Academic journal article Contemporary Economic Policy

Alcohol Prevalence, Alcohol Policies, and Child Fatal Injury Rates from Motor Vehicle Crashes

Academic journal article Contemporary Economic Policy

Alcohol Prevalence, Alcohol Policies, and Child Fatal Injury Rates from Motor Vehicle Crashes

Article excerpt


Motor vehicle crashes are the leading contributor to fatal injuries from accidental/unintentional causes for all age groups. Among children, motor vehicle crashes are the leading cause of death in the 5-14 age group, and the second leading cause of death (after "all other accidents and adverse effects") for the 0-4 age group. (1) Therefore, it is valuable from a policy perspective to determine what laws are useful in reducing such fatal injuries among children.

It is well established that an important risk factor for a motor vehicle accident is alcohol use by drivers. Over the past two decades states have introduced a number of legal interventions to reduce the incidence of alcohol-impaired driving, or "driving under the influence" (DUI), such as illegal per se blood alcohol concentration (BAC) limits and administrative license revocation (ALR). States have also introduced legal interventions specifically targeted at reducing alcohol use among youth, such as the minimum legal drinking age (MLDA) of 21 and "zero tolerance" laws. Such interventions appear to be associated with temporal declines in the number of alcohol-related motor vehicle crashes as well as a decrease in associated mortality. The National Highway Traffic Safety Administration (NHTSA) reports that during 1982-2002, the proportion of motor vehicle fatalities that were alcohol-related (where at least one driver had a BAC [greater than or equal to] 0.01) decreased from 60% to 41% and those involving a BAC of 0.08 or more decreased from 53% to 35% (Figure 1). (2) During the same time period, the overall fatality rate of alcohol-related crashes declined from 11.3 to 6.1 per 100,000 population. (3)


Extant empirical literature generally supports the effectiveness of DUI laws in reducing motor vehicle fatalities among the overall population and among teens, but no study that we are aware of has specifically examined their effects on child fatality. Motor vehicle fatality rates among children are substantially lower than those among adolescents and adults. Figure 2 shows that fatality rates among children aged 0-15 yr have been less than 7 per 100,000 population since 1982. (4) This contrasts sharply with rates for adolescents of driving age (16-20), for whom fatality rates have ranged from 38.6 to 29.2. For the population as a whole (inclusive of children and adolescents of driving age), the rates have ranged from 15.4 to 13.0. (5) Following a national trend in the reduction of the rate of fatalities of all ages during this time, fatality rates for CMVO have also generally decreased--for children younger than 5 yr old, it has dropped from 4.50 to 2.52 per 100.000 population and for children aged 5-9 yr, it has dropped from 2.71 to 2.26 per 100,000 population. (6) Nevertheless, motor vehicle fatalities among children continue to be a serious concern. Motor vehicle crashes are the leading cause of death and disability among children, (7) accounting for almost half (44%) of pediatric deaths (aged 0-14) due to injury. A 2004 Centers for Disease Control and Prevention (CDC) report in the Morbidity and Mortality Weekly Report stated that 2,355 children died in alcohol-related motor vehicle crashes between 1997 and 2002, of whom 1,588 (68%) were riding with drinking drivers. Minors who are drinking drivers contribute substantially to this problem--Margolis, Foss, and Tolbert (2000) found that drivers younger than 21 yr who had been drinking accounted for 30% of alcohol-related passenger deaths among children between 1991 and 1996.


Outrage over continued DUI-related child fatalities has led to some scholars calling for more stringent alcohol policies, including lower legal BAC limits for drivers with a child passenger (Quinlan et al., 2000), higher beer prices (Margolis, Foss, and Tolbert, 2000), and even a zero tolerance policy for alcohol-impaired driving akin to the one for alcohol-impaired flying (Li. …

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