title: Alcohol Policies and Alcohol-Related Motor Vehicle Crash Fatalities Among Young People in the US.
abstract: BACKGROUND
  Motor vehicle crashes (MVCs) are a leading cause of death among young people in the United States. We examined the relationship between states' alcohol policy environments and alcohol-related MVC fatalities among children, adolescents, and young adults under the minimum legal drinking age of 21 years.
  
  
  METHODS
  We used the Alcohol Policy Scale (APS), an assessment of 29 alcohol policies across 50 states and Washington, DC, developed with the assistance of an interdisciplinary Delphi panel. Using the Fatality Analysis Reporting System, we examined APS scores in relation to fatalities of people ≤20 years old from 2000 to 2013 occurring in crashes in which ≥1 involved driver had a blood alcohol content ≥0.08%. Logistic regression was used with a 1-year lag between policies and MVC fatalities and adjusted for potential confounders.
  
  
  RESULTS
  Of 84 756 MVC fatalities of those ≤20 years old during the study period, 23 757 (28.0%) were alcohol related, including deaths of 11 006 (46.3%) drivers, 10 212 (43.0%) passengers, and 2539 (10.7%) pedestrians, cyclists, and others. People killed in alcohol-related MVCs were predominantly male (72.7%) and older (65.5% were 18-20 years old), and 51.2% were non-Hispanic white. Restrictive policy environments were associated with fewer fatalities (adjusted odds ratio, 0.91 per 10-percentage-point increase in APS score; 95% confidence interval, 0.89-0.94). The association was observed for drivers and passengers, male and female decendents, and children, adolescents, and young adults.
  
  
  CONCLUSIONS
  More restrictive alcohol policies are associated with reduced alcohol-related MVC mortality among young people. Studies should scrutinize the relationship between policies and fatalities to highlight mechanisms.
authors.affiliation: Division of General Pediatrics, Department of Pediatrics, Boston University School of Medicine, Boston, Massachusetts; scott.hadland@bmc.org.|Division of Adolescent/Young Adult Medicine, Department of Medicine, Boston Children's Hospital, Boston, Massachusetts.|Department of Pediatrics, and.
authors.forename: Scott E
authors.initials: SE
authors.lastname: Hadland
authors.affiliation: Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts.
authors.forename: Ziming
authors.initials: Z
authors.lastname: Xuan
authors.affiliation: Division of Adolescent/Young Adult Medicine, Department of Medicine, Boston Children's Hospital, Boston, Massachusetts.
authors.forename: Vishnudas
authors.initials: V
authors.lastname: Sarda
authors.affiliation: Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts.
authors.forename: Jason
authors.initials: J
authors.lastname: Blanchette
authors.affiliation: Institute of Public Health, Georgia State University, Atlanta, Georgia; and.
authors.forename: Monica H
authors.initials: MH
authors.lastname: Swahn
authors.affiliation: Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts.
authors.forename: Timothy C
authors.initials: TC
authors.lastname: Heeren
authors.affiliation: Calverton Center, Pacific Institute for Research and Evaluation, Calverton, Maryland.
authors.forename: Robert B
authors.initials: RB
authors.lastname: Voas
authors.affiliation: Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts.|Section of General Internal Medicine, Boston Medical Center, Boston, Massachusetts.
authors.forename: Timothy S
authors.initials: TS
authors.lastname: Naimi
mesh_terms: D000063:Accidents, Traffic / Q000517:prevention & control / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000428:Alcohol Drinking / Q000331:legislation & jurisprudence; D000434:Alcoholic Beverages; D000067401:Blood Alcohol Content; D002648:Child; D002675:Child, Preschool; D003132:Commerce / Q000331:legislation & jurisprudence; D000066448:Driving Under the Influence / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011640:Public Policy; D044469:Racial Groups / Q000706:statistics & numerical data; D017678:Sex Distribution; D013219:State Government; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000067401:Blood Alcohol Content