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Economic Impact of Motor-Vehicle Crashes Involving Teenaged Drivers -- Kentucky, 1994

Motor-vehicle crashes (MVCs) are the leading cause of death and disability for teenagers of driving age (16-19 years) in the United States (1). In addition, teenaged drivers account for a disproportionate number of MVCs compared with adult drivers (aged greater than or equal to 20 years) (1). In Kentucky, teenagers are overrepresented in MVCs. To characterize the economic costs associated with MVCs involving teenaged drivers in Kentucky, the Kentucky Injury Prevention and Research Center conducted a cost analysis of data from MVCs involving such drivers for 1994. This report presents the findings of this analysis, which indicate that, during 1994, crashes involving at least one teenaged driver in Kentucky incurred costs of $410 million.

Data were analyzed for all fatal and nonfatal MVCs and for MVCs involving property (vehicle) damage only (PDO) identified in the 1994 Kentucky Accident Reporting System maintained by the Kentucky State Police, Information Services Branch. Injury costs were based on the maximum injury sustained using the Abbreviated Injury Scale -- a standardized system for categorizing injury type and quantifying severity based on immediate threat to life (2). Costs were estimated using a National Highway Traffic Safety Administration (NHTSA) report (3) and the CrashCost software program (4) designed to calculate cost estimates of MVCs in state or local jurisdictions.

In 1994, teenaged drivers represented 5.6% of licensed drivers in Kentucky but accounted for 26,905 (22%) of the state's 124,037 MVCs. Teenaged drivers were involved in 120 (17%) of 706 fatal MVCs, 8490 (25%) of 34,643 nonfatal injury MVCs, and 18,295 (21%) of 88,688 PDO crashes (5). Of the 142 persons killed in crashes involving a teenaged driver, 62 (44%) were the teenaged driver (5). Based on information from Kentucky Uniform Police Traffic Accident Report forms, alcohol was not a major contributing factor to MVCs involving teenaged drivers: 17 (14%) of the 120 fatal crashes involving a teenaged driver were alcohol-related; in comparison, 242 (41%) of 586 fatal crashes involving an adult driver were alcohol-related (5).

Teenaged drivers were more likely than adult drivers to be killed or injured in an MVC. The death rate for teenaged drivers (44 per 100,000 teenaged licensed drivers) was more than twice that for adult drivers (19 per 100,000 adult licensed drivers). The rate of nonfatal injury for teenaged drivers was approximately three times greater than that for adult drivers. The rate of nonfatal injury was highest for 16-year-olds and decreased with increasing age.

Odds ratios (ORs) were calculated to estimate the relative risk for involvement in an MVC, for fatal and incapacitating injury, and for fatal injury for teenaged compared with adult drivers (Table_1). For all three outcomes, the crude ORs and the Mantel-Haenszel age-adjusted ORs were statistically significant at each age from 16 to 19 years. The age-adjusted OR for involvement in an MVC was greater for teenaged drivers (OR=3.30, 95% confidence interval {CI}=3.26-3.34), and the risk for sustaining a fatal or incapacitating injury was almost as high (OR=2.91, 95% CI=2.72-3.11). The age-adjusted risk for a teenaged driver sustaining a fatal injury was more than twice that for adult drivers (OR=2.30, 95% CI=1.77-2.99).

The economic costs of MVCs involving teenaged drivers were calculated for injury- and noninjury-related costs on a "unit" (i.e., per injured person or per damaged vehicle) basis (Table_2). Using NHTSA's CrashCost software (4), the estimated cost of a single MVC-related fatality was $642,700. For fatal injuries, 80% of the cost was from lost productivity; insurance administration and legal/court costs accounted for 17%. The estimated cost of a single critical injury was $563,000. For critical injuries, medical expenses accounted for 45% and productivity losses accounted for 33% of the total unit costs. Unit costs for all other levels of injury severity ranged from approximately $5700 (minor injury) to approximately $151,000 (severe injury). In general, estimated unit costs increased with increasing levels of injury severity.

To calculate the estimated total costs of MVCs involving teenaged drivers in 1994, unit costs were multiplied by the number of fatal and nonfatal injuries and the number of vehicles involved in crashes with PDO (Table_3). The software adjusts the number of crashes to account for unreported crashes. The total estimated cost of all 142 fatal injuries sustained in a crash involving a teenaged driver was $91 million. For all MVCs in which at least one teenager was driving, the total estimated cost of all MVC-related injuries (regardless of severity level) and noninjury costs for all persons and for all crashes involving PDO was $410 million.

Reported by: LA Goldstein, PhD, CW Spurlock, PhD, PA Kidd, PhD, RH McCool, MS, Kentucky Injury Prevention and Research Center, Lexington; R Finger, MD, State Epidemiologist, Dept for Health Svcs, Kentucky Cabinet for Human Resources. Div of Unintentional Injuries Prevention, National Center for Injury Prevention and Control, CDC.

Editorial Note

Editorial Note: Teenaged drivers are involved disproportionately in MVCs throughout the United States and other developed countries. Kentucky has ranked consistently among the 10 states with the highest death rate for teenagers in MVCs (6). Factors accounting for the high proportion of MVC costs associated with teenaged drivers when compared with adult drivers include 1) higher morbidity and death rates for teenagers; 2) greater risk among teenaged drivers for involvement in crashes resulting in serious injury or death; and 3) potentially greater lifetime productivity losses for younger drivers than some older age groups. Although teenagers may not provide financial support for their families, fatal or permanently disabling injuries from MVCs generate a substantial economic loss by removing these youth from society as potential producers and consumers.

Findings from the CrashCost software used to analyze the data for this report have at least four limitations. First, the software averages lost productivity costs across all age groups for each injury level, producing conservative estimates for costs associated with crashes involving teenaged drivers. Second, the software uses proportions derived from national estimates for the distribution of injury severity, driver age, crash-related costs, and crashes unreported to the police, then applies them to state data. The national estimates may not reflect the actual distributions of these factors in Kentucky. Third, the software uses an assessment of injury severity made by the police, which is accurate for minor injury and fatal injury categories but accurate for less than half of those whose injuries were classified in other categories. Finally, the costs may be underestimated because they do not include intangible costs (e.g., "pain and suffering").

Strategies aimed at reducing the number of MVCs attributed to teenaged drivers should substantially decrease both the overall numbers of traffic-related injuries and deaths and the costs of these crashes. Use of graduated driver licensing (GDL) systems is an important approach for reducing the number and subsequent costs of crash-related deaths and injuries among teenagers, their passengers, and other drivers. The intent of GDL systems is to provide young, novice drivers an opportunity to gain driving experience in low-risk settings. The system consists of three licensing stages, named by the type of license possessed at each stage: learner's permit, intermediate or provisional license, and full or unrestricted license. The system is not intended to raise the age for drivers' licensing. GDL programs target the driving behaviors and crash characteristics of teenagers that increase their risk for crash involvement (e.g., inexperience; poor decision-making skills; and high risk-taking behavior such as speeding, alcohol use, and nonuse of safety belts {7}; and high-risk exposure such as nighttime driving and driving with young passengers). A recent evaluation of the GDL system implemented in New Zealand in 1987 indicated that, from 1987 to 1992, the number of serious motor-vehicle-related injuries among 15-19-year-olds declined 7%-23%. Because other types of injuries for this age group also declined during the same period, the reduction could not be attributed entirely to GDL (8). In the United States, states that have implemented components of GDL have reported small but statistically significant decreases in the number of traffic-related injuries and deaths (9,10).

In March 1996, the Kentucky Legislature passed the Graduate Drivers' Licensing for Youth bill, one of the most comprehensive GDL programs in the United States. Under this new legislation, a young, novice driver begins with a learner's permit and driving restrictions, including a period of supervised driving, a 6-month waiting period before applying for a license, a nighttime driving restriction, and a reduced point threshold for suspension of the license as a result of traffic citations. This program is expected to reduce the number of deaths, injuries, and economic costs associated with MVCs among teenagers in Kentucky.

References

  1. National Center for Statistics and Analysis. Traffic safety facts, 1994: young drivers. Washington, DC: US Department of Transportation, National Highway Traffic Safety Administration, 1994.

  2. CDC. Cost of injury -- United States: a report to Congress, 1989. MMWR 1989;38:743-6.

  3. Blincoe LJ, Faigin BM. The economic cost of motor vehicle crashes, 1990. Washington, DC: US Department of Transportation, National Highway Traffic Safety Administration, 1992; report no. DOT-HS-807-876.

  4. Blincoe, LJ. Estimating crash costs in state or local jurisdictions. Washington, DC: US Department of Transportation, National Highway Traffic Safety Administration, Plans and Policy, 1994; report no. DOT-HS-808-135.

  5. Kentucky Transportation Center. Kentucky traffic accident facts, 1994: report. Lexington, Kentucky: University of Kentucky, College of Engineering, 1994.

  6. National Association of Independent Insurers. Phasing in the driving privilege. Des Plaines, Illinois: National Association of Independent Insurers, 1995.

  7. Insurance Institute for Highway Safety. All the 16-year-olds didn't make it home. In: Status report. Arlington, Virginia: Insurance Institute for Highway Safety, 1994;29:1-11.

  8. Langley JD, Wagenaar AC, Begg DJ. An evaluation of New Zealand's Graduated Driver Licensing System. Accid Anal Prev 1996:28;139-46.

  9. Hagge R, Marsh WC. An evaluation of the traffic safety impact of provisional licensing. Sacramento, California: California Department of Motor Vehicles, 1988; report no. CAL-DMV-RSS-88-116.

  10. McKnight AJ, Tippetts AS, Marques PR. Provisional Driver License System for follow-up evaluation of Maryland Youth License Control Demonstration Project. Washington, DC: US Department of Transportation, National Highway Traffic Safety Administration, 1990; report no. DOT-HS-807-669.



Table_1
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TABLE 1. Comparison of teenaged * drivers with all other licensed drivers in
motor-vehicle crashes (MVCs) -- Kentucky, 1994
===================================================================================================
                                                     Fatal and
                    Involvement in MVC         incapacitating + injury          Fatal injury
                 -------------------------     -----------------------     ----------------------
Age (yrs)        Crude OR &   (95% CI @)       Crude OR     (95% CI)       Crude OR     (95% CI)
-------------------------------------------------------------------------------------------------
16                   5.2       (5.0-5.3)         4.4        (3.8-5.0)        2.4       (1.2-4.7)
17                   3.6       (3.5-3.7)         2.8        (2.4-3.2)        2.6       (1.5-4.2)
18                   2.9       (2.8-3.0)         2.7        (2.4-3.1)        1.9       (1.1-3.2)
19                   2.6       (2.5-2.7)         2.4        (2.1-2.8)        2.5       (1.5-3.9)

Age-adjusted         3.30     (3.26-3.34)        2.91      (2.72-3.11)       2.30     (1.77-2.99)
-------------------------------------------------------------------------------------------------
* Aged 16-19 years.
+ Any injury other than a fatal injury that prevents injured persons from walking, driving, or
  normally continuing the activities they were capable of before the injury occurred.
& Odds ratio. Referent group was drivers aged >=20 years.
@ Confidence interval.
===================================================================================================

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Table_2
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TABLE 2. Estimated cost of motor-vehicle crashes involving teenaged * drivers per
injured person or per damaged vehicle, by type of expense and injury severity level + --
Kentucky, 1994 &
====================================================================================================
Expense                  PDO @     Minor    Moderate    Serious      Severe   Critical       Fatal
--------------------------------------------------------------------------------------------------
Injury

  Medical                   --     $ 690     $ 5,558    $18,725    $ 57,459   $251,633     $ 3,733
  Premature funeral         --        --          --         --          --         --       2,767
  Emergency
    services              $ 22       124         275        413         940        957         861
  Vocational
    rehabilitation          --        12          80        174         227        432          --
  Market
    productivity            --       971       9,127     29,856      41,960    149,044     418,236
  Household
    productivity            33       298        2,48      7,854      11,131     38,015      92,710
  Insurance
    administration         117       390       1,592      5,206      10,669     41,056      44,769
  Workplace costs           28       142       1,075      2,396       2,610      4,623       6,091
  Legal/Court               --       274       1,981      9,364      18,622     70,438      65,700

  Total **                 200     2,901      22,177     73,989     143,618    556,198     634,866

Noninjury

  Travel delay              98       158         158        158         158        158         353
  Property damage        1,072     2,665       2,741      4,715       6,823      6,549       7,464

  Total **               1,169     2,823       2,899      4,872       6,981      6,707       7,816

Total **                $1,369    $5,724     $25,076    $78,861    $150,599   $562,905    $642,683
--------------------------------------------------------------------------------------------------
 * Aged 16-19 years.
 + Injury costs were computed based on the maximum injury sustained using the Abbreviated
   Injury Scale, a standardized system for categorizing injury type and quantifying severity
   based on immediate threat to life (3).
 & Estimates were derived by using the National Highway Traffic Safety Administration's
   CrashCost software and were adjusted for locality (Kentucky) and year (1994).
 @ Property damage only.
** Numbers may not add to totals because of rounding.
====================================================================================================

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Table_3
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TABLE 3. Total costs of motor-vehicle crashes involving teenaged * drivers --Kentucky,
1994
===================================================================================================
Category        Unit cost &    Incidence @     Total cost
---------------------------------------------------------
Injury level

  Minor             $ 5,724         18,834   $107,805,816
  Moderate           25,076          2,171     54,439,996
  Serious            78,861            698     55,044,978
  Severe            150,599             85     12,800,915
  Critical          562,905             45     25,330,725
  Fatal             642,683            142     91,260,986

PDO                   1,369         46,031     63,016,439

Total                                        $409,699,855
---------------------------------------------------------
* Aged 16-19 years.
+ Injury costs were computed based on the maximum injury sustained using the Abbreviated
  Injury Scale, a standardized system for categorizing injury type and quantifying severity based
  on immediate threat to life (3).
& Cost per injured person or per damaged vehicle.
@ Many crashes are not reported to police and are missing in state records; however, these
  crashes constitute a large proportion of crash costs. The number of observed incident cases
  has been adjusted to account for the percentage of unreported crashes by applying the
  following national estimates for unreported crashes: minor, 23.7%; moderate, 16.5%; serious,
  6.8%; severe, 0.7%; critical, 0; fatal, 0; and property (vehicle) damage only (PDO), 48.0%.
===================================================================================================

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