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Choice of denominator to measure disparities in motor vehicle crash deaths of teens and young adults

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Analyzed MVC death data in NC for ages 16-24 for a 5-year period, 2000-2004 ... Accuracy of reporting race/ethnicity in death records. ... – PowerPoint PPT presentation

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Title: Choice of denominator to measure disparities in motor vehicle crash deaths of teens and young adults


1
Choice of denominator to measure disparities in
motor vehicle crash deaths of teens and young
adults
  • Christopher J. Mansfield, PhD
  • Satomi Imai, PhD
  • East Carolina University
  • Greenville, NC
  • 134th Annual APHA Meeting
  • November 4-8, 2006
  • Presenter

2
Objectives
  • Examine regional, racial/ethnic, and gender
    disparities in motor vehicle crash deaths for
    teens and young adults in North Carolina.
  • Compare motor vehicle crash (MVC) mortality rates
    for the young drivers using two measures - per
    population and per licensed drivers
  • Identify vulnerable populations to whom
    interventions should be targeted for motor
    vehicle crash deaths

3
Acknowledgement
  • Center for Highway Research, UNC Chapel Hill for
    data on the number of young licensed drivers in
    NC.

4
Background
  • Over the past 5 years, 24 of drivers and 30 of
    passengers who died in motor vehicle crushes in
    NC were ages 16-24. The number of deaths is
    highly disproportionate considering this age
    group represents 12 of the total population.
  • Mortality rates due to MVC for ages, 16-24, have
    increased since 2000 in NC despite the enactment
    of graduated licensing law.
  • Healthy People 2010 and Healthy Carolinians 2010
    have not identified disparities as specific
    problems to be addressed for young deaths by MVC.

5
  • Typically, MVC mortality rates are expressed as
    deaths per population (e.g., Healthy People
    2010).
  • However, risks for fatal crashes may differ
    according to age, race/ethnicity, and region for
    young population because of varied exposure to
    motor vehicles.
  • Age Teens (15-19) drive fewer miles than 20-24
    yr olds, who drive fewer miles than 25-54 yr
    olds.
  • Race African Americans drive less than whites
  • (2001 National Household Travel Survey)

6
  • Miles or hours driven is an appropriate
    denominator to examine MVC mortality risk for
    young drivers.
  • 19 year-olds had a highest MVC mortality rate per
    population, but
  • 16 year-olds MVC mortality rate per 100 million
    vehicle miles traveled was 1.4 times higher than
    18 yr olds and 2.2 times higher than 20-24 yr
    olds.
  • (Fatality facts 2004, Insurance Institute for
    Highway Safety)
  • However, data on miles driven at the state/county
    level by race/ethnicity are not available.
  • An alternative The number of licensed drivers
    for the denominator.

7
  • We suspect that disparities by race/ethnicity
    exist but are underestimated by conventional
    definition of mortality rate.
  • We compare here the difference in young adult MVC
    mortality rates calculated per population to
    rates per licensed drivers in NC by
    race/ethnicity, region, and gender.

8
Methods
  • Analyzed MVC death data in NC for ages 16-24 for
    a 5-year period, 2000-2004
  • from the North Carolina State Center for Health
    Statistics
  • MVC mortality rates
  • Per 100,000 population
  • from the National Center for Health Statistics
  • Per 100,000 NC licensed drivers
  • from the UNC Highway Safety Research Center

9
  • We looked at MVC mortality rates for young
    drivers in NC by
  • Race/Ethnicity Whites, African Americans, Native
    Americans, and Hispanics
  • 41 Eastern Counties
  • Gender Male vs. Female

10
Results
11
(No Transcript)
12
  • MVC mortality rates
  • per population vs. per licensed drivers

13
  • MVC mortality rates per population
  • Peak at age 19, then gradual decline to age 24.
  • MVC mortality rates per licensed drivers
  • Highest at 16 yrs old, drop at age 17, gradual
    decline to age 24.
  • The use of mortality rates per population
    underestimates the MVC death risks for teen
    drivers

14
  • Racial/ethnic disparities assessed by different
    mortality rate definitions

15
Substantial differences, particularly for Native
Americans.
16
Disparities are much more substantial when
measured by the licensed driver rate
17
When using Licensed Drivers as the denominator,
for 17 year olds, disparity ratio compared to
Whites changes Native Americans from
3.51 to 8.11 Hispanics from 0.81 to
5.51 African-American from 0.51 to
1.31
18
  • Regional disparity
  • Eastern NC vs. the rest of the state

19
Regional disparity
20
(No Transcript)
21
  • Eastern NC has much higher MVC mortality rates
    than the rest of the state.
  • Minority drivers in eastern NC are particularly
    vulnerable to MVC deaths.
  • MVC mortality rates for Native American and
    Hispanic drivers in eastern NC were more than two
    times higher than white drivers in the same
    region.

22
Gender disparity
  • 2.7 times more males (1256) died of MVC than
    females (470) in NC, 2000-2004.
  • Males and females have similar rates of obtaining
    a drivers license, thus gender disparity is
    comparable between mortality rates per population
    and per licensed driver.

23
  • Yearly trend
  • 2000-2004

24
  • Since 2000, MVC crash mortality rates of young
    drivers in NC have increased each year regardless
    of the denominator used.
  • 2004 marked the highest mortality rate per
    licensed drivers in the past 5 years, 45
    increase from 2000 in eastern NC and 24 increase
    from 2000 in NC.
  • MVC mortality rates for teen drivers, especially
    16 yr old drivers, have been increasing since
    2000.

25
Teen drivers mortality rates increased radically
from 2000 to 2004 (80 increase).
26
Limitations
  • Caution is needed for the interpretation of
    results in this presentation.
  • The data might not be reliable due to the small
    number of deaths among Native American and
    Hispanic drivers.
  • Accuracy of reporting race/ethnicity in death
    records.
  • Accuracy of population estimates for minority
    populations, especially Hispanics.

27
Conclusions
  • MVC mortality rates per licensed drivers for
    young drivers show wider disparities by
    race/ethnicity and region than those per
    population.
  • MVC death risk for teen and minority drivers is
    underestimated by the use of mortality rate per
    population.

28
  • In particular, 16 year-old drivers, and young
    Native American and Hispanic drivers had
    tragically high rates for MVC deaths. Young
    African American drivers had a similar MVC
    mortality rate to young white drivers when
    licensed drivers were used as the denominator.
  • Despite the enactment of the graduated licensing
    law, the mortality rate for 16 year old drivers
    has increased.

29
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