Teenage driver crash incidence and factors influencing crash injury by rurality ☆ Corinne Peek-Asa a,b,c, ⁎, Carla Britton b,c , Tracy Young c , Michael Pawlovich d , Scott Falb e a Department of Occupational and Environmental Health, College of Public Health, University of Iowa, USA b Department of Epidemiology, College of Public Health, University of Iowa, USA c Injury Prevention Research Center, USA d Office of Traffic and Safety, Iowa Department of Transportation, USA e Office of Driver Services, Iowa Department of Transportation, USA a b s t r a c t a r t i c l e i n f o Article history: Received 18 April 2010 Received in revised form 4 October 2010 Accepted 20 October 2010 Available online 6 November 2010 Keywords: Adolescent health Motor-vehicle collisions Rurality Background: Previous research has identified teenage drivers as having an increased risk for motor-vehicle crash injury compared with older drivers, and rural roads as having increased crash severity compared with urban roads.Few studies have examined incidence and characteristics of teen driver-involved crashes on rural and urban roads. Methods: All crashes involving a driver aged 10 through 18 were identified from the Iowa Department of Transportation crash data from 2002 through 2008. Rates of overall crashes and fatal o severe injury crashes were calculated for urban, suburban,rural,and remote rural areas. The distribution of driver and crash characteristics were compared between rural and urban crashes. Logistic regression was used to identify driver and crash characteristics associated with increased odds of fatal or severe injury amo urban and rural crashes. Results: For younger teen drivers (age 10 through 15), overall crash rates were hig for more rural areas, although for older teen drivers (age 16 through 18) the overall crash rates were lower rural areas. Rural teen crashes were nearly five times more likely to lead to a fatal or severe injury crash th urban teen crashes. Rural crashes were more likely to involve single vehicles, be late at night, involve a fail to yield the right-of-way and crossing the center divider. Conclusions: Intervention programs to increase sa teen driving in ruralareas need to address specific risk factors associated with rural roadways. Impact on Industry: Teen crashes cause lost work time for teen workers as well as their parents. Industries such as saf health care, and insurance have a vested interest in enhanced vehicle safety, and these efforts should addr risks and injury differentials in urban and rural roadways. © 2010 National Safety Council and Elsevier Ltd. All rights reserved. 1. Introduction Rural roadways have higher crash incidence and crash injury rates than other types of roadways (Muellman & Mueller, 1996; National Highway Traffic Safety Administration, 2001; Peek-Asa,Zwerling,& Stallones,2004; Zwerling et al., 2005). This differential has been attributed to many factors including road design (Graham,1993; Karlaftis & Golias, 2002), reduced use of safety devices (Baker, Clarke, & Brandt, 2000; Lundell, 2003; Zwerling et al., 2001), reduced enforcementof traffic safety laws,and prolonged access to acute medical care (Grossman et al., 1997; Maio,Green,Becker,Burney,& Compton,1992; Peek-Asa et al., 2004; Rogers et al., 1997).Although several studies have examined overall trends for rural roadway crashes, few studies have identified populations that could be particularly vulnerable to the challenges of driving in the rural environment. Teenage drivers are involved in a disproportionate number of motor- vehicle crashes. The NationalHighway Traffic Safety Administration (2006) estimates that per mile, young drivers are involved in three times as many fatal crashes as all other drivers. Motor-vehicle crashes are also the leading cause of death for teens, accounting for approximately 35% of deaths in this age group (Centers for Disease Control and Prevention, 2010). Teenage drivers may be differentially vulnerable to crashes on rural roads because of their inexperience and lack of maturity compared with older and more experienced drivers (Mayhew, Simpson, & Pak, 2003; McCartt, Mayhew, Braitman, Ferguson,& Simpson,2009). Challenges such as gravel surfaces,animals in the roadway, narrow roads, and sharp ungraded turns require additional driver experience to safely negotiate. In addition,teens may be less likely to use safety devices, such as seat belts (Williams & Shabanova, 2002). Few studies have examined crash incidence and injury outcomes on rural and non-rural roadways for teenage drivers. A study using the Journal of Safety Research 41 (2010) 487–492 ☆ This research was supported by the Iowa Department of Transportation and the University of Iowa Injury Prevention Research Center, funded by the National Center for Injury Prevention and Control (CDC) (grant number, R49CCR703640). ⁎ Corresponding author. University of Iowa, 100 Oakdale Blvd. #114 IREH, Iowa City, IA 52242-5000, USA.Tel.: +1 319 335 4895; fax: +1 319 335 4225. E-mail address: Corinne-peek-asa@uiowa.edu (C. Peek-Asa). 0022-4375/$ – see front matter © 2010 National Safety Council and Elsevier Ltd. All rights reserved. doi:10.1016/j.jsr.2010.10.002 Contents lists available at ScienceDirect Journal of Safety Research j o u r n a l h o m e p a g e : w w w. e l s ev i e r. c o m / l o c a t e / j s r