Post-World War II baby boomers are reaching age 65 and over (older adults), and are projected to drive more miles later in life compared to previous generations. This demographic shift raises national-level traffic safety concerns, because older adult drivers have an elevated crash rate, are more likely to be injured in a crash, and are less likely to recover from injuries and resume the level of daily life activity prior to bing injured. States have enacted various licensing laws pertaining to older drivers. To date, little research has investigated the effectiveness of these laws in protecting not only older drivers, but also those who share the roadways with them. It remains unclear how these laws affect driving behaviors among older adults, whether they reduce driver injuries per driving hours or trips, the extent to which they increase the use of alternative transportation, and whether there are corresponding increases in injuries to older adults as passengers or pedestrians. Therefore, we propose a four-year project with objectives to determine, across multiple states, the impact of licensing laws for older adults on driving decisions, alternative transportation choices, and rates of injurious and fatal crashes among older adult drivers, passengers, pedestrians, and bicyclists. We hypothesize that the effectiveness of licensing laws is impacted by certain provisions of the law, and that the licensing laws reduce driving trips and injuries, but increase non-driving trips and injuries.
The aims of this project are to determine which provisions of licensing laws reduce driving hours and trips, licensure rates, and crash rate per driving hours (Aim 1), to identify which provisions of laws increase alternative transportation and non-driving injury and fatality (Aim 2), and to identify which provisions of laws affect total transportation trips, hours, and crashes among older adults (Aim 3). The following legislative provisions will be examined: means of renewal (in-person or mail/online), length of the renewal cycle, requirements for vision tests, requirements for road tests, requirements for knowledge tests, and mandatory physician reporting for medical conditions.
The aims will be accomplished by combining and analyzing travel, license, economic, legislative, population, and crash data from a variety of data systems maintained by federal, state, and private agencies. Multilevel generalized linear and negative binomial models will be used to estimate the effects of state-level laws on individual-level travel behaviors and state-level crash rates. Guided by strong preliminary data, this study is also innovative. For example, the innovative measurement of crash rate per hour of driving in combination with crash rate per capita will help determine whether the effects of the legislative provisions in reducing crash rate per capita are due to a reduction in driving hours, due to safer driving, or due to some combination of both. This study is significant, because the findings can inform policymakers' efforts to update or modify existing legislation to effectively reduce injurios crashes among older adults while preserving their personal freedom and mobility.

Public Health Relevance

Healthy People 2020 has identified motor vehicle crashes as an important public health issue, and the National Institute on Aging has emphasized 'a better understanding of needs and interventions to improve the safety of older drivers' in the 2007 report 'Living long and well in the 21st century: Strategic directions for research on aging'. The proposed research will assess the extent to which licensing laws affect transportation choices, and identify the effective and ineffective provisions of licensing laws for older adults in reducin crashes, injuries and deaths. It will delineate an optimal law to inform states that are enacting new or enhancing existing legislation to achieve actual reductions in traffic crashes involving older adults while preserving their mobility; and will provide much-needed scientific evidence to inform other important policy decisions relevant to transportation safety and protection of the traveling public.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Research Project (R01)
Project #
5R01AG050581-04
Application #
9277337
Study Section
Community Influences on Health Behavior Study Section (CIHB)
Program Officer
Karraker, Amelia Wilkes
Project Start
2016-09-01
Project End
2020-05-31
Budget Start
2018-06-01
Budget End
2019-05-31
Support Year
4
Fiscal Year
2018
Total Cost
Indirect Cost
Name
Nationwide Children's Hospital
Department
Type
DUNS #
147212963
City
Columbus
State
OH
Country
United States
Zip Code
43205
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