio, shared a 7-point score.
• The lowest-scoring state was North Dakota, with only 4 points. Above this lowest mark, Idaho, Iowa and neighboring South Dakota got 5 points apiece.

An interesting result of the study is that the top scores came from states with a generally low population per square mile -- but so did the lowest ones. This suggests population density is not the only factor that drives vehicle safety in states and that public policy decisions can have a significant effect.

Safety standards examined by the Emergency Nurses Association included:

• Whether a state has a primary enforcement seat belt law (which allows officers to issue tickets to drivers for not wearing seat belts) on the books.
• Whether the state's child passenger safety law (which enforces use of safety seats or, for older children, seat belts) covers all ages up to 16 years.
• Whether the state appropriately addresses a "learning stage" for young drivers.
• What kind of motorcycle helmet use the state requires.
• How the state addresses driving under the influence, or DUI.

A September 2010 report by the federal Centers for Disease Control and Prevention came up with a big number for accident-related costs in all 50 states: more than $99 billion a year for medical care and "soft costs," including loss of productivity. Among CDC recommendations for limiting traffic accident losses are seat belt laws, DUI crackdowns and education for teen drivers, who remain one of the riskiest categories of drivers on roads across the country.