Impact of driver licensing renewal policies on older driver crash involvement and injury rates in 13 states, 2000-2019.

IF 2.4 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Injury Epidemiology Pub Date : 2025-01-14 DOI:10.1186/s40621-024-00555-9

Cara J Hamann, Jonathan A Davis, Gilsu Pae, Motao Zhu, Gregory H Shill, Brian Tefft, Joseph E Cavanaugh

{"title":"Impact of driver licensing renewal policies on older driver crash involvement and injury rates in 13 states, 2000-2019.","authors":"Cara J Hamann, Jonathan A Davis, Gilsu Pae, Motao Zhu, Gregory H Shill, Brian Tefft, Joseph E Cavanaugh","doi":"10.1186/s40621-024-00555-9","DOIUrl":null,"url":null,"abstract":"Background: Motor vehicle crashes are the second leading cause of injury death among adults aged 65 and older in the U.S., second only to falls. A common state-level approach to mitigating older adult crash risk is the implementation of driver license renewal policies which vary largely between states and data on their effectiveness in preventing crashes and injuries are limited. To fill this gap, the aim of this study is to examine the association between state driver license renewal policies and older driver crash and injury rates.Methods: Historical crash data, license renewal policy data, and other relevant policy and demographic data were gathered from 13 U.S. states (CO, IL, IA, KS, MN, MO, NE, ND, OH, SD, UT, WI, WY) for years 2000 through 2019, inclusive. Main exposures included six license renewal policies: renewal period, in-person renewal frequency, vision testing, knowledge testing, on-road drive testing, and mandatory physician reporting. The primary outcomes were crash and injury rates per 100,000 population.Results: The study population included 19,010,179 crash-involved drivers aged 40 and older. State policies became less restrictive in many states over the study period, even for drivers aged 75 and older, resulting in longer times between renewals and fewer in-person renewal requirements. Loosening of in-person renewal from every time to less than every time was associated with increased crash rates, among drivers aged 65 to 74 (RRcrash = 1.08, 95% CI: 1.01-1.16). A longer duration between in-person renewals was associated with increased injury rates among drivers 75 and older (RRinjury = 1.18, 95% CI: 1.00-1.39).Conclusions: Generally, state policies became less restrictive and resulted in longer required intervals between license renewal. Loosening of driver license renewal policies was associated with increased crash and injury rates. However, safety benefits of restrictive older driver licensing policies should be carefully weighed against costs to older adult well-being and quality of life following licensure loss. Additional methods to assess fitness to drive are necessary to identify the mechanisms behind the increased rates.","PeriodicalId":37379,"journal":{"name":"Injury Epidemiology","volume":"12 1","pages":"3"},"PeriodicalIF":2.4000,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11730141/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Injury Epidemiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s40621-024-00555-9","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Motor vehicle crashes are the second leading cause of injury death among adults aged 65 and older in the U.S., second only to falls. A common state-level approach to mitigating older adult crash risk is the implementation of driver license renewal policies which vary largely between states and data on their effectiveness in preventing crashes and injuries are limited. To fill this gap, the aim of this study is to examine the association between state driver license renewal policies and older driver crash and injury rates.

Methods: Historical crash data, license renewal policy data, and other relevant policy and demographic data were gathered from 13 U.S. states (CO, IL, IA, KS, MN, MO, NE, ND, OH, SD, UT, WI, WY) for years 2000 through 2019, inclusive. Main exposures included six license renewal policies: renewal period, in-person renewal frequency, vision testing, knowledge testing, on-road drive testing, and mandatory physician reporting. The primary outcomes were crash and injury rates per 100,000 population.

Results: The study population included 19,010,179 crash-involved drivers aged 40 and older. State policies became less restrictive in many states over the study period, even for drivers aged 75 and older, resulting in longer times between renewals and fewer in-person renewal requirements. Loosening of in-person renewal from every time to less than every time was associated with increased crash rates, among drivers aged 65 to 74 (RR_crash = 1.08, 95% CI: 1.01-1.16). A longer duration between in-person renewals was associated with increased injury rates among drivers 75 and older (RR_injury = 1.18, 95% CI: 1.00-1.39).

Conclusions: Generally, state policies became less restrictive and resulted in longer required intervals between license renewal. Loosening of driver license renewal policies was associated with increased crash and injury rates. However, safety benefits of restrictive older driver licensing policies should be carefully weighed against costs to older adult well-being and quality of life following licensure loss. Additional methods to assess fitness to drive are necessary to identify the mechanisms behind the increased rates.

查看原文本刊更多论文

2000-2019 年美国 13 个州驾驶执照更新政策对老年驾驶员肇事和受伤率的影响。

背景：机动车碰撞是美国65岁及以上成年人伤害死亡的第二大原因，仅次于跌倒。减轻老年人碰撞风险的一种常见的州一级方法是实施驾驶执照更新政策，这些政策在各州之间差异很大，关于其在预防碰撞和伤害方面的有效性的数据有限。为了填补这一空白，本研究的目的是检查州驾驶执照更新政策与老年驾驶员撞车和受伤率之间的关系。方法：从2000年至2019年（含2019年）收集美国13个州（CO、IL、IA、KS、MN、MO、NE、ND、OH、SD、UT、WI、WY）的历史车祸数据、许可证更新政策数据以及其他相关政策和人口统计数据。主要暴露内容包括6项换证政策：换证期限、换证频率、视力测试、知识测试、道路驾驶测试和强制医师报告。主要结果是每10万人的撞车率和受伤率。结果：研究人群包括19010179名年龄在40岁及以上的撞车司机。在研究期间，许多州的州政策变得不那么严格了，甚至对75岁及以上的司机也是如此，导致续保间隔更长，亲自续保的要求更少。在65岁至74岁的司机中，从每次到少于每次的现场更新的放松与撞车率的增加有关（RRcrash = 1.08, 95% CI: 1.01-1.16）。在75岁及以上的司机中，面对面更新的间隔时间越长，受伤率越高（RRinjury = 1.18, 95% CI: 1.00-1.39）。结论：一般来说，国家政策变得不那么严格，导致许可证更新之间所需的时间间隔更长。驾照更新政策的放松与车祸和受伤率的增加有关。然而，限制性老年驾驶执照政策的安全效益应该仔细权衡，与失去执照后老年人福祉和生活质量的成本。评估驾驶适应性的其他方法是必要的，以确定增加率背后的机制。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Injury Epidemiology Medicine-Medicine (all)

CiteScore

3.20

自引率

4.50%

发文量

审稿时长

13 weeks

期刊介绍： Injury Epidemiology is dedicated to advancing the scientific foundation for injury prevention and control through timely publication and dissemination of peer-reviewed research. Injury Epidemiology aims to be the premier venue for communicating epidemiologic studies of unintentional and intentional injuries, including, but not limited to, morbidity and mortality from motor vehicle crashes, drug overdose/poisoning, falls, drowning, fires/burns, iatrogenic injury, suicide, homicide, assaults, and abuse. We welcome investigations designed to understand the magnitude, distribution, determinants, causes, prevention, diagnosis, treatment, prognosis, and outcomes of injuries in specific population groups, geographic regions, and environmental settings (e.g., home, workplace, transport, recreation, sports, and urban/rural). Injury Epidemiology has a special focus on studies generating objective and practical knowledge that can be translated into interventions to reduce injury morbidity and mortality on a population level. Priority consideration will be given to manuscripts that feature contemporary theories and concepts, innovative methods, and novel techniques as applied to injury surveillance, risk assessment, development and implementation of effective interventions, and program and policy evaluation.