Risky youth to risky adults: Sustained increased risk of crash in the DRIVE study 13 years on.

The objective of this study was to investigate if drivers who exhibit risky driving behaviours during youth (aged 17-24 years) have an increased risk of car crash up to 13 years later. We used data from the DRIVE study, a 2003/04 survey of 20,806 young novice drivers in New South Wales, Australia. The data were linked with police crash, hospital and deaths data up to 2016. We analysed differences in crash associated with 13 items of risky driving behaviours using negative binominal regression models adjusted for driver demographics, driving exposure and known crash risk factors. The items were summarised in one index and grouped into quintiles for the analysis. After adjusting for confounding, drivers of the third (RR 1.16, 95% CI 1.05-1.30), fourth (RR1.22, 95% CI1.09-1.36) and fifth quintile (RR 1.36, 95% CI 1.21-1.53) had higher crash rates compared to the lowest risk-takers. Drivers with the highest scores on the risky driving measure had higher rates of crash related hospital admission or death (RR 1.92, 95% CI 1.13-3.27), crashes in wet conditions (RR 1.35,95% CI 1.05-1.73), crashes in darkness (RR 1.55, 95% CI 1.25-1.93) and head-on crashes (RR 2.14, 95% CI 1.07-4.28), compared with drivers with the lowest scores. Novice adolescent drivers who reported high levels of risky driving when they first obtained a driver licence remained at increased risk of crash well into adulthood. Measures that successfully reduce early risky driving, have the potential to substantially reduce road crashes and transport related injuries and deaths over the lifespan

Are there sex differences in crash and crash-related injury between men and women? A 13-year cohort study of young drivers in Australia

BackgroundYoung men have long been known to be disproportionately impacted by road crash and crash-related injury compared to young women and older drivers. However, there is limited insight into how sex differences in crash and crash-related injury changes over time as men and women get older and gain more driving experience. To explore sex differences in crash and crash-related injury, we undertook a sex disaggregated analysis in a large longitudinal cohort of over 20,000 young drivers in New South Wales, Australia, for up to 13 years after they first attained their independent car driver licence.MethodsDRIVE Study survey data from 2003-04 were linked with police, hospital and deaths data up to 2016. Sex differences were analysed using cumulative incidence curves investigating time to first crash and in negative binominal regression models adjusted for driver demographics and crash risk factors.ResultsAfter adjusting for demographics and driving exposure, compared with women, men had 1.25 (95% CI 1.18-1.33), 2.07 (1.75-2.45), 1.28 (95% CI 1.13-1.46), 1.32 (95% CI 1.17-1.50) and 1.59 (95% CI 1.43-1.78) times higher rates of any crash, single vehicle crash, crash on streets with a speed limit of 80 km/h or above, crash in wet conditions and crash in the dark, respectively. By contrast, men were less likely to be involved in crashes that resulted in hospitalisation compared to women 0.73 (95% CI 0.55-0.96).ConclusionsYoung men are at increased risk of crash, and this risk persists as they get older and gain more driving experience. Despite lower risk of crash, women are at higher risk of crash related injury requiring hospitalisation. These differences in men's and women's risk of crash and injury signal the need for better understanding of how sex and/or gender may contribute to risk of crash and injury across the life-course

The road beyond licensing: the impact of a driver licensing support program on employment outcomes for Aboriginal and Torres Strait Islander Australians

Background: With increasingly tough graduated driver licensing laws in all Australian States and Territories, driver licensing support programs are recognised as being important to support Aboriginal and Torres Strait Islander peoples to obtain a driver licence. Such programs appear to improve licensing attainment rates, but few studies have examined the broader impact that these programs can have. This research aims to 1) examine the impact of a New South Wales (NSW) based driver licensing support program (Driving Change) on client employment outcomes; 2) assess the influence of geographical area of program delivery on driver licence attainment. Methods: Driving Change was delivered from February 2013 to August 2016 in 4 urban and 7 regional Aboriginal communities of NSW. Clients were followed-up at 6 months or more following contact with the program as part of routine program operations. Descriptive statistics and regression models were used to analyse data. Results: From 933 clients contacted 254 agreed to provide feedback, a response rate of 27%. Those that responded were mostly female (57%), aged 24 years and under (72%), unemployed (85%) with secondary education or less (71%) and from a regional area (74%). Adjusted logistic regression indicated that clients who achieved an independent licence were more likely (OR: 2.5, 95% CI: 1.22–5.24, p = 0.011) of reporting a new job or change in job than those who did not attain a licence. Clients from regional areas were more likely (OR: 1.72, 95% CI: 1.27–2.33, p < 0.001) to gain an independent licence than those from urban areas. There was no difference in employment outcomes (OR: 1.2, 95% CI: 0.53–2.52, p = 0.719) for clients from urban compared to regional areas. Conclusion: The Driving Change program appears to be effective in improving employment outcomes for those who gained a licence. Clients from regional areas were more likely to gain a licence compared to those in urban settings, and were predominantly young and unemployed, often a hard to reach cohort. Future licensing programs being delivered in regional areas need integrated pathways into employment opportunities to provide holistic services that address the social and economic challenges faced by Aboriginal and Torres Strait Islander Australians

The road beyond licensing: the impact of a driver licensing support program on employment outcomes for Aboriginal and Torres Strait Islander Australians.

Background With increasingly tough graduated driver licensing laws in all Australian States and Territories, driver licensing support programs are recognised as being important to support Aboriginal and Torres Strait Islander peoples to obtain a driver licence. Such programs appear to improve licensing attainment rates, but few studies have examined the broader impact that these programs can have. This research aims to 1) examine the impact of a New South Wales (NSW) based driver licensing support program (Driving Change) on client employment outcomes; 2) assess the influence of geographical area of program delivery on driver licence attainment. Methods Driving Change was delivered from February 2013 to August 2016 in 4 urban and 7 regional Aboriginal communities of NSW. Clients were followed-up at 6 months or more following contact with the program as part of routine program operations. Descriptive statistics and regression models were used to analyse data. Results From 933 clients contacted 254 agreed to provide feedback, a response rate of 27%. Those that responded were mostly female (57%), aged 24 years and under (72%), unemployed (85%) with secondary education or less (71%) and from a regional area (74%). Adjusted logistic regression indicated that clients who achieved an independent licence were more likely (OR: 2.5, 95% CI: 1.22–5.24, p = 0.011) of reporting a new job or change in job than those who did not attain a licence. Clients from regional areas were more likely (OR: 1.72, 95% CI: 1.27–2.33, p < 0.001) to gain an independent licence than those from urban areas. There was no difference in employment outcomes (OR: 1.2, 95% CI: 0.53–2.52, p = 0.719) for clients from urban compared to regional areas. Conclusion The Driving Change program appears to be effective in improving employment outcomes for those who gained a licence. Clients from regional areas were more likely to gain a licence compared to those in urban settings, and were predominantly young and unemployed, often a hard to reach cohort. Future licensing programs being delivered in regional areas need integrated pathways into employment opportunities to provide holistic services that address the social and economic challenges faced by Aboriginal and Torres Strait Islander Australians

Acculturation and risk of traffic crashes in young Asian-born Australian drivers

The study examines changes over time in crash risk differences between young Australian drivers born in Asia and those born in Australia. Data from the 2003 baseline survey of the DRIVE cohort of 20 806 young drivers aged 17-24 years were linked to police, hospital and death data up until 2016. The association between country of birth and crash was investigated using flexible parametric survival models adjusted for confounders. Six months after baseline, the crash risk in Asian-born drivers was less than half that of their Australian-born counterparts (mean HR, MHR 0.41; 95% CI 0.29 to 0.57), only to increase steadily over time to resemble that of Australian-born drivers 13 years later (MHR 0.94; 95% CI 0.66 to 1.36). This is likely to be associated with acculturation and the adoption by young Asian-born Australian drivers of driving behaviour patterns akin to those born locally. This needs to be considered in future road safety campaigns

Reducing young driver road trauma: guidance and optimism for the future

This paper highlights lessons from each of the Expert Panel papers in the present supplement that provide guidance for future research and initiatives. Although some shortfalls still remain in our understanding, it is argued that much has been learned and we are ready for more translation, implementation, and evaluation of multilevel interventions to help reduce young driver road trauma. Non‐use of restraints, speeding, driving at night and with passengers, and fatigue are highlighted as key risk factors to address. “Best practice” intervention is proposed as implementing and strengthening graduated driver licensing systems and complementary candidate programs and research, such as hazard perception training programs. A schematic cognitive‐perceptual model to explain the crash sequence process is explored. There is optimism that meaningful impacts can be made, especially coupled with the advances in vehicle technologies, but caution is necessary in the absence of targeted “real world” evaluations and broader implementation and diffusion strategies

Restraint use and injury patterns of young drivers and passengers admitted to hospitals in new South Wales, Australia

AUSns aged 17 to 25 years who travel in cars have a high risk of death and injury in crashes despite mandatory seat belt laws, graduated licensing programs for young drivers, and stringent enforcement. This analysis examined characteristics and injury outcomes of occupants aged 17 to 25 years injured in crashes in New South Wales, AUS. The study focused on restraint use. A linked hospital and police record data set for car occupants admitted to hospitals between 2005 and 2007 was used. Descriptive techniques were used to compare the characteristics of injured occupants of ages 17 to 25 years with those of older occupants and logistic regression was used to test the associations. Only 87% of injured young adults were wearing seat belts. Young adults were more likely than were their older counterparts to be in severe crashes, crashes that involved loss of control, crashes that involved single and older vehicles, and crashes when they were seated in the rear. Young adults also had more head, abdominal or lower torso, and neck injuries and fewer thoracic injuries than did older occupants. Young females were more likely to have been in newer vehicles and less likely to have been in more severe crashes than were young males. Young females also had fewer head injuries and more abdominal or lower torso injuries than young males had. Greater effort is required to increase the use of restraints and modern vehicles among young adults, to encourage industry to improve rear passenger protection, and to increase understanding of the factors that underpin the high involvement of young people in single-vehicle and loss-of-control crashes