J Epidemiol Community Health 64:998-1003 doi:10.1136/jech.2009.091496
  • Research report

Socioeconomic status and risk of car crash injury, independent of place of residence and driving exposure: results from the DRIVE Study

  1. R Norton1
  1. 1The George Institute for Global Health, The University of Sydney, Sydney, Australia
  2. 2Mount Sinai School of Medicine, New York, New York, USA
  1. Correspondence to Rebecca Ivers, The George Institute for Global Health, The University of Sydney, PO Box M201, Missenden Road, Sydney, NSW 2050, Australia; rivers{at}
  1. Contributors All authors contributed to the planning, conduct and reporting of the work described in the article, and HYC, RQI and ALCM are responsible for the overall content as guarantors.

  • Accepted 13 September 2009
  • Published Online First 12 October 2009


Background Previous studies that found increased crash risks for young drivers of low socioeconomic status (SES) have failed to adjust for factors such as driving exposure and rural residence. This aim of this study is to examine the independent effect of SES on crash risk, adjusting for such factors, and to examine the relationship between injury severity following a crash and SES.

Methods Information on risk factors for crash collected from 20 822 newly licenced drivers aged 17–24 years in New South Wales, Australia, as part of the DRIVE Study was prospectively linked to hospitalisation data. SES was classified as high, moderate or low based on the Australia 2001 Socio-Economic Index for Areas. Poisson regression was used to model risk of crash-related hospitalisation by SES, adjusting for confounders. Two measures of injury severity—urgency of treatment and length of hospital stay—were examined by SES.

Results Results of multivariable analysis showed that drivers from low SES areas had increased relative risk (RR 1.8, 95% CI 1.1 to 3.1) of crash-related hospitalisation compared to drivers from high SES areas. This increased risk remained when adjusting for confounders including driving exposure and rurality (RR 1.9, 95% CI 1.1 to 3.2). No significant association was found between injury severity and SES.

Conclusion The higher risk of crash-related hospitalisation for young drivers from low SES areas is independent of driving exposure and rural–urban differences. This finding may help improve and better target interventions for youth of low SES.


  • Funding This work was supported by National Health and Medical Research Council of Australia, Roads and Traffic Authority of New South Wales (NSW), NRMA Motoring and Services, NRMA-ACT Road Safety Trust, NSW Health and the Motor Accidents Authority. RQI, TS, SB and MS received salary funding from the National Health and Medical Research Council of Australia. ALCM was supported by a fellowship from the Canadian Institutes of Health Research.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of The University of Sydney Human Research Ethics Committee and the NSW Health Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.