Little is known about how state-level driver licensure laws, such as
in-person renewal, vision tests, road tests, and the frequency of license
renewal relate to the older driver traffic fatality rate.
To determine whether state driver's license renewal policies are associated
with the fatality rate among elderly drivers.
Design, Setting, and Population
Retrospective, longitudinal study conducted January 1990 through December
2000 of all fatal crashes in the contiguous United States identified in the
Fatality Analysis Reporting System, which involved either an older (ages 65-74
years, 75-84 years, and ≥85 years) or middle-aged (ages 25-64 years) driver.
Two regression approaches were used to study the effect of state laws mandating
in-person renewal, vision tests, road tests, and frequency of license renewal
on driver fatalities, controlling for state-level factors including the number
of licensed elderly drivers, primary and secondary seatbelt laws, maximum
speed limit laws, blood alcohol level of 0.08, and administrative license
revocation drinking and driving laws, per capita income, and unemployment
rate. The first regression approach examined only elderly driver fatalities
and the second approach examined daytime elderly driver fatalities and used
daytime fatalities among middle-aged drivers as a general control for unobserved
variation across states and over time.
Main Outcome Measures
Older driver fatalities and older and middle-aged daytime driver fatalities.
Among individuals aged 85 years or older, there were a total of 4605
driver fatalities and 4179 daytime driver fatalities during the study period.
For this age cohort, after controlling for middle-aged daytime driver deaths,
states with in-person license renewal were associated with a lower driver
fatality rate (incident rate ratio [RR], 0.83; 95% confidence interval [CI],
0.72-0.96). This was the only policy related to older drivers that was significantly
associated with a lower fatality risk across both regression models. Thus,
state-mandated vision tests, road tests, more frequent license renewal, and
in-person renewal (for individuals aged 65-74 years and 75-84 years) were
not found to be independently associated with the fatality rate among older
drivers in the 2 models.
In-person license renewal was related to a significantly lower fatality
rate among the oldest old drivers. More stringent state licensure policies
such as vision tests, road tests, and more frequent license renewal cycles
were not independently associated with additional benefits.