Academic journal article International Public Health Journal

Reducing Alcohol-Impaired Driving Deaths in America: A Policy Recommendation

Academic journal article International Public Health Journal

Reducing Alcohol-Impaired Driving Deaths in America: A Policy Recommendation

Article excerpt

Introduction

In the United States, motor vehicle crashes are a leading cause of injury and mortality and alcohol consumption is the single greatest cause of motor vehicle fatalities, contributing to approximately onethird of all motor vehicle fatalities (1). In 2017, there were about 37,000 deaths from motor vehicle crashes, and every day, 29 people will die from alcohol-related vehicle crash i.e., one person every 49 minutes, making alcohol-impaired driving a growing public health concern (2). Alcohol consumption also causes about 430,000 non-fatal injuries each year (2). Alcohol-impaired driving also has economic impacts: in 2010, the total cost of alcohol-impaired driving crashes was 121.5 billion dollars, including medical costs, earnings and productivity losses, vehicle damage, and legal costs, among others (3). According to the National Highway Traffic Safety Administration (NHTSA) 2017 report, 53% of fatal crashes caused by BAC = 0.08% involved drivers aged 21-34 years (4).

Alcohol-impaired driving deaths are preventable, and although the causes are complex and multifaceted, there are many evidence-based and promising strategies to address the issue (1). The National Academy of Sciences, Engineering, and Medicine (NASEM) released a report in 2018 detailing evidence-based interventions and recommendations for reducing alcohol-impaired driving fatalities to zero (1). Since 2010, there has been a stagnation in the rate of decrease of alcohol-impaired driving fatalities and this is related to the paucity of new alcohol-related policies. The last major law enacted to combat alcohol-impaired driving at the federal level was 2000 (5). This paper examines the current policies that exist to combat alcohol-impaired driving and proposes a new policy recommendation to reduce further alcohol-related injuries and fatalities.

Alcohol consumption and alcoholimpaired driving: Setting the context

Alcohol-impaired driving occurs in the context of an environment of alcohol consumption. Alcohol consumption is determined by several factors such as social and cultural norms, availability of alcohol, pricing and marketing and the policies and laws that influence these factors (1). Alcohol consumption is normative behavior in the United States. According to the 2017 National Survey of Drug Use and Health, 52% (140.6 million) of persons 12 years and older were current users of alcohol, of these, 47.4% (66.6 million) were binge drinkers and 11.9% (16.7 million) were heavy alcohol users.6 In the past 25 years, alcohol has become more available, even to underage individuals, and is more widely promoted and advertised (1). The alcohol industry has large political sphere and influence and spent huge amounts of money in lobbying - $13.2 million at the state level and $27 million at the federal level (1).

Alcohol-impaired driving gained public health attention in the United States in the 1980s, and between the early 1980s and 2010, the annual rate of alcohol-impaired driving deaths reduced from 24,000 to about 10,000 (1). This was largely due to community advocacy, legislation and policies that increased the legal age of drinking and instituted stricter drunk driving laws both at state and national levels. Since then alcohol policies and laws have been in the public health agenda and in public consciousness (1, 2, 5).

The media - both print and news outlets are filled with stories of alcohol-impaired driving fatalities. A content analysis of alcohol-impaired driving stories in the news found that over a 7-year period, there were 618 news stories related to alcohol-impaired crashes featured in four newspapers and three cable television news outlets that have a national coverage and represented the spectrum of political ideologies (1). Media reports tend to focus more on individual problem/responsibility, individually targeted solutions, and policy changes focused on efforts to punish offenders (1).

However, there are several other issues that are related to alcohol-impaired driving including culture of alcohol use; sales and marketing of alcohol; and policy changes to place stricter limits on drunk driving, and policy changes that target these issues will be effective in creating an environment where excessive drinking is not tolerated and where drunk driving can be prevented (1, 7, 8). …

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