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Prevention Status Reports

Motor Vehicle Injuries

PSR NATIONAL SUMMARY

Icon depicting foward facing carThe Prevention Status Reports highlight—for all 50 states and the District of Columbia—the status of public health policies and practices designed to address 10 important public health problems and concerns. The following policies are recommended by the Community Preventive Services Task Force and the National Highway Traffic Safety Administration because scientific studies support their effectiveness in preventing or reducing crash-related injuries and deaths (1–15):

  • Implementing primary enforcement seat belt laws that cover occupants in all seating positions
  • Mandating the use of car seats and booster seats for motor vehicle passengers through at least age 8 years
  • Implementing comprehensive graduated driver licensing (GDL) systems, which help new drivers gain experience under low-risk conditions by granting driving privileges in stages. Research shows that more comprehensive GDL systems prevent more crashes and deaths than less comprehensive GDL systems (4–11). Components of comprehensive GDL systems include
    • A minimum age of 16 years for learner’s permits
    • A mandatory holding period of at least 12 months for learner’s permits
    • Nighttime driving restrictions between 10:00 pm and 5:00 am (or longer) for intermediate or provisional license holders
    • A limit of zero or one young passengers who can ride with intermediate or provisional license holders without adult supervision
    • A minimum age of 18 years for unrestricted licensure
  • Requiring the use of ignition interlock devices for everyone convicted of alcohol-impaired driving

Other strategies recommended by scientific evidence for preventing motor vehicle injuries include enhanced seat belt enforcement campaigns (1,4), 0.08% blood alcohol concentration laws (16), minimum legal drinking age laws (4,16), publicized sobriety checkpoint programs (4,16,17), alcohol-impaired driving mass media campaigns (4,18), increased alcohol taxes (19), car and booster seat distribution plus education campaigns (2), and community-wide car seat and booster seat information and enhanced enforcement campaigns (2).

Seat belt law

A primary enforcement seat belt law allows police to stop a vehicle solely because a driver or passenger is not wearing a seat belt. A secondary enforcement seat belt law requires police to have another reason for stopping a vehicle before citing a driver or passenger for not buckling up. The most comprehensive policies are primary seat belt laws that cover all occupants, regardless of where they are sitting.

RatingState seat belt law
GreenPrimary enforcement law covering all seating positions
YellowPrimary enforcement law covering only the front seats
RedSecondary enforcement law OR no law


How These Ratings Were Determined
These ratings reflect the extent to which states’ seat belt laws allowed for primary enforcement and covered all seating positions. Ratings are based on data collected from the Insurance Institute for Highway Safety (IIHS) on July 1, 2015, and therefore reflect IIHS’s interpretation of each state’s policy at that time (20). The “as of” date referenced in the Motor Vehicle Injuries state reports—July 1, 2015—is the date CDC assessed the policy. The date does not reflect when the law was enacted or became effective.

Child passenger restraint law

A law that requires child passengers to travel in appropriate child passenger restraints, such as car seats or booster seats, until adult seat belts fit them properly.

RatingAge requirement for use of child passenger restraints
GreenChildren through age 8 years
YellowChildren through age 6 or 7 years
RedChildren aged 5 years or younger


How These Ratings Were Determined
These ratings reflect the age through which states required child passengers to travel in appropriate child passenger restraints. Ratings are based on data collected from the Insurance Institute for Highway Safety (IIHS) on July 1, 2015, and therefore reflect IIHS’s interpretation of each state’s policy at that time (20). The “as of” date referenced in the Motor Vehicle Injuries state reports—July 1, 2015—is the date CDC assessed the policy. The date does not reflect when the law was enacted or became effective.

Graduated driver licensing: learner’s permit age

Age at which a young driver can first acquire a learner’s permit, which requires a novice driver to practice driving under the supervision of an adult.

RatingMinimum age for state learner’s permit
Green≥16 years
Yellow14 years, 7 months through 15 years, 11 months
Red≤14 years, 6 months


How These Ratings Were Determined
These ratings reflect the age at which states allowed drivers to first acquire a learner’s permit. Ratings are based on data collected from the Insurance Institute for Highway Safety (IIHS) on July 1, 2015, and therefore reflect IIHS’s interpretation of each state’s policy at that time (21). The “as of” date referenced in the Motor Vehicle Injuries state reports—July 1, 2015—is the date CDC assessed the policy. The date does not reflect when the law was enacted or became effective.

Graduated driver licensing: learner's permit holding period

The length of time a driver must maintain a learner’s permit before being allowed to apply for an intermediate or provisional license.

RatingState learner’s permit mandatory holding period
Green≥12 months
Yellow6–11 months
Red<6 months


How These Ratings Were Determined
These ratings reflect the length of time states required a driver to maintain a learner’s permit before being allowed to apply for an intermediate or provisional license. Ratings are based on data collected from the Insurance Institute for Highway Safety (IIHS) on July 1, 2015, and therefore reflect IIHS’s interpretation of each state’s policy at that time (21). The “as of” date referenced in the Motor Vehicle Injuries state reports—July 1, 2015—is the date CDC assessed the policy. The date does not reflect when the law was enacted or became effective. If a state had varying holding periods dependent on the age the young driver received his/her learner’s permit, its rating was based on the shortest holding period allowable for novice drivers. Exceptions to learner’s permit holding periods (e.g., a shorter holding period for completion of a driver’s education course) were not considered, and states were rated based on the general law.

Graduated driver licensing: nighttime driving restriction

A restriction against intermediate or provisional license holders driving without adult supervision during certain nighttime hours.

RatingState nighttime driving restriction
GreenBegan on or before 10:00 pm and ended on or after 5:00 am
YellowBegan between 10:01 pm and 11:59 pm
RedBegan on or after midnight OR no restriction


How These Ratings Were Determined
These ratings reflect the extent to which states restricted intermediate or provisional license holders from driving without adult supervision at night. Ratings are based on data collected from the Insurance Institute for Highway Safety (IIHS) on July 1, 2015, and therefore reflect IIHS’s interpretation of each state’s policy at that time (21). The “as of” date referenced in the Motor Vehicle Injuries state reports—July 1, 2015—is the date CDC assessed the policy. The date does not reflect when the law was enacted or became effective. If a state had varying nighttime driving restrictions dependent on the month of the year or day of the week, its rating was based on the least restrictive requirement. Provisions loosening restrictions based on the length of time the young driver had been licensed were not considered; states were rated based on the initial restriction only.

Graduated driver licensing: young passenger restriction

A restriction against intermediate or provisional license holders transporting more than a certain number of young passengers without adult supervision.

RatingState young passenger restriction
GreenLimit of zero or one young passengers without adult supervision
YellowLimit of two or more young passengers without adult supervision
RedNo limit on young passengers


How These Ratings Were Determined
These ratings reflect the extent to which states restricted intermediate or provisional license holders from transporting young passengers without adult supervision. Ratings are based on data collected from the Insurance Institute for Highway Safety (IIHS) on July 1, 2015, and therefore reflect IIHS’s interpretation of each state’s policy at that time (21). The “as of” date referenced in the Motor Vehicle Injuries state reports—July 1, 2015—is the date CDC assessed the policy. The date does not reflect when the law was enacted or became effective. If a state had varying young passenger restrictions dependent on the time of day, its rating was based on the least restrictive requirement. Provisions loosening restrictions based on the length of time the young driver had been licensed were not considered; states were rated based on the initial restriction only.

Graduated driver licensing: unrestricted licensure age

The minimum age at which drivers who have met all requirements of intermediate or provisional license may first drive unsupervised without nighttime or young passenger restrictions.

RatingState unrestricted licensure age
GreenNighttime and young passenger restrictions existed and were lifted for drivers aged ≥18 years
YellowNighttime and young passenger restrictions existed, and one or both were lifted for drivers between ages 16 years, 7 months and 17 years, 11 months
RedNighttime and/or young passenger restrictions were lifted for drivers aged ≤16 years, 6 months; OR only one or no restriction existed


How These Ratings Were Determined
These ratings reflect the minimum age at which states allowed drivers who have met all requirements of intermediate or provisional license to first drive unsupervised with no nighttime driving or young passenger restrictions. States that did not have both restrictions were rated red. Ratings are based on data collected from the Insurance Institute for Highway Safety (IIHS) on July 1, 2015, and therefore reflect IIHS’s interpretation of each state’s policy at that time (21). The “as of” date referenced in the Motor Vehicle Injuries state reports—July 1, 2015—is the date CDC assessed the policy. The date does not reflect when the law was enacted or became effective.

Ignition interlock law

A law that mandates the use of ignition interlocks for drivers convicted of alcohol-impaired driving. An ignition interlock is a device that analyzes a driver’s breath and prevents the vehicle from starting if alcohol is detected.

RatingState ignition interlock law
GreenIgnition interlocks required for all offenders convicted of alcohol-impaired driving (i.e., driving with a blood alcohol concentration [BAC] ≥0.08 g/dL), which includes both first-time and repeat offenders
YellowIgnition interlocks required for repeat offenders convicted of alcohol-impaired driving or first-time offenders with a particularly high BAC (e.g., BAC ≥0.15 g/dL)
RedIgnition interlocks not required for any offenders convicted of alcohol-impaired driving


How These Ratings Were Determined
These ratings reflect the extent to which states required use of ignition interlocks for drivers convicted of alcohol-impaired driving. Ratings are based on data collected from the Insurance Institute for Highway Safety (IIHS) on July 1, 2015, and therefore reflect IIHS’s interpretation of each state’s policy at that time (22). The “as of” date referenced in the Motor Vehicle Injuries state reports—July 1, 2015—is the date CDC assessed the policy. The date does not reflect when the law was enacted or became effective.

References

  1. Shults RA, Nichols JL, Dinh-Zarr TB, et al. Effectiveness of primary enforcement safety belt laws and enhanced enforcement of safety belt laws: a summary of the Guide to Community Preventive Services systematic reviews. Journal of Safety Research 2004;35(2):189–96.
  2. Zaza S, Sleet DA, Thompson R, et al. Reviews of evidence regarding interventions to increase use of child safety seats. American Journal of Preventive Medicine 2001;21(4S):31–47.
  3. Eichelberger AH, Chouinard AO, Jermakian JS. Effects of booster seat laws on injury risk among children in crashes. Traffic Injury Prevention 2012;13(6):631–9.
  4. Goodwin A, Kirley B, Sandt L, et al. Countermeasures That Work: A Highway Safety Countermeasures Guide for State Highway Safety Offices. 7th edition. Washington, DC: National Highway Traffic Safety Administration; 2013.
  5. Williams AF, McCartt AT, Mayhew DR, et al. Licensing age issues: deliberations from a workshop devoted to this topic. Traffic Injury Prevention 2013;14(3):237–43.
  6. Williams AF, Chaudhary NK, Tefft BC, et al. Evaluation of New Jersey's graduated driver licensing program. Traffic Injury Prevention 2010;11(1):1–7.
  7. Williams AF. Licensing age and teenage driver crashes: a review of the evidence. Traffic Injury Prevention 2009;10(1):9–15.
  8. Masten SV, Foss RD, Marshall SW. Graduated driver licensing program component calibrations and their association with fatal crash involvement. Accident Analysis & Prevention 2013;57:105–13.
  9. Baker SP, Chen LH, Li G. National evaluation of graduated driver licensing programs. Washington, DC: US Department of Transportation; 2006.
  10. Williams AF, Tefft BC, Grabowski JG. Graduated driver licensing research, 2010–present. Journal of Safety Research 2012;43(3):195–203.
  11. Mayhew D, Williams A, Pashley C. A new GDL framework: evidence base to integrate novice driver strategies. Ottawa, Canada: Traffic Injury Research Foundation; 2014.
  12. Elder RW, Voas R, Beirness D, et al. Effectiveness of ignition interlocks for preventing alcohol-impaired driving and alcohol-related crashes: a Community Guide systematic review. American Journal of Preventive Medicine 2011;40(3):362–76.
  13. Shults RA, Elder RW, Sleet DA, et al. Primary enforcement seat belt laws are effective even in the face of rising belt use rates. Accident Analysis & Prevention 2004;36(3):491–3.
  14. Beck LF, West BA. Vital signs: nonfatal, motor vehicle-occupant injuries (2009) and seat belt use (2008) among adults—United States. MMWR 2011;59(51):1681–6.
  15. Shults RA, Beck LF. Self-reported seatbelt use, United States, 2002–2010: does prevalence vary by state and type of seatbelt law?. Journal of Safety Research 2012;43(5–6):417–20.
  16. Shults RA, Elder RW, Sleet DA, et al. Reviews of evidence regarding interventions to reduce alcohol-impaired driving. American Journal of Preventive Medicine 2001;21(4S):66–88.
  17. Bergen G, Pitan A, Qu S, et al. Publicized sobriety checkpoint programs: a Community Guide systematic review. American Journal of Preventive Medicine 2014;46(5):529–39.
  18. Elder RW, Shults RA, Sleet DA, et al. Effectiveness of mass media campaigns for reducing drinking and driving and alcohol-involved crashes: a systematic review. American Journal of Preventive Medicine 2004;27(1):57–65.
  19. Elder RW, Lawrence B, Ferguson A, et al. The effectiveness of tax policy interventions for reducing excessive alcohol consumption and related harms. American Journal of Preventive Medicine 2010;38(2):217–29.
  20. Insurance Institute for Highway Safety/Highway Loss Data Institute. State Laws: Safety Belts―Safety Belts and Child Safety Seats. Arlington, VA: Insurance Institute for Highway Safety/Highway Loss Data Institute; 2015.
  21. Insurance Institute for Highway Safety/Highway Loss Data Institute. State Laws: Teenagers―Graduated Driver Licensing Introduction. Arlington, VA: Insurance Institute for Highway Safety/Highway Loss Data Institute; 2015.
  22. Insurance Institute for Highway Safety/Highway Loss Data Institute. State Laws: Alcohol-Impaired Driving―DUI/DWI. Arlington, VA: Insurance Institute for Highway Safety/Highway Loss Data Institute; 2015.


**State count includes District of Columbia.

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