Effects of Alcohol on the Geographic Variation of Driver Fatalities in Motor Vehicle Crashes

Abstract

Abstract. Objective: To determine whether the increased risk of dying in a rural vs nonrural motor vehicle crash (MVC) can be attributed to driver demographics, crash characteristics, or police-reported alcohol use. Methods: A retrospective cohort study was conducted, comparing all rural (116,242) and a 20% random sample of nonrural (104,197) Michigan drivers involved in an MVC during [1994][1995][1996]. Data consisted of all police-reported traffic crashes on public roadways. A logistic regression model was created, using survival as the dependent variable and gender, age, crash characteristics, and rural or nonrural county as independent variables. Driver alcohol use, as reported by the investigating officer, was introduced into the model, and the effect was analyzed. Results: Nonsurvivors represented 0.2% of the total; 99.8% were survivors. Police-reported alcohol use was reported for 3.9% of drivers. Drivers in rural MVCs were more likely to be male, to be more than 50 years of age, to have been drinking alcohol, and to have more severe vehicle deformation as a result of the MVC. The relative risk (RR) for MVC nonsurvivors was 1.69 [95% confidence interval (CI) = 1.3 to 2.1] times higher for drivers in rural than nonrural counties. After adjusting for demographic and crash characteristics, the RR was 1.56 (95% CI = 1.2 to 1.9). Controlling for alcohol and its interactions decreased the RR to 1.26 (95% CI = 0.6 to 2.4), a nonsignificant difference between rural and nonrural MVC mortalities. Conclusions: Alcohol use by drivers in Michigan was a significant contributor for nonsurvivors of rural crashes. Efforts to decrease rural MVC mortality must address alcohol use.

Spatial analysis of alcohol-related motor vehicle crash injuries in southeastern Michigan

“…Other studies have reported that differences in the quality of medical care may partly explain this pattern (Baker et al, 1987;Bentham, 1986). Our study and that by Borgialli et al (2000), both in Michigan, indicate that rural-urban differences in MVC mortality could be partially explained by alcohol use. The finding that drivers involved in MVCs in rural areas are more likely to have a positive BAC than those in urban crashes suggests that differences in drinking behavior could be a risk factor for increased MVC mortality.…”

“…This suggests that there might be an association between alcohol-related car crashes and rural areas. A previous study in Michigan demonstrated an association between alcohol-related MVC fatality and rural crash location, using the county as the geographic unit and the MSA status of each county for the urban/rural classification (Borgialli et al, 2000). In our study, both counties are MSAs and would have been classified as urban in the previous study.…”

Student drivers: A study of fatal motor vehicle crashes involving 16-year-old drivers

“…In addition, crashes in rural areas have a higher casefatality rate and may have different distributions of speeding, alcohol involvement, safety belt use, vehicle types, and crash mechanisms. [15][16][17][18][19][20] We believed that it was important to control for the effects of geographic locale to make valid estimates about the association between the novice age group and various crash and driver variables.…”

“…Motor vehicle crashes are the leading cause of death for 15 to 19 year olds in the United States; in fact, 40% of all deaths among US teenagers are the result of motor vehicle crashes. The death rates among these young drivers are 4 to 8 times higher than among older drivers per mile traveled.…”

Screening and Brief Intervention for Alcohol and Other Drug Problems: What Will It Take?

“…Borgialli and colleagues 4 in their article report that alcohol use by drivers in Michigan was, in part, a significant contribution for fatalities in rural crashes. They recommend that prevention efforts to decrease motor vehicle crash mortality must address the issue of alcohol use.…”