Risk and type of crash among young drivers by rurality of residence: findings from the DRIVE Study.
BACKGROUND
Most previous literature on urban/rural differences in road crashes has a primary focus on severe injuries or deaths, which may be largely explained by variations of medical resources. Little has been reported on police-reported crashes by geographical location, or crash type and severity, especially among young drivers.


METHODS
DRIVE is a prospective cohort study of 20,822 drivers aged 17-24 in NSW, Australia. Information on risk factors was collected via online questionnaire and subsequently linked to police-reported crashes. Poisson regression was used to analyse risk of various crash types by three levels of rurality of residence: urban, regional (country towns and surrounds) and rural.


RESULTS
Compared to urban drivers, risk of crash decreased with increasing rurality (regional adjusted RR: 0.7, 95% CI 0.6-0.9; rural adjusted RR: 0.5, 95% CI 0.3-0.7). Among those who crashed, risk of injurious crash did not differ by geographic location; however, regional and rural drivers had significantly higher risk of a single versus multiple vehicle crash (regional adjusted RR 1.8, 95% CI 1.3-2.5; rural adjusted RR: 2.0, 95% CI 1.1-3.6), which was explained by speeding involvement and road alignment at the time or site of crash.


CONCLUSIONS
Although young urban drivers have a higher crash risk overall, rural and regional residents have increased risk of a single vehicle crash. Interventions to reduce single vehicle crashes should aim to address key issues affecting such crashes, including speeding and specific aspects of road geometry.
Chen
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The George Institute for International Health, The University of Sydney, PO Box M201, Missenden Road, Sydney, NSW 2050, Australia. tchen@george.org.au
Ivers
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Martiniuk
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Boufous
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Senserrick
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Woodward
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Stevenson
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Williamson
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Norton
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D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001334:Automobile Driving / Q000706:statistics & numerical data*; D001336:Automobiles / Q000706:statistics & numerical data*; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D008297:Male; D009517:New South Wales; D011446:Prospective Studies; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012306:Risk; D018570:Risk Assessment; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data*; D014505:Urban Population / Q000706:statistics & numerical data*; D055815:Young Adult