Researchers at the Center for Injury Research and Prevention at Children’s Hospital of Philadelphia are collaborating with researchers from the Royal College of Physicians in Ireland, Brown University School of Public Health, and other research organizations to conduct traffic medicine and transportation equity research.
Traffic medicine embraces all the disciplines, techniques, and methods developed to not only reduce injuries and deaths from motor vehicle crashes, but also to support safe mobility, including assessing fitness to drive as we age and providing alternative means of transportation when driving is not an option. The goal is to offer continued safe driving for those with relevant medical conditions whenever possible and to support the use of public transportation and ride sharing services like Uber and Lyft when it’s not.
Transportation equity research focuses on identifying and addressing 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. More than 3.6 million Americans miss or delay healthcare because of transportation barriers, and this lack of access to care can lead to serious short-term and long-term health issues.
Transportation Equity, Health and Aging: A Novel Approach to Healthy Longevity with Benefits Across the Life Span
There is a need for a balanced medical perspective when assessing fitness to drive, one that can appropriately weigh actual safety risks against the real health consequences of restricting mobility. A partnership between the fields of health care and transportation could facilitate this balance. More sophisticated, individualized approaches and modeling are becoming available and could allow for personalized prevention that optimize outcomes not only for older adults, but also across the life span. In a commentary for the National Academy of Medicine (NAM), researchers seek to promote a culture that ensures our future well-being by encouraging physicians to support safe transportation as a key determinant of health and social inclusion.
Authors: Desmond O’Neill, MD; Eliabeth Walshe, PhD; Dan Romer Nina R. Joyce, PhD; Andrew R. Zullo, PharmD, MPH; Jasjit S. Ahluwalia, MD; Melissa R. Pfeiffer, MPH; Allison E. Curry, PhD; Funding: Children’s Hospital of Philadelphia
Individual and Geographic Variation in Driver’s Suspension: Evidence of Disparities by Race, Ethnicity, and Income
Using data from the New Jersey Safety Health Outcomes (NJ-SHO) Data Warehouse 2004–2018, researchers from Brown University School of Public Health and CIRP compared characteristics of suspended drivers, their residential census tract, as well as access to public transportation and jobs, by reason for the suspension (driving or non-driving related).They found that the vast majority (91%) of license suspensions were for non-driving-related (NDR) events, with the most common reason for a suspension being failure to pay a fine. The study also found that these NDR suspensions disproportionately affect people living in low-income neighborhoods and in neighborhoods with a high proportion of Black and Hispanic residents. Almost half (45%) of these NDR suspensions occurred in 2018. Future research will explore how these NDR suspensions may negatively affect health and economic well-being, particularly among individuals and communities already facing other barriers to employment and healthcare.
Principal Investigators: Nina R. Joyce, PhD; Allison E. Curry, PhD; Funding: Agency for Healthcare Research and Quality; Department of Veterans Affairs Office of Academic Affiliations in Health Services Research and Development; National Institute on Aging; Eunice Kennedy Shriver National Institute for Child Health and Development; Centers of Biomedical Research Excellence
Vehicle Safety Characteristics in Vulnerable Driver Populations
This study, published in Traffic Injury Prevention, highlights important disparities in vehicle safety features among drivers by age and income. The researchers analyzed data from the NJ Safety and Health Outcomes Data Warehouse, which includes all crash and licensing data for the state of NJ from 2010-17 and used NHTSA’s Product Information Catalog and Vehicle Listing platform to decode the VIN of each crash-involved vehicle to obtain model year, presence of electronic stability control (ESC), vehicle type, engine horsepower, and presence of front, side, and curtain airbags. They found that teens, older adults (age 65+), and those from low-income neighborhoods are more likely to be driving vehicles that are less safe, putting them at greater risk of injury and death in the event of a crash.
Principal Investigators: Kristi Busico Metzger, PhD, MPH; Allison E. Curry, PhD, MPH; Funding: Eunice Kennedy Shriver National Institute of Child Health and Human Development
Driver’s License Suspension Policies as a Barrier to Health Care
CIRP researchers are partnering with researchers from Brown University School of Public Health to address barriers to reliable transportation for improving health outcomes and reducing health disparities. In 43 states courts can suspend a driver’s license for non-driving-related (NDR) events, such as failure to pay a fine or appear in court. Evidence suggests that NDR suspensions are disproportionately imposed on low-income and racial and ethnic minority drivers who are already more likely to face other barriers to care. In an editorial published in the American Journal of Public Health, researchers explain the impact of a suspended license on access to health care and what must be addressed to improve transportation equity in this area.
Authors: Nina R. Joyce, PhD; Andrew R. Zullo, PharmD, MPH; Jasjit S. Ahluwalia, MD; Melissa R. Pfeiffer, MPH; Allison E. Curry, PhD; Funding: Agency for Healthcare Research and Quality; Department of Veterans Affairs Office of Academic Affiliations in Health Services Research and Development; National Institute on Aging; Eunice Kennedy Shriver National Institute for Child Health and Development; Centers of Biomedical Research Excellence