Disparities in motor vehicle crash fatalities of young drivers in North Carolina.
BACKGROUND
Motor vehicle crashes (MVCs) are the leading cause of death for young people, but rates based on the general population do not account for differences in risk across groups as proportions of people driving vary. We examine disparities in MVC death rates for various demographic groups based on numbers of drivers in each group.


METHODS
North Carolina driver license holders 16 through 24 years of age are determined. Fatality rates per population and per licensed driver are calculated and compared by age, gender, race/ethnicity, and region.


RESULTS
Proportions of individuals holding a license vary substantially by age, race/ethnicity, and region. Eighty-three percent of young Whites hold licenses compared to 68% of Hispanics, 55% of African Americans, and 52% of Native Americans. Substantial disparities in fatality by race/ethnicity and age exist using a rate per licensed driver. In younger age groups, fatality rates per licensed drivers are much greater than rates per population: 300%, 200%, 50%, and 25% greater for 16, 17, 18, and 19-year-olds, respectively. African Americans have the lowest fatality rate per population, but their rate per driver is equal to that of Whites. The rate for Native Americans is 2.2 times greater than Whites; for Hispanics, 1.5 times greater. Disparities are 20%-60% greater when rates per driver are used.


CONCLUSIONS
Potential misspecification of race and ethnicity in records, inability to count unlicensed drivers, and exclusion of those with learner's permits may unequally bias rates across subgroups.


CONCLUSIONS
Significant disparities are revealed using a rate based on number of drivers. Policy makers and physicians should tailor prevention efforts accordingly.
Imai
Satomi
S
Center for Health Services Research and Development at East Carolina University, USA. imais@ecu.edu
Mansfield
Christopher J
CJ