As the proportion of fatal crashes involving older drivers rises, two new studies underscore significant challenges ahead, including one led by Dr. Andrew Zullo.
Learn about the NJ-SHO Center for Integrated Data that is conducting research on traffic safety and transportation equity with its unique data warehouse and a public health lens.
This study sought to provide a deeper understanding of inequalities in traffic safety. Among New Jersey drivers involved in crashes, people who live in lower opportunity neighborhoods and people of minoritized race and ethnicity groups were more likely to be involved in injury crashes and all crashes. These findings emphasize the need to consider a person’s lived experience when assessing their crash risk and a path to reducing disparities in traffic safety.
Dr. Kristi Metzger reflects on the results of a recent NJ-SHO team paper published in the Journal of Safety Research which explored disparities in crash risk.
Some medications, such as antihistamines and antidepressants, can impact a person’s driving and are considered potentially driver-impairing (PDI). Over half of older Medicare beneficiaries involved in crashes in New Jersey were exposed to two or more potentially driver-impairing (PDI) medications before and after a crash. Some drivers started taking more PDI medications after a crash, suggesting the need for more attention to the effects on driving for older people involved in crashes.
Using population-based crash and hospital discharge data, the incidence of motor vehicle crashes over a 28-day period did not change on average after surgery, but specific populations are at risk.
Examining crash reports with linked community-level indicators may optimize efforts aimed at improving traffic safety behaviors, like seat belt use. This study found that not wearing a seat belt is 121% more prevalent in communities with the largest percentage of the population living with three or more indicators of vulnerability than those in the least vulnerable communities.
In 30 states, licensing agencies can restrict the distance from home that "medically-at-risk" drivers are permitted to drive. This study found that a majority of crashes occur within a few miles from home with little variation among driver demographics or medical conditions. Therefore, distance restrictions may not reduce crash rates among older adults. Future research is needed to understand the extent to which older adults drive and to identify other factors that influence crash risk.
Adolescents with ADHD have 30 to 40% higher crash rates than their peers without ADHD. They are also 9% more likely to be at fault for their crashes and 15% more likely to be inattentive. Research using naturalistic data is needed to identify driving performance differences that might not be detected in police-reported data. This information will help optimize driver training for teens with ADHD.
By successfully linking hospital discharge data with motor vehicle crash reports to account for crash injuries more accurately, CIRP researchers make clear the continued need for data integration efforts to classify the true burden of crash-related injuries. Armed with this information, prevention efforts can be tailored to populations most at risk for crash-related injuries.
Information from New Jersey police-reported crashes showed that children were typically restrained during crashes, but not always correctly, especially among younger children. Many drivers in this study did not follow best practice recommendations for child restraint use, as well as NJ child passenger safety laws.
This study shares how the NJ-SHO Data Warehouse combines New Jersey statewide administrative databases to create one comprehensive data source. The data warehouse fills in gaps previously found in traffic safety research and enables investigation of research questions that previously could not be addressed due to the lack of appropriate data.
Applying the BISG algorithm to traffic safety analyses may reduce potential biases commonly found in data collection and analysis related to the use of race and ethnicity data. Its use can ultimately promote more effective and equitable interventions and policies to improve road safety for all.
Compared with their non-autistic peers, young drivers with autism have lower rates of moving violations and license suspensions, as well as similar to lower crash rates. Although half as likely to crash due to speeding, the autistic young drivers were three times more likely to crash when making a left or U-turn, suggesting the need for tailored training in these areas.
Doctors typically discuss depression, suicide, and substance abuse with adolescent patients with ADHD. However, they rarely discuss risky sexual behaviors and almost never discuss driver readiness and medication diversion. Additional resources and training are needed to help clinicians provide the best care for patients with ADHD.
To advance traffic safety knowledge, the ability to link different data sources is necessary. We need to help more researchers gain access to this data, as well as use it. Reforming state laws may be necessary to increase access to individual-level data.
Teens, older adults (age 65 and older), and those from low-income neighborhoods are more likely to be driving vehicles that are less safe (older models without electronic stability control and other safety features), putting them at greater risk of injury and death in the event of a crash. Ensuring these drivers are in the safest vehicles they can afford is a promising approach to reducing crash injuries and fatalities.
Adolescent drivers with ADHD are more likely to crash, be issued traffic and moving violations, and engage in risky driving behaviors than their peers without ADHD. More research is needed to measure if and how these risky behaviors contribute to crash risk.
Amblyopia—known as “lazy eye”—and unilateral vision impairment (UVI) are two conditions that cause reduced vision in one eye and decreased depth perception, both important in driving. This study found that young adults with these conditions were less likely to get licensed than those with no visual impairment. However, when licensed, neither of these conditions was associated with an elevated crash risk.
This study evaluated the quality of the metrics used to create the NJ-SHO Data Warehouse. The evaluation of this linkage suggests that it was of high quality and has the ability to support many rigorous studies.
Older drivers (age 65+) crash 27% less than middle-aged drivers (age 35-54) but are 40% more likely to die in a crash as compared to middle-aged drivers. Future research is needed to identify factors that influence risk of crash involvement and survivability after a crash.
This study is the first to estimate sensitivity and specificity of EHR-based ADHD diagnosis codes in classifying ADHD status. Findings show that the EHR-based algorithm was able to identify ADHD cases accurately and efficiently, proving that EHR-based diagnostic codes can be used by large-scale epidemiological and clinical studies with high sensitivity and specificity.
Lacking transportation is a major barrier to health care, and license suspension policies can contribute to this barrier. Contrary to popular belief, the majority of these suspensions are for non-driving related (NDR) events, such as failure to pay a court fee or appear in court. These NDR events are disproportionately imposed on low-income and racial and ethnic minorities. Developing policies to improve this transportation equity issue are needed.
This study found that the decline in crash rates from 2008-2012 among teen drivers following implementation of the GDL decal provision was not because of increased compliance with nighttime or passenger driving restrictions. Additional research is needed to understand how decal provisions may work to reduce young driver crashes.
