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Abstract
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BACKGROUND: Motor Vehicle Crashes(MVC) fatalities have been declining while states passed various legislation targeting driver behavior. This study assesses the impact of state laws on MVC fatality rates to determine which laws were effective.
METHODS: Publically available data were collected on driver-related motor vehicle laws, law strengths, enactment years, and numbers of verified-trauma centers. Prospective data on crash characteristics and MVC fatalities ageā„16 from Fatality Analysis Reporting System(FARS) 1999-2015(n=850) was obtained. Generalize Linear Autoregressive Modelling was used to assess the relative contribution of state laws to the crude MVC fatality rate while controlling for other factors.
RESULTS: Lowering the minimum blood alcohol content(BAC) was associated with largest declines for all ages, especially the older cohorts:16-20years(B=0.23[p<0.001]),21-55years(B=1.7[p<0.001]);56-65years(B=3.2[p<0.001]);>65years(B=4.1[p<0.001]). Other DUI laws were also significant. Per se BAC laws accompanying a reduced BAC further contributed to declines in crude fatality rates:21-55years(B=-0.13[p<0.001]);>65years(B=-0.17[p<0.05]). DUI laws enhancing penalties, making revocation automatic, or targeting social hosts had mixed-effects by age. Increased enforcement, mandatory education, vehicle impoundment, interlock devices, and underage alcohol laws showed no association with declining mortality rates. Red-light camera and seat-belt laws were associated with declines in mortality rates for all ages except for>65 years cohort, but speed camera laws had no effect. Graduated Driver License laws were associated with declines for 16-21years(B=-0.06[p<0.001]) only. Laws targeting specific risks(elderly, motorcycles, marijuana) showed no effect on declining MVC mortality rates during the study-period or were enacted too recently(cell phones).
CONCLUSIONS: States have passed a wide variety of laws with varying effectiveness. A few key laws, specifically laws lowering allowable BAC, implementing red light cameras, and mandating seatbelt use significantly reduced MVC mortality rates from 1999-2015. Simply adding more laws/penalties may not equate directly to lives saved. Continued research on state laws will better inform policy makers to meet evolving public health needs in the management of MVC fatalities. LEVEL OF EVIDENCE: Prospective study level III.Prognostic and Epidemiological.
Language: en |