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Perspectives in Disease Prevention and Health Promotion Alcohol-Related Highway Fatalities among Young Drivers -- United States

In 1981, 49,268 highway accident deaths involving 62,666 drivers occurred in the United States; young drivers (ages 16 to 24 years), constituting 17% of the U.S. population, were involved in accidents resulting in 48% of the fatalities.* A total of 21,431 young drivers accounted for crashes resulting in 23,690 fatalities, and 9,834 of these drivers themselves were killed.

Analysis of 1981 data from the Fatal Accident Reporting System (FARS)** shows that alcohol played an important role in fatal highway accidents involving young drivers. In 1981, 4,738 young drivers under the influence of alcohol were killed, and 9,310 persons died in accidents involving these young drivers.

Of the 21,431 young drivers involved in accidents, 8,222 had positive blood alcohol content (BAC) tests or were judged by investigating officers to have alcohol involvement; 4,738 were killed, for a case fatality rate of 58%. The remaining 13,209 were untested or had negative BAC; 5,096 of these were killed, for a case fatality rate of 39 per 100 young drivers with negative or unknown BAC. Thus, young drivers with known alcohol involvement were 49% more likely to be killed than those with zero or unknown alcohol involvement.

For single vehicle accidents, there was a steady, inverse relationship between age and involvement in fatal accidents, regardless of alcohol use (Table 1). Young drivers accounted for 41% of the 25,095 fatal single vehicle accidents, compared with 11% for drivers 55 years or older. Young drivers were involved in nearly 45% of alcohol-related single vehicle accidents, compared with 5.5% for drivers 55 and older. A total of 7,158 fatal, alcohol-related, single vehicle accidents occurred in 1981. A comparison of BAC by driver age for single vehicle accidents shows a greater fraction of young than older drivers with low BAC, (Figure 1). *U.S. Department of Commerce, Bureau of the Census, 1970 and 1980 Census of Population. **Department of Transportation, National Highway Traffic Safety Administration, 1977-1981 data tapes.

The overall crude death rate in 1981 was 43.2/100,000 for highway accidents attributable to young people aged 16-24 years, compared with 31.9 for those 25-29 years, 23.7 for 30-34 years, 19.5 for 35-44 years, and 17.9 for those 45 years and older. No crude death rates were computed for drinking driver fatalities, because no reliable way exists for estimating the number of drinking drivers on the road at any given time.

The overall crude death rate attributable to highway traffic fatalities has been relatively stable over the 5-year period 1977-1981. Minor fluctuations in crude rates have occurred for all ages; for most age groups the trend has been slightly downward since 1978-1979 (Table 2). The most noteworthy aspect has been the extreme variablilty between ages in any given year. In 1981, the crude death rate for 16-year-olds was 28.7/100,000 and for 17-, 18-, and 19-year-olds, 40.5, 50,9, and 51.8, respectively. Only after age 35 did the rate decrease below the overall crude rate. This pattern has occurred in all 5 data years, with the crude death rate for 16-24 year olds exceeding the overall rate by more than 2 to 1 in each year. Reported by H Malin, MA, J Trumble, MSW, C Kaelber, MD, B Lubran, MPH, Alcohol Epidemiology Data System, Div of Biometry and Epidemiology, National Institute on Alcohol Abuse and Alcoholism.

Editorial Note

Editorial Note: Because testing for BAC is not uniform for all states and police jurisdictions, actual overall alcohol involvement in highway traffic fatalities may be underestimated. In addition, traffic deaths are only tabulated if they occur within 30 calendar days of the highway traffic accident; thus, deaths are also undercounted. Nevertheless, alcohol-related motor vehicle crashes are the leading cause of death in the 16-24-year age group.

These data, and an awareness of the tragic health and social consequences of the use of alcohol by youth, have led the Department of Health and Human Services to emphasize the need for a combined effort by adults and young people against youth alcohol abuse and to announce an Initiative on Teenage Alcohol Abuse. The Secretarial Initiative, designed to increase public awareness of the seriousness of the problem and to mobilize public and private action, includes the following major activities.

  1. A Secretarial Conference for Youth on Drinking and Driving, co-sponsored by the Departments of Education, Transportation, and Agriculture, will be held in Chevy Chase, Maryland, March 26-28, 1983, for young people working to combat drinking and driving. Teenagers across the country will be invited to share experiences on implementing programs in their local communities to reduce alcohol- and drug-related traffic fatalities.

  2. A series of 10 regional conferences on prevention and early intervention, held across the country for school personnel, parent groups, and alcohol and drug abuse program personnel, has resulted in a prevention guide, "Prevention Plus: Involving Schools, Parents, and the Community in Alcohol and Drug Education," which will be printed early in 1983.

  3. Beginning the summer of 1983, a series of 1-day regional conferences will be held to help communities assess the need for and design comprehensive treatment services for youth.

  4. Agencies within the Department of Health and Human Services have been asked to identify activities in research, education, and prevention designed to curb teenage alcohol abuse. In addition, the Department will be involved in the "National Drunk and Drugged Driving Awareness Week," December 12-18, 1982.

  5. Communication has been established with the World Health Organization to develop a collaborative relationship on the issue.

  6. Studies to examine the medical and developmental consequences of youth alcohol consumption are being undertaken.

Selected Bibliography

  1. Malin HJ, Graves C, Harford TC, Kaelber CT. Alcohol-related traffic fatalities: findings from the Fatal Accident Reporting System (FARS) (in press).

  2. Malin HJ, Munch NE, Archer LD. A National surveillance system for alcoholism and alcohol abuse. In: Proceedings of the 32nd International Congress on Alcoholism and Drug Dependence. Congress held Warsaw, Poland, 1978.

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