from rigorous science from rigorous science to impactful practice - PDF document

September 17, 2009 September 17, 2009 from rigorous science … from rigorous science … … to impactful practice … to impactful practice 1

Stay Tuned Stay Tuned Toward elimination of healthcare associated infections   Toward elimination of healthcare associated infections (Oct 15) (Oct 15) Public health impact of tobacco product and advertising   Public health impact of tobacco product and advertising regulation in the United States (Nov 22) regulation in the United States (Nov 22) Polio vaccine effectiveness in India – implications for polio   Polio vaccine effectiveness in India – implications for polio eradication (Dec 17) eradication (Dec 17) Food safety (January 21)   Food safety (January 21) Getting to Zero Traffic-Related Deaths Getting to Zero Traffic-Related Deaths National Center for Injury Prevention and Control National Center for Injury Prevention and Control 2

yxvutsrponmlkjihgfedcbaWVUTSRPNMIHGECBA Outline Outline   Presentation: Grant Baldwin, PhD, MPH and Presentation: Grant Baldwin, PhD, MPH and Ann Dellinger, PhD: Applying What Works: Ann Dellinger, PhD: Applying What Works: Promoting Evidence-based Motor Vehicle Promoting Evidence-based Motor Vehicle Interventions Interventions   Focused discussion: David Sleet, PhD: Global Focused discussion: David Sleet, PhD: Global Road Traffic Safety: The United States in Context Road Traffic Safety: The United States in Context   Partner perspective: Justin McNaull, Director, Partner perspective: Justin McNaull, Director, State Relations, AAA: The Roles and State Relations, AAA: The Roles and Experiences of Stakeholders in Influencing Experiences of Stakeholders in Influencing Motor Vehicle Policies Motor Vehicle Policies   Focused discussion: Barron H. Lerner, MD, PhD: Focused discussion: Barron H. Lerner, MD, PhD: Historical Barriers to Traffic Safety Historical Barriers to Traffic Safety 10 Leading Causes of Death by Age Group, 10 Leading Causes of Death by Age Group, United States, 2006 United States, 2006 3

Years of Potential Life Lost before Age 65: Years of Potential Life Lost before Age 65: Top 10 Causes of Death and Motor Vehicle Top 10 Causes of Death and Motor Vehicle Deaths, United States, 2006 Deaths, United States, 2006 0 1,000,000 2,000,000 3,000,000 All Injury (excluding Motor Vehicle) Malignant Neoplasms Heart Disease Motor Vehicle Perinatal Period Congenital Anomalies Cerebrovascular Liver Disease HIV Diabetes Mellitus Chronic Lower Respiratory Disease Years Potential Life Lost Source: CDC, NCIPC, Office of Statistics and Programming, WISQARS. Data Source: CDC, NCHS, National Vital Statistics System. Economic Costs of Motor Vehicle Death Economic Costs of Motor Vehicle Death and Injuries and Injuries Percentage Percentage Costs Percentage Deaths of Deaths Injuries of Injuries (in millions) of Costs ROAD USER TYPE MV Occupant 33,230 73.8% 2,790,567 75.8% 70,083 70.6% Motorcyclist 4,550 10.1% 237,689 6.5% 11,945 12.0% Pedalcyclist 1,006 2.2% 474,355 12.9% 5,488 5.5% Pedestrian 6,056 13.4% 167,029 4.5% 10,310 10.4% MV Unspecified 187 0.4% 13,104 0.4% 1,493 1.5% Total 45,029 3,682,744 99,318 AGE Kids (0-14) 2,147 4.8% 512,975 13.9% 7,352 7.4% Teens (15-19) 4,904 10.9% 530,008 14.4% 13,628 13.7% Adults (20-64) 30,670 68.1% 2,441,527 66.3% 75,087 75.6% Older Adults (65+) 7,308 16.2% 198,234 5.4% 3,251 3.3% Total 45,029 3,682,744 99,318 Source: Naumann et al., 2009 Unpublished - 4

Percentage of Motor Vehicle Fatalities Percentage of Motor Vehicle Fatalities Involving Key Risk Factors, 2007 ors, 2007 Involving Key Risk Fact 60 54 50 40 Percent 32 31 30 20 7 10 0 t l g e l o e e n h B i r o d h c e T t a l e A e l p l S A S o N Source: NHTSA – Traffic Safety Facts - 2007 Percentage of Popul ge of Population/Licensed Drivers/ ation/Licensed Drivers/ Percenta Registered Vehicles vs. Pe Registered Vehicles vs. P ercentage of rcentage of Motor Vehicle Fatalities by Risk Factor, 2007 Motor Vehicle Fatalities by Risk Factor, 2007 60 57 50 40 Percent 30 23 20 13 13 10 6.4 3 0 Percent of Percent of Percent of Percent of Licensed Drivers Population Percent of Percent of Fatalities Fatalities Fatalities Registered Drivers Rural Teenagers Motorcyclists Source: NHTSA – Traffic Safety Facts - 2007 5

Motor Vehicle Death Rates by State, 2006 Motor Vehicle Death Rates by State, 2006  7 fold variation in rates  7 fold variation in rates 35  States with lowest rates tend to have  States with lowest rates tend to have Age-adjusted Rate per 100,000 30 stronger laws, but the relationship is not stronger laws, but the relationship is not that simple that simple 25 20 15 10 5 0 R H Y L R M C D A V N Y K Z D C A L O D V S X E N E A N T I K D A O A I N A L T H J Y I A . S T T W A H M I R C W A A W K O A N F N N K D N U O A O W C N N N M M N S S L T I G M T I I M V M P V C C M I M . D State State Source: CDC, NCIPC, Office of Statistics and Programming, WISQARS. Data Source: CDC, NCHS, National Vital Statistics System. Fatalities and Fatality Rates per 100 Million Fatalities and Fatality Rates per 100 Million Vehicle Miles Traveled from 1961-2008 Vehicle Miles Traveled from 1961-2008 MV Safety Act MV Safe ty Act BAC Law BAC Law 0.10 to 0.08 0.10 to 0.08 55 mph 55 mph Speed Limit Speed Limit Seat Belt Seat Belt Laws Laws 6

Domains Important for Motor Vehicle Safety Domains Important for Motor Vehicle Safety Roads Roads Vehicles Vehicles Infrastructure Infrastructure People People Focus on People Focus on People  High risk groups  High risk groups  Safety device use  Safety device use  Risk factors  Risk factors  Policy  Policy 7

Teenage Drivers: Risk Factors Teenage Drivers: Risk Factors  Inexperience  Inexperience  Immaturity  Immaturity  Teenage passengers  Teenage passengers Benefits of Driving Experience Benefits of Driving Experience Crash Rates by Months of Licensure Crash Rates by Months of Licensure Crashes per 10,000 Novice Drivers Crashes per 10,000 Novice Drivers In the first 6 months, newly licensed drivers In the first 6 months, newly licensed drivers are 8 times more likely to be involved in fatal are 8 times more likely to be involved in fatal crashes than more experienced drivers. crashes than more experienced drivers. Months of Licensure Months of Licensure Source: Mayhew, 2003 8

Male Driver Crash Rates per Licensed Driver During Male Driver Crash Rates per Licensed Driver During 1 - 4 Years of Licensure by Driver Age, Ontario 1 - 4 Years of Licensure by Driver Age, Ontario Source: Mayhew and Simpson, unpublished Crash Rates by Driver Age and Passenger Crash Rates by Driver Age and Passenger Presence - per 10,000 Trips Presence - per 10,000 Trips 6 5 Rate 4 3 2 1 0 1 1 2 3+ 0 2 3+ 2 3+ 0 1 Ages 18-19 Ages 30 59 - Ages 16-17 Number of Passengers Source: Insurance Institute for Highway Safety 9

Risks for Everyone, but Greater for Teens Risks for Everyone, but Greater for Teens  Non-use safety belts  Non-use safety belts  Speed  Speed  Night-time driving  Night-time driving  Distraction  Distraction  Alcohol  Alcohol  Fatigue  Fatigue Seat Belt Use by Age Seat Belt Use by Age 100% 2007 2008 88% 90% 84% 84% Seat Belt Use 83% 83% 82% 80% 80% 77% 70% 60% 50% 8 15 - 16 24 - 25-69 70+ Age Group Source: NHTSA (2009) 10

Speeding Drivers in Fatal Crashes Speeding Drivers in Fatal Crashes 45 40 35 Males Females 30 25 Percent 20 15 - zyxwvutsrponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA 10 5 0 15-20 21-24 25-34 35 44 - 45-54 55 64 65-74 75+ Age Group Source: NHTSA (2008) Fatal Crashes per 100 Million Miles Fatal Crashes per 100 Million Miles Day y v vs s. Night, by . Night, by Driver Age Driver Age Da 30 Fatal Crashes per 100 M Miles 25 20 day 15 night 10 5 0 6 7 8 9 - - - - - - - - - - + 0 5 0 5 0 5 0 5 0 5 1 1 1 1 0 2 2 3 3 4 4 5 5 6 6 7 Age Group Source: Insurance Institute for Highway Safety 11