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CDC conducts research in motor vehicle injury prevention and supports research through partners, including CDC-funded injury control research centers (ICRCs), academic institutions, non-governmental organizations, state health departments, and other federal agencies. Priority areas include alcohol-impaired driving, older drivers, young drivers, child passenger safety, and pedestrian safety. Highlights from 2000–2001 motor vehicle injury prevention research include:
Alcohol and Driving
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Each December, CDC scientists analyze new data on alcohol involvement in fatal motor vehicle crashes and publish results in CDC’s Morbidity and Mortality Weekly Report. Analysis of data from the National Highway Traffic Safety Administration’s Fatality Analysis Reporting System indicated that the number of alcohol-related fatalities in 2000 was 4.2% higher than in 1999. In 2000, the fatality rate for alcohol-related crashes was 5.9 per 100,000 persons. This rate will need to decline 32% to meet the Healthy People 2010 objective of 4.0 per 100,000 persons. CDC. Notice to Readers: Alcohol involvement in fatal motor-vehicle crashes—United States, 1999–2000.
MMWR 2001;50(47):1064–5.
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To assess the effectiveness of prevention activities to reduce alcohol-impaired driving, CDC scientists analyzed data from the Behavioral Risk Factor Surveillance System, a national telephone survey, and from Mothers Against Drunk Driving (MADD). The researchers examined the association between states’ grades on the 1999 MADD Rating the States survey and residents’ self-reported drinking and driving. They found that drivers from states with lower MADD grades were more likely than drivers from states with higher grades to report drinking and driving. Shults RA, Sleet DA, Elder RW, Ryan GW, Sehgal M. The association between state-level drinking and driving counter-measures and self-reported alcohol-impaired driving.
Injury Prevention 2002;8:106–10.
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CDC’s research findings about the number of children killed in cars driven by drunk drivers have led legislators in several states to introduce bills to help protect children from drinking drivers. These bills create special penalties under state child abuse laws for persons who transport children ages 15 and younger while driving drunk. The research, published in the Journal of the American Medical Association in May 2000, found that nearly two-thirds of children killed in drinking driver–related crashes were riding with the impaired driver. Quinlan KP, Brewer RD, Sleet DA, Dellinger AM. Child passenger deaths and injuries involving drinking drivers.
JAMA 2000:283(17)2249–52.
Older Drivers
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 CDC scientists worked with the University of California, San Diego, to survey drivers ages 55 and older living in community settings to find out why they stopped driving. The most common reasons for stopping were medical conditions and poor vision. This research provides insight into why older drivers decide that they are no longer fit to drive, which can help public health practitioners develop programs to reduce motor vehicle–related injuries in this population. Dellinger AM, Sehgal M, Sleet DA, Barrett-Connor E. Driving cessation: What older former drivers tell us. Journal of the
American Geriatrics Society 2001;49(4):431–5.
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To determine whether older drivers were more likely than younger drivers to be
involved in crashes when someone else died, CDC researchers analyzed three years of motor vehicle crash data. They found that, in fact, older drivers were involved in
fewer of these crashes than were drivers 16 to 34 years old. Crashes caused by older
drivers were more likely to kill the older driver than to kill others involved in the crash. This study helps dispel the myth that older drivers present an unacceptable threat to others on the road.
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CDC researchers explored fatal crash involvement rates for older drivers by assessing the contributions of the crash fatality rate (risk of death), incidence density (risk of crash), and exposure prevalence (amount of driving) to the fatal crash involvement rates of older drivers. Although fatal crash involvement rates increased with the driver’s age, the
components of the involvement rates did not. The crash fatality rates and the incidence densities increased with age, while the exposure prevalence decreased. In other words, although older drivers drove less, they were more likely to crash and to die in a crash.
Dellinger AM, Langlois JA, Li G. Fatal crashes among older drivers: Decomposition of rates into contributing factors.
American Journal of Epidemiology 2002;155(3):234–41.
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CDC researchers analyzed annual mortality data to identify differences in motor vehicle– and fall-related death rates among older adults by sex, race, and ethnicity. From 1990 to 1998, overall motor vehicle-related death rates remained stable, while death rates from unintentional falls increased among older Americans. Both motor vehicle– and fall-related death rates were higher among men. Motor vehicle–related death rates were higher among people of color; death rates from falls were higher among whites. Among whites, the annual relative increase in deaths from falls was 3.8% for both men and women. Fall death rates were higher among non-Hispanics than Hispanics.
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With CDC funding, researchers at the University of Washington are investigating the relationship between older drivers’ crash risk and the time since last license renewal. The interval between license renewals is an issue of public policy, and states must balance the risk of crashes caused by drivers who have become impaired against the cost and inconvenience of more frequent renewals. The results of this study will help decision makers determine the appropriate interval between license renewals for older drivers.
Teen Drivers
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 Between 1991 and 1997, teens’ drinking-and-driving behavior did not change appreciably. Consistently, more than one-third of students reported that in the past month, they had ridden with a driver who had been drinking alcohol, and one in six had driven after drinking alcohol. These findings, from CDC’s 1991, 1993, 1995, and 1997 Youth Risk Behavior Surveys, point to a need for stronger incentives to prevent adolescent drinking and driving.
Everett SA, Shults RA, Barrios LC, Sacks JJ, Lowry R, Oeltmann J. Trends and subgroup differences in transportation-related risk and safety behaviors among high school students, 1991–1997.
Journal of Adolescent Health 2001;28:228–34.
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CDC scientists are working with the National Institutes of Health to examine parental influences on teen driving behavior and motor vehicle crashes. This research will help determine whether persuasive communication, setting clear driving expectations,
supervising teens’ driving, limiting driving in high-risk conditions, and penalizing unsafe driving will result in teens’ engaging in fewer risky driving behaviors, having fewer traffic violations, and most important, having fewer crashes.
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Learning to drive safely takes time and practice. Graduated driver licensing (GDL) is one strategy that allows for skills development. This system places restrictions on young drivers that are systematically lifted as teens gain driving experience and competence. GDL studies around the world have found 5% to 16% reductions in crashes among teenage drivers. Thirty-four states and the District of Columbia have some form of GDL law, but the strength of the components varies widely. CDC supports research at the Southern California Injury Prevention Research Center in Los Angeles to examine the effectiveness of particular components of GDL. Results from this research will help in the development of informed, science-based policies and practices.
Child Passenger Safety
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In a survey conducted by CDC scientists in collaboration with the Injury Prevention Section of the Georgia Division of Public Health, only 44% of children were observed riding in age-appropriate restraints in the back seat of motor vehicles, as is currently recommended. In May and June 2001, police officers at road blocks across the state recorded age, restraint type, and seating position of 1,858 children ages 12 and younger. Results from this survey showed that 58% of children in the state rode in age-appropriate restraint systems, and 75% of children sat in the back seat. Infants were frequently observed riding incorrectly in forward-facing car seats (29%) and/or in the front seat
(21%). Only 6% of children ages 5 to 8 were seen riding in booster seats, and 9- to 12-year-olds were observed riding in the front seat 39% of the time. Results reveal the need for improved child occupant safety in Georgia and highlight areas of particular concern.
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CDC scientists found that the number of children ages 4 to 8 who died in motor vehicle crashes remained stable—about 500 per year—between 1994 and 1998. Only one-third of children killed were restrained at the time of the crash. Only about half were riding in the back seat, the recommended seating position for children ages 12 and younger. This research points to a need to increase efforts to promote passenger safety for children in this age group.
CDC. Motor-vehicle occupant fatalities and restraint use among children aged 4–8 years—United States, 1994–1998.
MMWR 2000;49(7):135–7.
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