Europe just places a relatively high bar for driving skills. You do see the outcome in road safety and much more orderly driving behaviour (with the usual caveat that Europe is diverse and this applies more to some regions than some others yadda yadda).
I've driven in many countries and Italy had more than an equal share of near death experiences.
https://en.wikipedia.org/wiki/List_of_countries_by_traffic-r...
The general trend for pedestrian and cycling deaths is up in the US, because increasingly popular SUVs and crossovers strike a person higher on the body, and also are more likely to push a person under the car towards the wheels or forward where they’ll be run over again, rather than over the hood.
https://www.iihs.org/news/detail/new-study-suggests-todays-s...