Sydney, AUSTRALIA | Beijing, CHINA | Hyderabad, INDIA | London, UK

Affiliated with the University of Sydney

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Socio-economic status and crash risk in young driversA/Professor Rebecca Ivers

Over-representation of youth in road trauma

#1 cause of death & acquired disability of adolescents & young adults

NSW novice drivers (<26 years of age)15% licensed driver population36% road fatalities

NSW 17 year-old drivers in first stage of licensing4x more likely to be involved in fatal crash than driver 26+

Inexperience primary contributing factor

Figure 1. Casualty crashes in Victoria by years licensed, 2000-2006(VicRoads, 2008)

Novice drivers in the UK

6Lynam et al, 2006

The social gradient of injury

The social class gradient in injury is well documented, especially for children (Towner and Dowswell, 2001)DrowningChokingHouse fires (15 times increased risk) Road injury (5 times increased risk)

Risk of injury increases with deprivation (Laflamme and Diderichsen, 2000)

Gap in deprivation is increasing in the UK

Increased risk reflects differential exposure of children to various hazards (rather than differences in behaviour)

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Life expectancy and income level

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Marmot Review

Crash rates in Australia by social status

Crash rates decreasing by ~5% per year for novice drivers over past 10 years

Due to combination of graduated licensing, enforcement and general improvements in road safety

But NOT decreasing for drivers who live in rural areas, or those of low SES – no significant change

(Chen HY et al , Journal of Safety Research, 2010)9

Trends in fatality rate for young drivers in NSW by SES, 1997-2007

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0.00

0.50

1.00

1.50

2.00

2.50

3.00

3.50

1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007

(per

10

000

licen

sed

driv

ers)

High SESModerate SESLow SES

WHY?

Individual level factors

Increased driving exposure

Risk behaviours, including substance abuse

Poor parental behaviours

Older, less safe cars

Fatigue

Mental health?

Experience

Area level factors

Low SES associated with regional or rural areas

Less or different enforcement?

Poor road conditions and road related infrastructure

Higher posted speed limits

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Factors associated with increased risk

The factors that contributed significantly to increased risk were:

For rural fatalities: High posted speed limits, drink driving   and not wearing a seatbelt

For low SES fatalities: High posted speed limits, fatigue and driving an older vehicle

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Factors inter-related

Many factors that increase risk in low SES areas also influence risk in rural areas

E.g. rural and low SES drivers may share the same risky behaviours, such as high alcohol consumption and failure to wear seatbelts while driving

E.g. drivers of low SES may drive longer distances or use less safe cars, which is also likely to be true for rural residents

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DRIVE Study

Data from 20,000 novice drivers in NSW

Participants completed survey and consented to linkage to police reported crash reports, and road related hospitalisations

Opportunity to disentangle area level factors (age, gender, risk behaviours, driving experience and exposure) from area level effects (place of residence, socioeconomic status)

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Findings

People from low SES areas had ~double risk of crash related hospitalisation (ie serious injury)

Analysis took into account where they lived (urban vs rural) as well as individual level factors

Results means that there are some factors related to social status that increase the risk of crash after we take into account where they live, how far they drive, risk behaviours

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Implications

Need to better understand the factors that relate to social statusArea level factors eg infrastructureCommunity behaviour?Cars?

Need for investment in prevention in low SES areas• Speed management

• Road infrastructure

• Community policing

• Education?

• Access to safe and convenient public transport16

A Safe Systems approach

Safe roads and places

Safe people

Safe vehicles

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Safe roads (and places)

Road design to minimise speed (chicanes, speed humps)

Prevent crashes/minimise impact of crashesIntersection designRight hand turn lanesShoulders and curved sectionsDesign for vulnerable road users eg pedestrians and cyclists

Appropriate urban planningReduce exposure to drivingGood public transport systems

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Safe people

Graduated licensing for novice drivers

Appropriate enforcement (including speed detection devices

Education and social marketing

Targeted initiatives for high risk populationsEg parent-teen contracts, involvement of schools and communities, parental support,

building resilience (eg Griffin, 2004)

Lessons can be learned from child injury research:Minimize exposure Community partnerships (involve families and communities)Less focus on individual behaviours and more on structural issues

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Safe vehicles

Fleet safetyNovice drivers in second hand car marketNeed to have good fleet safety overall

Other ways to increase safety of novice driver cars?

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Summary

Increasing understanding of the social gradient in novice driver injury

But little research specifically aimed at developing or evaluating programs

Significant opportunities to close the gap

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Acknowledgements

FundingNational Health and Medical Research CouncilIn-kind support from RTANRMA Motoring and Services NRMA-ACT Road Safety TrustNSW HealthMotor Accidents Authority of NSW

Advisory Committee

Participants

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