older motor vehicle drivers involved in injury crashes in san diego county

Older Motor Vehicle Drivers Involved in Injury Crashes in

San Diego County

Barbara M. Stepanski, MPH Leslie Upledger Ray, MA, MPPA

Patti Murrin, RN, MPHAlan M. Smith, MPH, PhD(C)

County of San Diego Health and Human Services Agency, Division of Emergency Medical Services

County of San Diego Division of Emergency Medical Services

EMS

Problem: Elderly Drivers

• Concerns– Physical limitations

– Possibly higher crash rates

– More severe injuries due to fragility of aging bodies

• Proposed license restrictions– Reverse graduated licensing


EMS

Population

• Nationally, 70+ age group increased 2.1 times faster than the total population from 1989 to 1998

• Locally, the population over 55 is expected to more than double by 2020

• The number of drivers and collisions are expected to increase proportionally


EMS

Research Questions

• What is the crash rate in elderly?– Compared with other age groups– Severity

• What factors contribute to crashes involving elderly drivers?

• What impact do older drivers have on the overall population?


EMS

Data Sources• Statewide Integrated Traffic Records System

(SWITRS), FY 99/00

• San Diego County Emergency Medical Services (EMS) Prehospital Database, FY 99/00

• Department of Motor Vehicles (DMV) Drivers License Information


EMS

Data ExaminedPrehospital

– Age groups

– Gender

– Ethnicity

– Restraints

– Hour

– Paramedic Run Outcome

SWITRS– Incident Location

– Fault


EMS

Licensed Drivers by Age

0

100

200

300

400

500

16-19 20-24 25-34 35-44 45-54 55-64 65-74 75-84 85+

Lic

ense

d D

rive

rs (

x 10

00)

Source: California Department of Motor Vehicles, DL information report 01/01/00


EMS

Percent Licensed by Age

45.80%

85.17%77.08%

69.92%

31.23%

73.01%

95.30%93.17%90.59%

0%

20%

40%

60%

80%

100%

16-19 20-24 25-34 35-44 45-54 55-64 65-74 75-84 85+

Source: California Department of Motor Vehicles, SANDAG population estimates, January 2000


EMS

Prehospital Responses:Motor Vehicle Drivers

• 8800 Emergency Patients

• 1372 Age 55 and Older (15.6%)– 49% Male– 74% White (when known)– Time: 11a.m. – 4 p.m.


EMS

Prehospital Prehospital Responses to Motor

Vehicle Drivers, by Age

10941385

19861697

1188

579393 315

850

500

1000

1500

2000

2500

15-19 20-24 25-34 35-44 45-54 55-64 65-74 75-84 85+

Age Group

Num

ber

of P

atie

nts

Source: County of San Diego, Health and Human Services Agency Division of Emergency Medical Services; Prehospital Database, FY 9900


EMS

Prehospital Response Rate per 100,000 Population, by Age

360 331274

191257

224

450

619

689

0

100

200

300

400

500

600

700

800

16-19 20-24 25-34 35-44 45-54 55-64 65-74 75-84 85+

Rat

e pe

r 10

0,00

0

Prehospital patients / Population X 100,000

Source: County of San Diego, Health and Human Services Agency Division of Emergency Medical Services; Prehospital Database, FY 99/00


EMS

Prehospital Response Rate per 100,000 Licensed Drivers, by Age

MV Drivers

386 347 375

612

302 291

497

885

1505

0

200

400

600

800

1000

1200

1400

1600

16-19 20-24 25-34 35-44 45-54 55-64 65-74 75-84 85+

Rat

e pe

r 10

0,00

0

prehospital patients / # licensed drivers X 100,000

Source: County of San Diego, Health and Human Services Agency Division of Emergency Medical Services; Prehospital Database, FY 9900


EMS

Gender by Age Group

49% 47% 50%

61%

51% 53% 50%

39%

0%

10%

20%

30%

40%

50%

60%

70%

55-64 65-74 75-84 85+

Male Female

Source: County of San Diego, Health and Human Services Agency Division of Emergency Medical Services; Prehospital Database, FY 9900.


EMS

Race/Ethnicity of Drivers Seen by Prehospital Personnel:

55 years and upPatients

White74%

Black5%

Hisp10%

Asian/Other11%

Note:194 (14%) had unknown race/ethnicity.

Population

White76%

Black3%

Hisp13%

Asian/Other

8%

Source: County of San Diego, Health and Human Services Agency Division of Emergency Medical Services; Prehospital Database, FY 9900; SANDAG Population Estimates, January 2000.


EMS

Hour Call Received, Patients 55 Years and Older, Monday - Friday

0

20

40

60

80

100

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23

Hour



EMS

Hour Call Received by Age Group of Victim, Monday - Friday

0

100

200

300

400

500

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23

<55 Years 55 and Older



EMS

Percent of Injured Drivers in Moderate or Acute Status by Age

0%

4%

8%

12%

16%

20%

15-1

920

-24

25-3

435

-44

45-5

455

-64

65-7

475

-84

85+

Moderate

Acute


Per

cent


EMS

Restraint Use - Drivers 55 and Over

Active Restraint

86%

Passive Only2%

Unrestrained4%

Unknown8%



EMS

Percent of Drivers Unrestrained, by Age

5.12%

7.43%

5.80%

4.41%3.79% 3.44% 3.73%

3.33%

8.33%

0%

1%

2%

3%

4%

5%

6%

7%

8%

9%

15-19 20-24 25-34 35-44 45-54 55-64 65-74 75-84 85+



EMS

SWITRS

Percent of Drivers at Fault by Age*

51%

41%37% 36% 36%

44%

59%63%59%

0%

10%

20%

30%

40%

50%

60%

70%

15-19 20-24 25-34 35-44 45-54 55-64 65-74 75-84 85+

Source: SWITRS Database, FY 99/00

*Drivers at fault/Drivers in injury collisions

%


EMS

SWITRS

Rate (per Licensed Drivers) of At-Fault Collision by Age*

2396

1379

671494 412 358 365

532821

0

500

1000

1500

2000

2500

3000

15-19 20-24 25-34 35-44 45-54 55-64 65-74 75-84 85+

Age Group

Rat

e p

er 1

00,0

00


*Drivers at fault/Licensed drivers


EMS

SWITRS

Road Type by Age of Driver at Fault

70%60% 65% 67% 66% 70% 75% 77% 78%

30%40% 35% 33% 34% 30% 25% 23% 22%

0%

20%

40%

60%

80%

100%

15-19 20-24 25-34 35-44 45-54 55-64 65-74 75-84 85+

Age Group

Side Street Highway/Freeway



EMS

Violation Category by Age of Driver at Fault

11%13%

4%

34% 32%

25%

17%13% 14%

16% 16%

29%

8% 8%11%

0%

10%

20%

30%

40%

15-24 25-54 55+

DUI Alcohol/Drugs Unsafe Speed

Improper Turning Auto Right-of-Way

Traffic Signals and Signs



EMS

Leading Violation Categories by Age

0%

10%

20%

30%

40%

15 to

19

20 to

24

25 to

34

35 to

44

45 to

54

55 to

64

65 to

74

75 to

84

85 a

nd old

er

Auto Right of Way

Unsafe Speed

Improper Turning

Traffic Signals/Signs

DUI



EMS

Collision Type by Age of Driver at Fault

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

15-24 25-54 55+

Head-on

Sideswipe

Rear-end

Broadside

Hit Object

Overturned

Auto/Pedestrian

Other



EMS

Conclusions• Crash rates and at-fault rates are lower in seniors

than previously thought

• Crash rates of 55-64 and 65-74 are comparable to middle-aged drivers

• Highest crash and fault rates in youngest drivers (16-24)

• Percent at fault comparable to 16-24 year-olds

• Crashes– Side streets– More in the middle of the day (younger: rush hours)– Violation: auto right of way– Collision type: broadside


EMS

Conclusions (cont.)

• Results question the proposed restrictions on elderly drivers, which may be detrimental to their independence

• Results support the need to focus safe driving interventions on young drivers


EMS

Acknowledgments

• San Diego Paramedics/EMTs, Prehospital Agencies and Hospitals

• SANDAG

• San Diego County Law Enforcement Agencies


EMS

Contact Information

Alan M. SmithCounty of San Diego

Health and Human Services AgencyEmergency Medical Services

6255 Mission Gorge RoadSan Diego, CA 92120 (619) 285-6429 phone

(619) 285-6531 [email protected]

older motor vehicle drivers involved in injury crashes in san diego county

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