Traffic fatalities are the second largest contributor to years of life lost before age 75 and are the leading cause of death among youth aged 15-24 years. Alcohol involvement in these crashes has remained relatively steady despite overall declines in traffic fatality rates. Public policies (laws, regulations, penalties) concerning alcohl and car safety have contributed to these declines, but there is enormous variation in policies among states. To date, little scholarship has systematically investigated the impact of such a diverse regulatory environment on health outcomes. This study uses variation across states from 1980-2010 as a natural experiment to examine the relationship between the evolution of state policies concerning alcohol and motor vehicle safety on changes in traffic fatalities and injuries, and the role of alcohol in these outcomes. Data come from the Alcohol Policy Information System, linked to other available datasets and supplemented by original legal research. The study proposes to develop a comprehensive database on state alcohol and traffic safety policies;identify patterns in state law adoption;assess factors associated with health policy adoption and diffusion;and quantify the impact of multiple state health policies on traffic fatalities and injuries over time. The study is consistent with and contributes to NIAAA's prioritis for assessing the alcohol policy environment.

Public Health Relevance

Study results will enhance the design of effective policy-based approaches to reducing deaths and injuries from alcohol and motor vehicles as consistent with Health People 2020 objectives of reducing traffic fatalities by 10 percent. Results will aid policymakers in understanding barriers to adoption of new evidence-based policies, allowing them to perform policy surveillance to identify gaps and areas for potential improvements.

National Institute of Health (NIH)
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Research Project (R01)
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Community Influences on Health Behavior (CIHB)
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Bloss, Gregory
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New York University
Schools of Education
New York
United States
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Macinko, James; Silver, Diana (2015) Diffusion of Impaired Driving Laws Among US States. Am J Public Health 105:1893-900
Macinko, James; Silver, Diana; Bae, Jin Yung (2015) Age, period, and cohort effects in motor vehicle mortality in the United States, 1980-2010: the role of sex, alcohol involvement, and position in vehicle. J Safety Res 52:47-57
Bae, Jin Yung; Anderson, Evan; Silver, Diana et al. (2014) Child passenger safety laws in the United States, 1978-2010: policy diffusion in the absence of strong federal intervention. Soc Sci Med 100:30-7
Silver, D; Macinko, J; Bae, J Y et al. (2013) Variation in U.S. traffic safety policy environments and motor vehicle fatalities 1980-2010. Public Health 127:1117-25