White House Conference on Aging: Policy CommitteeListening Session – Transportation – January 8, 2004

Screening and Assessment for Driver Licensure

presented by

Loren Staplin, Ph.D. TransAnalytics, LLC

TransAnalytics, LLC

BACKGROUND

• As the number and proportion of older persons in the U.S. surges in the decades ahead, the inevitability of age-related losses in visual, physical, and cognitive abilities needed to drive safely will demand more effective countermeasures to avoid a crisis in personal and public safety.

• The frequency of crashes due to age-related impairments will rise… one HHS/NHTSA-sponsored study projects fatalities of >20,000/year by 2030.

• U.S. economic costs for each fatal crash average $997,000; for each critically injured crash survivor the cost is $1.1 million (in 2000 dollars).

• While current policy favors infrastructure solutions, this will become increasingly costly and/or will be insufficient to mitigate crash problems; it also implies that responsibility rests exclusively with government.

• Screening is distinguished from assessment; and, skills from abilities.

White House Conference on Aging — Listening Session: Transportation

TransAnalytics, LLC

IMPORTANT RECENT DEVELOPMENTS

• Research sponsored by NHTSA and NIA has isolated a few functional abilities that are the best predictors of (at-fault) crash risk for seniors.

• Practical, reliable, standardized test procedures to screen drivers on the key crash predictors have been developed and are currently in use.

• Preliminary analyses of a motor vehicle administration’s experience with functional capacity screening indicate that it is both feasible to administer and can be implemented cost effectively. [for a referral pop.]

• The AMA has endorsed the evaluation of older patients’ fitness to drive as an ethical responsibility of physicians, and has issued guidelines to assist them.

• Advocacy groups for seniors, and older persons themselves, express a growing acceptance of steps to ensure driving health/fitness.

White House Conference on Aging — Listening Session: Transportation

POLICY INITIATIVES AND ANTICIPATED BENEFITS

By promoting ‘fitness-to-drive’ screening for license renewal that is:

perceived by the public to be fair (not age biased); reasonably quick and convenient in its application; and cost-effective to implement, either by licensing authorities or credentialed private sector entities, depending on jurisdiction;

The following benefits are projected:

• Injury prevention for the great majority of seniors, due to ‘early warning’ of (mildly) impairing conditions that can be addressed through adaptive and/or remedial activities that actually extend the safe driving years.

• Many fewer drivers with profound functional losses on public roads and highways — making future ‘Santa Monicas’ much less likely.

• A net cost savings to society, if even 10% of fatal and/or serious injury crashes caused by functionally impaired drivers are prevented.

TransAnalytics, LLC

White House Conference on Aging — Listening Session: Transportation