My colleagues at the Center for Injury Research and Prevention (CIRP) at Children’s Hospital of Philadelphia (CHOP) and I first developed the New Jersey Safety and Health Outcomes (NJ-SHO) Data Warehouse back in 2011 to include the full licensing, citation, and motor vehicle crash (MVC) history of every New Jersey driver over a ten-year period. Our initial vision was that it could help us better understand teen driver licensing patterns and MVCs and the factors associated with them. But in just a few short years, we have expanded these data through 2018 to include several other important state-wide databases -- birth certificates, death certificates, electronic health records, and hospital discharge data -- to support studies on young drivers with developmental disabilities and child pedestrian/pedalcyclist injuries.
Now, I am thrilled to announce that we are broadening this novel resource's use by linking to Medicare and Medicaid claims data through a new research collaboration with Brown University School of Public Health researchers Andrew R. Zullo, PharmD, PhD and Nina R. Joyce, PhD. Through two new research programs, we aim to study the effects of medications on motor vehicle crashes in older adults and to help address health disparities due to driver’s license suspensions for non-driving-related offenses.
Older Adult Drivers and Medication Use
Through a pilot grant awarded to Dr. Zullo by Brown University’s 2019 Office of the Vice President for Research Seed Awards, we will build on Brown’s experience in studying the health effects of aging and expertise in pharmacoepidemiology by expanding to investigate transportation issues. Although many believe that prescription medication use in older adults is a leading cause of MVCs, data are scarce and controversy remains on the effects of medications on older drivers and their crash risk. According to Dr. Zullo, a major barrier to this progress has been the lack of detailed linked data on MVCs, prescription drug use, and age-related medical conditions.
To close this gap, we will link detailed licensing and crash histories from over 2.3 million licensed drivers ages 65 and older to rich clinical and prescription drug data. We plan to use these novel linked data to answer a wide array of medication-related questions in regard to traffic safety for older adults.
Transportation and Access to Health Care
The second research program, led by Dr. Joyce, will address barriers to reliable transportation for improving health outcomes and reducing health disparities, one of five non-medical priority areas for improving health as part of Medicare and Medicaid’s Accountable Health Communities Initiative.
Along with linking NJ-SHO data and Medicare/Medicaid data, we will also link publicly available data on systems-level factors that affect access to care, including the availability of transportation alternatives. We believe that a non-driving-related driver’s license suspension represents a barrier to care that may result in preventable hospital admissions and that Black and Hispanic drivers and those from lower socio-economic backgrounds may suffer the most.
According to Dr. Joyce, this research will address an important transportation-related health equity issue by establishing the prevalence of non-driving-related license suspensions by individual- and systems-level factors and determining the impact of these suspensions on healthcare utilization, particularly in communities already facing other barriers to accessing health care and transportation.
Doing so will help us more comprehensively understand the barriers that this class of license suspensions impose on healthcare utilization and their contribution to ongoing health disparities. With this knowledge, we can provide states with a critical evidence base to amend their license suspension policies for non-driving-related offenses. Notably, six states have repealed their license suspension policies in the last two years.
I look forward to working with my Brown University School of Public Health and CIRP colleagues to kick off this research to improve safe mobility and its many benefits so that more people can lead a healthy life.
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