Background Young drivers of low socioeconomic status (SES) have a disproportionally high risk of crashing compared with their more affluent counterparts. Little is known if this risk persists into adulthood and if it differs between men and women.
Methods We used data from a 2003/2004 Australian survey of young drivers (n=20 806), which included measures of drivers’ demographics and established crash risk factors. These data were linked to police-reported crash, hospital and death data up to 2016. We used negative binomial regression models to estimate the association between participants’ SES, with car crash.
Results After adjusting for confounding, drivers of lowest SES had 1.30 (95% CI 1.20 to 1.42), 1.90 (95% CI 1.25 to 2.88), 3.09 (95% CI 2.41 to 3.95) and 2.28 (95% CI 1.85 to 2.82) times higher rate of crash, crash-related hospitalisation, crash in country areas and crash on streets with a speed limit of 80 km/hour or above compared with drivers of highest SES, respectively. For single-vehicle crashes, women in the lowest SES groups had 2.88 (95% CI 1.83 to 4.54) times higher rate of crash compared with those in the highest SES group, but no differences were observed for men from different SES groups.
Conclusion Young drivers who lived in areas of low SES at the time of the survey had a sustained increased risk of crash over the following 13 years compared with drivers from the most affluent areas. Our findings suggest that in addition to traditional measures, road transport injury prevention needs to consider the wider social determinants of health.
- social inequalities
- social and life-course epidemiology
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Contributors All authors contributed to the conceptualisation and design of the study. KR cleaned the linked data. HM led the analysis and wrote the draft of the manuscript. All authors contributed to the interpretation of the findings and revision of the manuscript. RI, SB and TS contributed to the design of the DRIVE cohort study and PC and KR to the relinkage of the DRIVE cohort.
Funding Relinkage of the DRIVE study was funded by the National Roads and Motorists’ Association (NRMA)-Australian Capital Territory Road Safety Trust. The original DRIVE study was funded by the National Health and Medical Research Council (NHMRC) of Australia, Roads and Traffic Authority of New South Wales, NRMA Motoring and Services, NRMA-Australian Capital Territory Road Safety Trust, New South Wales Health, and the Motor Accidents Authority of New South Wales. RI was funded by an NHMRC Senior Research Fellowship (grant ID: APP1136430) and PC by an NHMRC Early Career Fellowship (grant ID: APP1158223). This research was supported by the Centre of Research Excellence: Driving Global Investment in Adolescent Health funded by the NHMRC (grant ID: APP1171981), and also by the Wellbeing Health & Youth Centre of Research Excellence in Adolescent Health funded by the NHMRC (grant ID: APP1134894).
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval This study was approved by the AH&MRC Ethics Committee, UNSW Human Research Ethics Committee and the NSW Population and Health Services Research Ethics Committee (reference: HREC/16/CIPHS/9).
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data may be obtained from a third party and are not publicly available.
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