Workshop Proceedings - AAA Foundation for Traffic Safety

ABSTRACT
This background paper was written to examine older driver licensing policies on a
federal and state level. We identify what federal bodies have done, particularly the
Federal Highway Administration (FHWA) and National Highway Traffic Administration
(NHTSA), to promote safety practices for older adults. We provide a brief synopsis of
state licensing practices and discuss four age-specific practices (e.g., accelerated
license renewal) and three other practices (e.g., third party referrals). We describe the
main activities of the five model states (California, Florida, Iowa, Maryland, and
Michigan). Based on the lessons learned from the federal bodies’ involvement, the
general state licensure policies, and the model state programs for licensing older
drivers, we summarize the main findings as: older driver safety activities are not widely
translated to implementation on the state level; efficacy of states licensing policies are
not certain; model states have in addition to licensing policies, also community
programs targeting the safety and continued mobility of older adults; a paucity of
research exists on state policies; and that past research has mainly focused on crash
datasets. In the light of these findings we discuss nine recommendations: advocate for
policy making in the broad spectrum of transportation; more coordinated efforts in
knowledge sharing; wider implementation of federal safety efforts; policies for in-person
renewal for the 85+ group; research to examine in-person renewal and other practices
by means of on-the-road test data; develop a registry of those who have received
driving interventions; more prospective research; examine the role and efficacy of the
community groups in older driver safety.
INTRODUCTION
Consistent with the growth in older persons is an increase in older drivers, and we
expect that, by 2030, about 25 percent of all drivers in North America will be 65 years of
age or older (Dellinger, 2003). Motor vehicle crashes are the leading cause of injuries
and fatalities among older adults 65 to 74 years, and the second leading cause among
those 75 years and older (CDC, 2005). Compared to younger individuals exposed to a
crash of similar impact, those 65 years and older have a two-to fourfold higher rate of
injury, hospitalization or death. For example, in 2004 the more than 28 million licensed
drivers age 65 years of age or older in the U.S. experienced 191,000 non-fatal and
6,512 fatal injuries which is, based on miles driven, substantially higher than most other
age groups (National Highway Traffic Safety Administration, 2006). The underlying
frailty, medical conditions, and medication use greatly contribute to the crash disparities
and increased risks for injuries and fatalities (Langford & Koppel, 2006; McGwin, Sims,
Pulley, & Roseman, 2000a). Beyond loss of function or life, injuries also contribute to
health care and economic costs with the average cost of one non-fatal motor vehicle
injury in the U.S. is over $60,000, while one fatal injury costs approximately $1,150,000
(National Safety Council).
These statistics, indicative of safety concerns for older drivers provided, the context for
this background paper: i.e., to examine model state programs on licensing older drivers.
Identifying the characteristics of model states, examining what policies these states
License Policies Workshop Proceedings-- 141