Cars don’t kill people. People do.

That’s the premise of a New York Times article that was published this week about pedestrian safety in New York City. With thousands of people flocking to New York City’s International Auto Show this week, the time is ripe to ask: Just how far have we come in making the transition from a car-centered culture to one that embraces walking, biking, and mass transit?

Although the dangers automobiles pose for drivers and passengers have been well documented, much less research has examined the safety of others.

New York City, along with many urban areas nationwide, has grown more car-friendly despite having increased spending on mass transit and biking infrastructure. Even as more New Yorkers are choosing public transit over driving, the presence of cars on the road has increased. Despite these trends, research shows, law enforcement officials in the city remain hesitant to punish dangerous drivers, creating an environment in which cyclists and pedestrians feel uncomfortable, and more importantly, unsafe.

“We have this sense of fatalism,” says Columbia University professor of epidemiology Charles DiMaggio. “We think, ‘well, accidents happen.’ But more often than not, they’re preventable.” DiMaggio’s study about pedestrian safety inspired the national Safe Routes to School program in New York, which redesigned busy street corners and intersections to make them safer for children who walk to and from school.

As America’s biggest city, New York has the highest rate of public transportation use nationwide, with 54 percent of people riding to work in 2006. But even in New York, where large mass transit networks render commuting by rail or metro second nature, the car is still king.

Since 2000, the number of cars on the road in New York City went up, along with rates of unsafe driving. In 2012, 60 percent of fatal pedestrian and bicyclist crashes were caused by illegal driving behavior such as speeding and distracted driving. New York City cyclists site driver behavior and traffic as the most common reasons they don’t bike to work. But New York City law enforcement officials have not responded with more traffic monitoring; in fact, in 2011 police issued four times as many tickets for tinted windows as for speeding.

Our love affair with cars is also persistent nationwide. Even as President Obama has called for increased spending on public transit, his administration has continued to fund new highways. The single-highest line item in the stimulus bill—road and highway construction—received more than half of all transportation funding. Even compared with the Mad Men-esque heyday of American cars of the 1950s, current spending on roads continues to outpace funding for public transit: in 2009, the public sector spent five times more on highways than it did in 1956.

People may not be as crazy about their cars as federal spending might suggest. In Los Angeles, long viewed as an automobile haven, the number of cyclists jumped 32 percent between 2009 and 2011. Without policies that promote biking and protect cyclist safety, bikers are still being injured—and killed—at an alarming rate. In 2011, three percent of all traffic deaths in 2011 were bicyclists. That’s a high number, for a city where cycling accounts for less than one percent of the population.

In New York, bikers are also taking to the streets, thanks to advocacy groups like Transportation Alternatives, WEBikeNYC and the New York Bicycle Coalition. Jill Guidera, who leads Transportation Alternatives' bicycle ambassador program, says groups like hers are part of what makes cycling in the city feasible. Between 2008 and 2012, the annual volume of cyclists jumped 58 percent. But in 2011, 755 people were injured in cycling crashes; three people died. In the same crashes, 10 people in automobiles were injured.

DiMaggio, whose work uses pedestrian injury research to push for safer public policies, says concrete interventions that slow down cars and protect people are necessary to improve public health. DiMaggio’s work, for example, designed narrower streets, built pedestrian islands in large intersections and turned two-way streets into one-way thoroughfares to protect children walking to school. Interventions that prevent the causes of injury rather than addressing the outcomes are critical, says DiMaggio.

“If you package things in a way they don’t break,” says DiMaggio, “You don’t have to worry about dropping them.”