Older Motor Vehicle Drivers Involved in Injury Crashes in
San Diego County
Barbara M. Stepanski, MPH Leslie Upledger Ray, MA, MPPA
Patti Murrin, RN, MPHAlan M. Smith, MPH, PhD(C)
County of San Diego Health and Human Services Agency, Division of Emergency Medical Services
County of San Diego Division of Emergency Medical Services
EMS
Problem: Elderly Drivers
• Concerns– Physical limitations
– Possibly higher crash rates
– More severe injuries due to fragility of aging bodies
• Proposed license restrictions– Reverse graduated licensing
County of San Diego Division of Emergency Medical Services
EMS
Population
• Nationally, 70+ age group increased 2.1 times faster than the total population from 1989 to 1998
• Locally, the population over 55 is expected to more than double by 2020
• The number of drivers and collisions are expected to increase proportionally
County of San Diego Division of Emergency Medical Services
EMS
Research Questions
• What is the crash rate in elderly?– Compared with other age groups– Severity
• What factors contribute to crashes involving elderly drivers?
• What impact do older drivers have on the overall population?
County of San Diego Division of Emergency Medical Services
EMS
Data Sources• Statewide Integrated Traffic Records System
(SWITRS), FY 99/00
• San Diego County Emergency Medical Services (EMS) Prehospital Database, FY 99/00
• Department of Motor Vehicles (DMV) Drivers License Information
County of San Diego Division of Emergency Medical Services
EMS
Data ExaminedPrehospital
– Age groups
– Gender
– Ethnicity
– Restraints
– Hour
– Paramedic Run Outcome
SWITRS– Incident Location
– Fault
County of San Diego Division of Emergency Medical Services
EMS
Licensed Drivers by Age
0
100
200
300
400
500
16-19 20-24 25-34 35-44 45-54 55-64 65-74 75-84 85+
Lic
ense
d D
rive
rs (
x 10
00)
Source: California Department of Motor Vehicles, DL information report 01/01/00
County of San Diego Division of Emergency Medical Services
EMS
Percent Licensed by Age
45.80%
85.17%77.08%
69.92%
31.23%
73.01%
95.30%93.17%90.59%
0%
20%
40%
60%
80%
100%
16-19 20-24 25-34 35-44 45-54 55-64 65-74 75-84 85+
Source: California Department of Motor Vehicles, SANDAG population estimates, January 2000
County of San Diego Division of Emergency Medical Services
EMS
Prehospital Responses:Motor Vehicle Drivers
• 8800 Emergency Patients
• 1372 Age 55 and Older (15.6%)– 49% Male– 74% White (when known)– Time: 11a.m. – 4 p.m.
County of San Diego Division of Emergency Medical Services
EMS
Prehospital Prehospital Responses to Motor
Vehicle Drivers, by Age
10941385
19861697
1188
579393 315
850
500
1000
1500
2000
2500
15-19 20-24 25-34 35-44 45-54 55-64 65-74 75-84 85+
Age Group
Num
ber
of P
atie
nts
Source: County of San Diego, Health and Human Services Agency Division of Emergency Medical Services; Prehospital Database, FY 9900
County of San Diego Division of Emergency Medical Services
EMS
Prehospital Response Rate per 100,000 Population, by Age
360 331274
191257
224
450
619
689
0
100
200
300
400
500
600
700
800
16-19 20-24 25-34 35-44 45-54 55-64 65-74 75-84 85+
Rat
e pe
r 10
0,00
0
Prehospital patients / Population X 100,000
Source: County of San Diego, Health and Human Services Agency Division of Emergency Medical Services; Prehospital Database, FY 99/00
County of San Diego Division of Emergency Medical Services
EMS
Prehospital Response Rate per 100,000 Licensed Drivers, by Age
MV Drivers
386 347 375
612
302 291
497
885
1505
0
200
400
600
800
1000
1200
1400
1600
16-19 20-24 25-34 35-44 45-54 55-64 65-74 75-84 85+
Rat
e pe
r 10
0,00
0
prehospital patients / # licensed drivers X 100,000
Source: County of San Diego, Health and Human Services Agency Division of Emergency Medical Services; Prehospital Database, FY 9900
County of San Diego Division of Emergency Medical Services
EMS
Gender by Age Group
49% 47% 50%
61%
51% 53% 50%
39%
0%
10%
20%
30%
40%
50%
60%
70%
55-64 65-74 75-84 85+
Male Female
Source: County of San Diego, Health and Human Services Agency Division of Emergency Medical Services; Prehospital Database, FY 9900.
County of San Diego Division of Emergency Medical Services
EMS
Race/Ethnicity of Drivers Seen by Prehospital Personnel:
55 years and upPatients
White74%
Black5%
Hisp10%
Asian/Other11%
Note:194 (14%) had unknown race/ethnicity.
Population
White76%
Black3%
Hisp13%
Asian/Other
8%
Source: County of San Diego, Health and Human Services Agency Division of Emergency Medical Services; Prehospital Database, FY 9900; SANDAG Population Estimates, January 2000.
County of San Diego Division of Emergency Medical Services
EMS
Hour Call Received, Patients 55 Years and Older, Monday - Friday
0
20
40
60
80
100
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
Hour
Source: County of San Diego, Health and Human Services Agency Division of Emergency Medical Services; Prehospital Database, FY 9900.
County of San Diego Division of Emergency Medical Services
EMS
Hour Call Received by Age Group of Victim, Monday - Friday
0
100
200
300
400
500
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
<55 Years 55 and Older
Source: County of San Diego, Health and Human Services Agency Division of Emergency Medical Services; Prehospital Database, FY 9900.
County of San Diego Division of Emergency Medical Services
EMS
Percent of Injured Drivers in Moderate or Acute Status by Age
0%
4%
8%
12%
16%
20%
15-1
920
-24
25-3
435
-44
45-5
455
-64
65-7
475
-84
85+
Moderate
Acute
Source: County of San Diego, Health and Human Services Agency Division of Emergency Medical Services; Prehospital Database, FY 96/97
Per
cent
County of San Diego Division of Emergency Medical Services
EMS
Restraint Use - Drivers 55 and Over
Active Restraint
86%
Passive Only2%
Unrestrained4%
Unknown8%
Source: County of San Diego, Health and Human Services Agency Division of Emergency Medical Services; Prehospital Database, FY 99/00
County of San Diego Division of Emergency Medical Services
EMS
Percent of Drivers Unrestrained, by Age
5.12%
7.43%
5.80%
4.41%3.79% 3.44% 3.73%
3.33%
8.33%
0%
1%
2%
3%
4%
5%
6%
7%
8%
9%
15-19 20-24 25-34 35-44 45-54 55-64 65-74 75-84 85+
Source: County of San Diego, Health and Human Services Agency Division of Emergency Medical Services; Prehospital Database, FY 99/00
County of San Diego Division of Emergency Medical Services
EMS
SWITRS
Percent of Drivers at Fault by Age*
51%
41%37% 36% 36%
44%
59%63%59%
0%
10%
20%
30%
40%
50%
60%
70%
15-19 20-24 25-34 35-44 45-54 55-64 65-74 75-84 85+
Source: SWITRS Database, FY 99/00
*Drivers at fault/Drivers in injury collisions
%
County of San Diego Division of Emergency Medical Services
EMS
SWITRS
Rate (per Licensed Drivers) of At-Fault Collision by Age*
2396
1379
671494 412 358 365
532821
0
500
1000
1500
2000
2500
3000
15-19 20-24 25-34 35-44 45-54 55-64 65-74 75-84 85+
Age Group
Rat
e p
er 1
00,0
00
Source: SWITRS Database, FY 99/00
*Drivers at fault/Licensed drivers
County of San Diego Division of Emergency Medical Services
EMS
SWITRS
Road Type by Age of Driver at Fault
70%60% 65% 67% 66% 70% 75% 77% 78%
30%40% 35% 33% 34% 30% 25% 23% 22%
0%
20%
40%
60%
80%
100%
15-19 20-24 25-34 35-44 45-54 55-64 65-74 75-84 85+
Age Group
Side Street Highway/Freeway
Source: SWITRS Database, FY 99/00
County of San Diego Division of Emergency Medical Services
EMS
Violation Category by Age of Driver at Fault
11%13%
4%
34% 32%
25%
17%13% 14%
16% 16%
29%
8% 8%11%
0%
10%
20%
30%
40%
15-24 25-54 55+
DUI Alcohol/Drugs Unsafe Speed
Improper Turning Auto Right-of-Way
Traffic Signals and Signs
Source: SWITRS Database, FY 99/00
County of San Diego Division of Emergency Medical Services
EMS
Leading Violation Categories by Age
0%
10%
20%
30%
40%
15 to
19
20 to
24
25 to
34
35 to
44
45 to
54
55 to
64
65 to
74
75 to
84
85 a
nd old
er
Auto Right of Way
Unsafe Speed
Improper Turning
Traffic Signals/Signs
DUI
Source: SWITRS Database, FY 99/00
County of San Diego Division of Emergency Medical Services
EMS
Collision Type by Age of Driver at Fault
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
15-24 25-54 55+
Head-on
Sideswipe
Rear-end
Broadside
Hit Object
Overturned
Auto/Pedestrian
Other
Source: SWITRS Database, FY 99/00
County of San Diego Division of Emergency Medical Services
EMS
Conclusions• Crash rates and at-fault rates are lower in seniors
than previously thought
• Crash rates of 55-64 and 65-74 are comparable to middle-aged drivers
• Highest crash and fault rates in youngest drivers (16-24)
• Percent at fault comparable to 16-24 year-olds
• Crashes– Side streets– More in the middle of the day (younger: rush hours)– Violation: auto right of way– Collision type: broadside
County of San Diego Division of Emergency Medical Services
EMS
Conclusions (cont.)
• Results question the proposed restrictions on elderly drivers, which may be detrimental to their independence
• Results support the need to focus safe driving interventions on young drivers
County of San Diego Division of Emergency Medical Services
EMS
Acknowledgments
• San Diego Paramedics/EMTs, Prehospital Agencies and Hospitals
• SANDAG
• San Diego County Law Enforcement Agencies
County of San Diego Division of Emergency Medical Services
EMS
Contact Information
Alan M. SmithCounty of San Diego
Health and Human Services AgencyEmergency Medical Services
6255 Mission Gorge RoadSan Diego, CA 92120 (619) 285-6429 phone
(619) 285-6531 [email protected]