After Vision Zero, San Francisco ‘Overhauls’ Approach to Tackling Traffic Violence

About every 15 hours, someone is rushed to San Francisco General Hospital with severe injuries from a traffic crash — a rate that medical experts describe as a public health crisis.

Building on months of efforts by the Board of Supervisors, and following the passage of the Street Safety Act, San Francisco on Friday launched a citywide overhaul of how it handles traffic safety after its Vision Zero policy expired last year. At City Hall, Mayor Daniel Lurie announced an executive directive that formally links police enforcement with public health data and transportation engineering.

The move creates a unified command structure to address the rising number of severe injuries and fatalities on city streets and aims to bring higher levels of commitment and accountability to the issue within the city government.

“The injuries from these accidents and crashes are some of the hardest things I’ve ever seen as a doctor,” said Dr. Christian Rose, an emergency physician at San Francisco General Hospital who spoke at the ceremony. “If you were hit by a vehicle going 40 mph, that’d be the equivalent of falling off of a five-story building.”

The announcement followed a number of recent tragedies on San Francisco streets. Earlier this month, a 72-year-old staff member at Self-Help for the Elderly was killed in a crash in the Russian Hill neighborhood, at Mason Street and Broadway. And on Sunday, a 1-year-old was struck and killed by a car in Hayes Valley, the San Francisco Chronicle reported.

“Everyone deserves to feel safe on the roads,” Anni Chung, Self-Help for the Elderly’s CEO, said. She noted that seniors make up a large portion of pedestrians in neighborhoods like Chinatown and the Tenderloin that are at high risk for traffic accidents.

The San Francisco Municipal Transportation Agency, the Department of Public Health and the San Francisco Police Department will co-chair the new Street Safety Initiative Working Group. While these agencies have collaborated in the past, Lurie’s order mandates a higher level of coordination and requires senior leaders from each department to meet regularly to align their strategies.

Lurie framed the city’s initiative as a more aggressive implementation of the “Safe System” approach, of which zero deaths on the roads is the goal. Lurie said the policy directs streets to be built to handle human error, managing vehicle speeds so that common mistakes don’t become fatal tragedies.

“Too often, traffic injuries are the result of predictable patterns and preventable conditions,” Lurie said. “This initiative will make streets safer for everyone … In San Francisco, safety is non-negotiable.”

However, some transportation experts and advocates have questioned whether a Safe System approach, the official strategy for roadway safety in the U.S., goes far enough to end traffic violence. One oft-cited concern is the idea of “shared responsibility” on the road for all users, a key pillar of the approach, which critics have said obscures the main causes of traffic crashes — such as speeding.

“If we actually want to save lives and reduce crashes, then we need to really put the spotlight on who has disproportionate power to save lives,” David Zipper, a senior fellow at the MIT Mobility Initiative, told KQED earlier this year.

In San Francisco, the city has addressed the issue of speeding through the expansion of electronic enforcement. Earlier this year, San Francisco became the first city in California to launch automated speed cameras. Early data from the pilot program shows a 78% reduction in speeding vehicles at camera locations.

Christopher White, executive director of the San Francisco Bicycle Coalition, said the shift toward automated enforcement is critical for protecting cyclists and pedestrians.

“The fact is that officers cannot be everywhere all the time,” White told KQED. “Having the consistency of automated speed enforcement and automated red light enforcement has had such an impact … We want to see it expanded throughout the city, and I think that the mayor’s initiative is going to give a lot of power behind that.”

2024 was the worst year for traffic fatalities in San Francisco since 2007, with 41 deaths recorded both years. So far, in 2025, the city has seen 16 pedestrian fatalities in traffic crashes — 23 total deaths.

A primary task within the first 100 days of this directive is to confirm and publish the 2025 High Injury Network — the map of the specific streets where the vast majority of severe crashes occur. Once confirmed, the city is tasked with identifying a priority list of “quick-build” projects, which use paint and physical barriers to rapidly improve safety in high-risk areas.

Within six months, the working group is required to release a Traffic Enforcement Strategy Report identifying the top crash-causing behaviors to target.

For advocates who have spent years pushing for safer streets, the directive represents a hopeful, yet overdue, step. White noted that while the Bicycle Coalition sees this as an extension of previous work, the direct involvement of the mayor’s office offers a new level of accountability.

“The Biking and Rolling Plan passed earlier in 2025, and we want to see that rolled out much faster,” White said. ‘It’s not addressed in the initiative until after year one. We can do a lot of the things in the Biking and Rolling plan sooner than that. It just takes the leadership and will to do it.”