Older Adults, New Mobility, and Automated Vehicles

58 pagesThe premise that autonomous vehicles will address older adults’ immobility is not a given. As argued in the Public Policy Institute’s publication Universal Mobility-as-a-Service, public- and private-sector actors need to come together to create a set of supportive circumstances that enable us to harness emerging technology for individual and societal benefit. This paper and associated framework lays out the myriad and interconnected factors that all stakeholders in this space should be thinking about so that the promise of autonomous vehicles and new shared-use mobility opportunities can be realized. The framework can be used as a checklist of design considerations for AV pilot testing, and it also may inform research and development programs. Moreover, it can provide an easy-to-consult reference for policymakers as they define roles and responsibilities among public- and privatesector actors whose actions can enable equitable access—or result in greater inequity. This research reveals a perennial flaw in our technology adoption process, at least in the mobility arena: the current default of designing for a broad clientele of mobile individuals is insufficient. The framework identified in this report is an important but only preliminary step to ensuring that the needs of harder-to-serve populations, such as frail older adults and people with mobility disabilities, are met. Additional, more tailored activity is needed. AARP looks forward to advancing this work

Building a Credible Case for Safety: Waymo's Approach for the Determination of Absence of Unreasonable Risk

This paper presents an overview of Waymo's approach to building a reliable case for safety - a novel and thorough blueprint for use by any company building fully autonomous driving systems. A safety case for fully autonomous operations is a formal way to explain how a company determines that an AV system is safe enough to be deployed on public roads without a human driver, and it includes evidence to support that determination. It involves an explanation of the system, the methodologies used to develop it, the metrics used to validate it and the actual results of validation tests. Yet, in order to develop a worthwhile safety case, it is first important to understand what makes one credible and well crafted, and align on evaluation criteria. This paper helps enabling such alignment by providing foundational thinking into not only how a system is determined to be ready for deployment but also into justifying that the set of acceptance criteria employed in such determination is sufficient and that their evaluation (and associated methods) is credible. The publication is structured around three complementary perspectives on safety that build upon content published by Waymo since 2020: a layered approach to safety; a dynamic approach to safety; and a credible approach to safety. The proposed approach is methodology-agnostic, so that anyone in the space could employ portions or all of it

Older Adult Injury Risk Assessment in the Driving and Occupational Environments

Thesis (Ph.D.)--University of Washington, 2016-08The United States is experiencing a demographic transition as the population of older adults increases. Many older adults continue to work and drive to support and sustain economic and social health. However, for some, the aging process can be accompanied by declines in cognitive and physical capacity which may increase the risk of a collision or injury. This dissertation examined the association between cognitive and physical function and the risk of motor vehicle collision or occupational injury among older adults. Chapters 2 and 3 explored crash risk associated with cognitive decline and dementia among older drivers. By 2024, 25% of US drivers will be over the age of 65 years. The fatal crash involvement rate among older drivers begins to increase after age 65. Driving simulator and road test studies found lower driving performance associated with lower cognitive function. In chapter 2, we conducted a retrospective cohort study to examine the association between incremental differences in cognition and crash risk among older drivers without dementia. Cognitive function was measured using the Cognitive Abilities Screening Instrument-Item Response Theory (CASI-IRT) score. Older adult participants were drawn from the Group Health Adult Changes in Thought (ACT) Study. ACT records were merged with Washington State crash and licensure records. Eligible participants were age 65 and above and had an active driver's license. We used a generalized estimating equation model with robust standard errors, clustered on the individual. Among ACT study participants, there were 23.4 police-reported crashes per 1000 driver-years. The adjusted incident risk ratio of crash, comparing a higher CASI-IRT score to a score one unit lower was 1.28 (95% CI: 1.08, 1.51). The change in CASI-IRT was not significantly associated with an increase in crash risk. Chapter 3 explored the hazard rate of a crash for older licensed drivers with diagnosed dementia compared to older adults without diagnosis of dementia. This retrospective cohort study used longitudinal clinical and pharmacy records for Group Health members age 65 to 79. Participant records were merged with Washington State police-reported crash records and licensure data from the Washington State Department of Licensing. We assessed the association between diagnosed dementia and crash risk using survival analysis. Dementia was modeled as a time-varying covariate. The overall crash rate was 14.7 per 1,000 driver-years. In a multivariate model, the hazard ratio of crash among those with dementia was 0.56 (95% CI: 0.33, 0.95) relative to older adults without diagnosed dementia. Chapter 4 focused on the association between the physical health of older workers in relation to the job requirements needed for employment and the risk of occupational injury. For this retrospective cohort study, job demands were assessed both objectively (using data derived from an expert panel available through the Occupational Information Network (O*NET)), and subjective assessment of job demand skills as reported by the older worker. Participants were drawn from the Health and Retirement study, a longitudinal national survey composed of biennial interviews age 50 and above. Analyses employed a modified Poisson regression model with robust standard errors, clustered on the individual. Overall, the rate of reporting any injury was 22 per 1000 person-years. Individuals with higher objective or subjective physical job demands were at greater risk of an occupational injury. When physical job demands were high, a mismatch between physical ability and job demands was associated with a two-to-three-fold higher risk of occupational injury

The road to zero a vision for achieving zero roadway deaths by 2050

Imagine that, in 2050, not a single person in the United States dies in a traffic crash. This is the scenario described in this article, in which RAND researchers set forth a vision and strategy for achieving zero roadway deaths by 2050. The authors propose that a combination of three approaches can realize this scenario. The first is doubling down on programs and policies that have already been shown to be effective, including laws and enforcement, changes to roadway infrastructure designed to reduce traffic conflicts, reductions in speeds where crashes are likely, improvements to emergency response and trauma care, and more safety education and outreach. The second is accelerating advanced technology, beginning with advanced driver assistance systems (many of which are already in the market) and progressing up to fully automated vehicles. The third is prioritizing safety, which includes both (1) embracing a new safety culture that will lead Americans to think differently about our individual and collective choices and (2) widespread adoption of the Safe System approach, a paradigm shift in addressing the causes and prevention of roadway deaths and injuries. The authors conclude with a list of actions that key stakeholdersincluding professional engineering and planning organizations, public-sector organizations, safety advocates, vehicle manufacturers, technology developers, public health, emergency medical and trauma care organizations, and law enforcement and judicial system representativescan take to bring about the changes needed to achieve zero roadway deaths by 2050. Document type: Boo

Injury in the Americas: the relative burden and challenge Los traumatismos en las Américas: carga relativa y desafíos

OBJECTIVES: To present evidence to support a higher priority for injury prevention in initiatives, research, and budget allocations. METHODS: Recent data (2000) for deaths from injury, infectious disease, heart disease, and cancer from 11 countries in the Region of the Americas were analyzed. Analyses focused on: first, Potentially Productive Years of Life Lost (PPYLL, discounted) from deaths occurring from 0-64 years of age; second, Years of Potential Life Lost (YPLL) from 1-64 years; and third, Years Lived with Disability (YLD). The burdens of injury and infectious disease were compared to the Pan American Health Organization (PAHO) budget allocations for these areas. RESULTS: There is a clear-cut disparity between funds allocated and the magnitude of injury burden as compared to the burden of infectious disease. CONCLUSIONS: In making decisions on budgetary allocations, the Member States of PAHO must consider the potential impact of injury research and control on the health of their populations.<br>OBJETIVOS: Presentar evidencias que respalden que la prevención de los traumatismos debe ser una prioridad para las iniciativas y la investigación en la Región. MÉTODOS: Se analizaron datos recientes (2000) de las muertes por traumatismos, enfermedades infecciosas, enfermedades cardíacas y cáncer en 11 países de la Región de las Américas. El análisis se centró en: a) años de vida productiva potencial perdidos (descontados) por las muertes ocurridas entre 0 y 64 años de edad; b) años de vida potencial perdidos por las muertes ocurridas entre 1 y 64 años de edad; y c) los componentes principales de las causas externas de muerte. Se compararon las cargas por traumatismos y por enfermedades infecciosas con los presupuestos asignados por la Organización Panamericana de la Salud (OPS) para las áreas correspondientes. RESULTADOS: Se observó una clara discrepancia entre los fondos asignados y la magnitud de la carga por traumatismos, en comparación con la carga por enfermedades infecciosas. CONCLUSIONES: Al decidir las asignaciones presupuestarias, los Países Miembros de la OPS deben tomar en cuenta el impacto potencial de las investigaciones sobre los traumatismos y su control en la salud de sus poblaciones