>US car death rate is significantly higher than Europe or elsewhere, very preventable with more stringent driving tests and lower blood alcohol level allowances.

if you think that's the key difference between driving in Europe versus the United States then i'm not sure what to tell you.

Distances are longer, traffic is denser, speed limits (in general) are higher, and the ability to drive from one place to another is more valuable given the lack of public transportation options, so there is a larger onus to drive even if you consider yourself unskilled or lesser-abled.

there is more to it than drunk driving and poor training regiments. furthermore drunk driving is an extraordinarily bad metric to compare countries given the varying BAC regulations throughout the world. Drunk driving in one place may very well be legal in another.