title: Trends in Alabama teen driving death and injury.
abstract: BACKGROUND
  Motor vehicle crashes (MVCs) are a leading cause of morbidity and mortality in teens. Alabama has been in the Top 5 states for MVC fatality rate among teens in the United States for several years. Twelve years of teen MVC deaths and injuries were evaluated. Our hypothesis is that the teen driving motor vehicle-related deaths and injuries have decreased related to legislative and community awareness activities.
  
  
  METHODS
  A retrospective analysis of Alabama teen MVC deaths and injury for the years 2000 to 2011 was conducted. MVC data were obtained from a Fatality Analysis Reporting System data set managed by the Center for Advanced Public Safety at the University of Alabama. A Lowess regression-scattergram analysis was used to identify period specific changes in deaths and injury over time. Statistical analysis was conducted using True Epistat 5.0 software. When the Lowess regression was applied, there was an obvious change in the trend line in 2007. To test that observation, we then compared medians in the pre-2007 and post-2007 periods, which validated our observation. Moreover, it provided a near-even number of observations for comparison. The Spearman rank correlation was used to test for correlation of deaths and injury over time. The Mann-Whitney U-test was used to evaluate median differences in deaths and injury comparing pre-2007 and post-2007 data.
  
  
  RESULTS
  Alabama teen MVC deaths and injury demonstrated a significant negative correlation over the 12-year period (Rs for deaths and injury, -0.87 [p < 0.001] and -0.92 [p < 0.001], respectively). Lowess regression identified a notable decline in deaths and injury after the year 2006. Median deaths and injury for the pre-2007 period were significantly higher than the post-2007 period, (U = 35.0, p = 0.003).
  
  
  CONCLUSIONS
  Alabama teen driver deaths and injury have decreased during the 12-year study period, most notably after 2006. Factors that may have contributed to this trend may include stricter laws for teen drivers (enacted in 2002 and updated in 2010), less teen driving because of a nationwide economic downturn, delayed licensing in teens, steady improvements in overall seat belt use, and heightened public awareness of risky behaviors in teen driving.
authors.affiliation: From the Pediatric Emergency Medicine (K.M., M.N., W.D.K.), and SafeKids of Alabama (M.C.), Southeast Child Safety Institute (W.D.K.), Children's of Alabama (E.I.), University of Alabama Hospital Systems, Birmingham; and Center for Advanced Public Safety (J.N.), The University of Alabama, Tuscaloosa, Alabama.
authors.forename: Kathy
authors.initials: K
authors.lastname: Monroe
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Irons
authors.forename: Marie
authors.initials: M
authors.lastname: Crew
authors.forename: Jesse
authors.initials: J
authors.lastname: Norris
authors.forename: Michele
authors.initials: M
authors.lastname: Nichols
authors.forename: William D
authors.initials: WD
authors.lastname: King
mesh_terms: D000063:Accidents, Traffic / Q000401:mortality* / Q000706:statistics & numerical data / Q000639:trends; D000293:Adolescent; D000407:Alabama; D001334:Automobile Driving / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008004:Licensure / Q000639:trends; D008297:Male; D009026:Mortality / Q000639:trends; D012189:Retrospective Studies; D012309:Risk-Taking; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000401:mortality