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APHA Scientific Session and Event Listing

Recorded presentation

Christopher J. Mansfield, PhD, Community Health and Preventive Medicine, Department of Family Medicine, East Carolina University, Center for Health Services Research and Development, Bldg. "N", Physicians' Quadrangle, Greenville, NC 27858 and Satomi Imai, PhD, Center for Health Services Research and Development, East Carolina University, Bldg. "N", Physicans' Quadrangle, Greenville, NC 27858, (252) 744-1383, imais@mail.ecu.edu.

Purpose: While mortality rates for motor vehicle crashes (MVCs) are typically expressed as deaths per population (e.g. HP2010 objectives), we suspected licensed drivers to be a more appropriate denominator to examine disparities in North Carolina. Method: Mortality rates and rate ratios were calculated for MVCs involving 16-24 year-old drivers only and drivers and vehicle occupants using population and licensed drivers as the denominator, then analyzed by region, race, gender, and ethnicity for the 5-year period, 2000-2004. Results: Choice of denominator makes an important difference because the proportion of licensed drivers per population varies substantially by race and ethnicity. Using licensed drivers (LDs) as denominator, the MVC death rate for teen and young adult drivers and occupants in the state is 35.5 per/100,000 LDs versus 26.5 per/100,000 population. Using LDs instead of population, the regional (Eastern NC-to-Rest of NC) disparity for these deaths increased from 1.45:1 to 1.68:1. Similarly, within Eastern NC, the Native American-to-White disparity increased from 2.27:1 to 3.02:1; Hispanic-to-White disparity increased from 2.25:1 to 3.25:1; and, the Black-to-White disparity increased from 0.78 :1 to 1.05:1. Similar increases in disparities are noted in MVC death rates involving drivers only when LDs is the denominator. Conclusions: Disparities by region, race and ethnicity are more pronounced using licensed driver as denominator. Young Blacks and Whites are at equal risk; Hispanic and Native Americans at much greater risk than Whites. While mortality of all is a compelling problem, disparities suggest specific interventions tailored to Blacks, Hispanics, and Native Americans are required.

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