Michigan Traffic Safety Conference

1
Michigan Traffic Safety Conference

• A Review of Behavioral Efforts
• To Reduce Motor Vehicle Fatalities
• James L. Nichols, Ph.D.
• Nichols and Associates

2
Behavioral CountermeasuresWhere Do We Fit?
Pre- Crash Crash Post- Crash
Driver Alcohol, Safety Belt Use, Speed, etc. (Safety Belt Use) (EMS)
Vehicle
Roadway
3
What Problems are We Most Interested in?

• Alcohol-Impaired Driving
• Non-Use of Restraint Systems
• Speeding
• Aggressive Inattentive Driving
• Pedestrian Crashes
• Bicyclist Crashes
• Motorcyclist Crashes

4
Relative Size of Various Problems(By Behavioral
Categorization)
?
?
5
Relative Size of Fatality Problem(Vehicle
Occupants and Non-Occupants)Source FARS, 2002
?
6
Relative Size of Fatality Problem(By Age of
Victim)
?
7
Number of FatalitiesBy Year of Age
(0-16)Source NHTSA/FARS, 2001
8
Summary of the Problem(as it relates to
fatalities)

• Primarily Involves the 16-54 age group
• 16-24 is worst major increases after age 12
• Mostly Occupants of Passenger Vehicles
• Cars and Light Trucks MCs significant
• Largest Behavioral Issues are
• Alcohol, Safety Belts, Speed
• Emerging Issues Include
• Drowsy, distracted, aggressive, elderly driving

9
Trends in Michigan (and in 2 Benchmark States)
10
Total Fatalities

• Long-Term
• Past Five Years

11
Michigan (vs Illinois Ohio)Number of Total
Fatalities(1982-2002 FARS)
12
Michigan (vs. Illinois Ohio)Number of Total
Fatalities(Past 5 Years 1998-2002 FARS)
13
Alcohol
14
Michigan (vs. Illinois and Ohio)Number of
Alcohol-Related Fatalities(1982-2002 FARS)
15
Michigan (vs. Illinois and Ohio)Number of
Alcohol-Related FatalitiesPast Five Years
(1998-2002) FARS
16
MichiganAlcohol-Related FatalitiesChange in
Various Indices Since 1998
17
Non-Use of Seat Belts
18
Michigan Observed Non-Use of Seat Belts(from
State-Reported Observed Data NCSA, 2003)
19
Observed Non-Use of Seat Beltsin all Region V
States(Source Reported Results from State
Surveys NCSA, 2003)
20
Reported Non-Use of Seat BeltsAmong Fatalities
in Region V States(Source FARS, 2002 Passenger
Vehicle Occupants)
21
Motorcycle Fatalities
22
Michigan (vs. Illinois and Ohio)Change in Number
of Motorcycle Fatalities(1997-2002 FARS)
23
Pedestrian Fatalities
24
Michigan (vs. Illinois and Ohio)Number of
Pedestrian Fatalities(1997-2002 FARS)
25
Our Focus Today

• Alcohol Impaired Driving
• Non-Use of Safety Belts

26
Our Options

• Alcohol Impaired Driving
• Prevention
• Intervention
• Deterrence (Traffic Law System)
• Treatment

• Safety Belt Non-Use
• Education
• Incentives
• Public Information
• Deterrence (Traffic Law System)

27
Alcohol Impaired Driving

• Characteristics of the Problem
• Implications for Countermeasures

28
Number of Drinking Drivers in Fatal Crashesby
Age Group(FARS, 1999)
29
Occupants and Non-Occupants as Victims of A/R
Crashes1999 FARS
30
Number of Prior Offenses Recordedof Drivers in
Fatal CrashesModerate Estimate Based on 1985 MN
Data
31
BAC Level of Alcohol Positive Drivers in A/R
Crashes
32
Restraint UseAmong A/R Crash Victims(FARS)
33
Estimated of DWIs Caught(One Year Period)
34
Implications forCountermeasures

• General versus Specific Effects

35
Significant Risk Factors in Alcohol-Related
Fatal Crashes

• Alcohol Consumption Among Youth
• Problem Drinking/Binge Drinking/Beer
• Males
• Age (16-34)
• Most Victims are in the DWIs Vehicle
• Most DWIs have no Prior A/R Arrest
• Late Night/Early Morning/Weekend Problem
• Low Seat Belt Use (as low as 15-20)

36
Alcohol Impaired DrivingCountermeasures

• What the Research Says

37
Major Approaches

• Prevention
• Intervention
• Deterrence
• Rehabilitation
• Technology

38
Prevention

• Mass Media
• Alcohol Education
• Alcohol Policy

39
Mass Media An Essential Component of Any Program

• Legislation
• requires public awareness
• Enforcement
• requires public awareness
• Sanctions
• require public awareness
• Incentives
• require public awareness

40
Mass Media

• Much potential for general impact
• Weak to moderate number of studies
• Recent CDC review suggests 13 effect
• Contributes to impact of other programs
• Agenda setting potential
• Public Service vs. Earned vs. Paid

41
Mass Media

• Brief, intense campaigns (most effective?)
• Multi-year, planned efforts
• High saturation, paid media, television
• Targeted messaging?
• Support for other, more effective, measures
  appears to be most effective

42
Alcohol Education

• Major obstacles to population-wide impact
• Education, normative, peer, resistance
• Evidence of self-reported impact on DD/RDD in
  classroom and on campus
• No evidence of crash reduction impact
• One of the best studies here in Michigan

43
Alcohol Policy

• Alcohol Advertising and Marketing
• Alcohol Availability
• Physical, Economic, Social, Subjective
• Minimum Drinking Age Laws

44
Alcohol Policy

• Strong potential for population-wide effect
• Some programs have shown impact (MDA)
• Consistent Findings that advertising and
  availability can affect consumption, but ..
• Little evidence of impact to date (likely due to
  less than full implementation)

45
Intervention

• Ride Service
• Designated Drivers
• Server Training
• Server Liability
• Enforcing ABC Laws

46
Ride Service

• Weak research base
• One example of community-wide impact
• Capable of creating general deterrence?
• Important part of a comprehensive community
  program
• Media likely essential for impact

47
Designated Driver

• Very weak research base CDC review
• Not likely to create general effect more likely
  to be a response to deterrence
• Major obstacle lack of use by high risk
• Some concern about increased drinking
• Another component of a comprehensive community
  program
• Media likely essential for impact

48
Responsible Beverage Service (RBS)

• Three Elements of RBS
• Server Training
• Management Policy
• ABC Enforcement
• Server Liability may be an essential factor
  (i.e. RBS likely to be a response to deterrence)

49
Responsible Beverage ServiceServer Training
Component

• Moderate research base
• Potential for population-wide impact
• Major obstacle management disinterest
• Relatively consistent findings of server change
• Need carrot and stick incentives
• Server Liability
• ABC Enforcement

50
Responsible Beverage ServiceManagement Policy
Component

• Weak research base
• Potential for population-wide impact
• Major obstacle management disinterest
• Need more research on policies (e.g. happy hours,
  cut off of serving at specified times, etc.)
• Need carrot and stick incentives
• Server Liability
• ABC Enforcement

51
Responsible Beverage ServiceABC Enforcement
Component

• Weak research base
• Potential for population-wide impact
• Major obstacle is lack of resources
• Some evidence of Impact
• Stings or Decoy Programs
• Cops in Shops

52
Server LiabilityDram Shop Laws/Model Law

• Weak research base
• Strong Potential for general impact
• Some evidence of Impact (e.g. Texas)
• Incentives for Responsible Alcohol Service

53
Deterrence(Traffic Law System)

• Legislation
• Enforcement
• Sanctions
• Fines
• License
• Vehicle
• Jail
• Interlocks

54
Laws That Have Shown Impact

• Illegal Per Se
• Administrative License Revocation (ALR)
• Minimum Drinking Age (MDA)
• .08 Illegal Per Se
• Zero Tolerance for Youth
• Vehicle Sanctions
• Primary Seat Belt Laws (Michigan)

55
Enforcement

• Strong research base consistent
• Checkpoints are most effective (-20)
• Obstacles among officers and management
• Saturation patrols and regular patrols are also
  effective
• Intensive media is an essential component
• Major obstacle competing priorities

56
License Sanctions

• Strong research base very consistent
• General and Specific Effect
• Most effective of any sanction/in spite of DWS
• DWS erodes general deterrence impact although
  specific deterrence remains high
• Intensive media is an essential component
• Administrative application has shown most effect

57
Vehicle Sanctionsfor repeat DWI or Driving
While Suspended (DWS)

• Moderate research base consistent results
• Strong specific effect potential for general
• Works better for repeat offenders than 1st off.
• Can be used to counter DWS and to deal with
  repeat offenders
• Intensive media is an essential component
• Administrative application is needed

58
Jail

• Moderate research base inconsistent results
• Possible specific effect for 1st offenders
• Some studies show detrimental effect
• Much potential for general effect
• Generally used for leverage/ last resort
• May work best in special facilities w/treat.
• Costly

59
Alcohol Safety Interlocks

• Moderate research base consistent results
• Strong specific effect (as much as -65)
• Effect appears limited to period of use
• No demonstrated potential for general impact
• May counter DWS often used to deal with repeat
  offenders
• Can work well with treatment

60
Alternatives to Jail(e.g., In-home detention,
Intense Probation, Custom Sentencing)

• Weak research base but consistent results
• Specific effect most likely to be demonstrated
• Potential for general effect (but universal
  application is unlikely via courts)
• Generally leveraged by threat of jail
• Many approaches complement treatment
• Potential for affecting hard core, repeat
  offender

61
Education and Treatment

• Strong research base relatively consistent
  results
• Some specific effect demonstrated (8-9)
• Less potential for general effect (but should be
  part of a comprehensive, balanced program)
• Often used in lieu of jail should not be used in
  lieu of license sanction (add to license effect)
• Perhaps most appropriate for hard core, repeat
  offender, but major behavior change unlikely.

62
What Has Worked Worldwide?Transportation
Research Board (TRB) Review

• Programs of the 1980s
• Activism
• Legislation
• Enforcement
• Sanctions
• Public Information
• Result Has Been A Change in the Norm!
• (Programs of the 1990s Remain Less Clear)

63
Results of CDC Systematic Review

• .08 BAC Laws (7 effect)
• Zero Tolerance Laws (17 effect)
• MLDA Laws 16 effect
• Checkpoints (18 to 21 effect)
• Server Training Programs some impact?
• Mass Media Programs (13 effect)?
• Designated Driver Insufficient Evidence?
• School-Based Education effect on RDD?

64
DeterrenceDoes It Work Only for the Least
Severe Offenders?

• There is Evidence to the Contrary

65
Youth A/R Fatalities1989-1999
66
High BAC Fatalities1989-1999
67
Where Are We Now?

• Progress Has Clearly Leveled Off
• Awareness and Concern Has Declined
• Enforcement Has Declined Significantly
• Youth Laws Not Being Enforced
• Many Laws Being Eroded
• Seat Belt Use Among A/R Drivers Low
• Other Priorities
• (not much has changed in several years)

68
Problems With the SystemHedlund and McCartt
(2001)

• Failure to detect, arrest, convict, sanction,
  monitor
• DWI laws are complicated inconsistencies
• Arrest rates have been declining
• Arrest procedures time-consuming/complicated
• Plea bargains and diversions
• Sanctions not applied (swiftly or certainly)
• Do not identify repeat offenders
• Do not monitor offenders in the system
• Poor data and records systems
• Inadequate resources

69
What Will Likely Work in the Future?

• Enforcing DUI Laws
• Enforcing MDA and ZT laws for Youth
• Alcohol Control and Serving Policies
• Graduated Sanctioning Systems
• Graduated Licensing and Vehicle Sanctions
• Primary Seat Belt Laws
• Technology?
• Fixing the Traffic Law System Components

70
Increasing Safety Belt Use

• What the Research Says

71
Increasing Safety Belt UseApproaches Used

• Education
• Incentives
• Mass Media/Public Information
• Legislation
• Enforcement
• Penalties

72
Education Programs

• Very little evidence of impact to date
• Early programs increased usage by very small
  amounts little evidence of sustained impact
• No evidence of impact on usage among crash
  victims
• Even if impact were documented, it would likely
  only affect those persons exposed

73
Elementary School Education Program(Ages 6-11)
Loudon County, VA (Senk and Schwartz, 1972)
74
Evaluation of Beltman Education Programin
Missouri (target group 500) (Missouri Office
of Highway Safety, 1981)
75
Incentive Programs

• Some evidence of impact at low use rates
• Early programs increased usage by modest amounts
  but there is little evidence that such impact
  remained over time
• No evidence of impact on usage among crash
  victims
• Somewhat broader impact potential than education
  programs

76
Corporate Education/Incentive ProgramBCBS,
Chapel Hill, NC (Campbell et al., 1982)
77
Incentive/Education/Policy ProgramU.S.D.O.T.
Headquarters, Washington, DC
78
Mass Media

• Potential for population-wide impact
• Little evidence of impact (when use alone) even
  at very low usage rates
• Recent consistent evidence of impact in
  conjunction with enforcement efforts
• Click it or Ticket programs
• Paid media efforts have been shown to result in
  major increases in awareness

79
How Effective is Mass Media By Itself?

• Perhaps the most frequently implemented
  countermeasure since the 1960s
• Not nearly as much documented research as for
  legislation and enforcement
• Much of the available research was conducted when
  usage rates were very low (which is also when
  programs are likely to be most effective)
• BUT there is some evidence of potential

80
Effect of Public Information Campaign in Oakland
Co. Michigan(Oakland Co.Traffic Improvement
Assoc.,1969)
81
Effect of Public Information Campaign in
Southeast Michigan(Motorists Information Inc.,
1978)
82
Study of High vs. Low Use CommunitiesThree
Activities Associated with High Use(Burkhart et
al., 1987)

• Tailored Media
• Greater Market Penetration
• Higher Enforcement Levels

83
Conclusions Regarding Effect of U.S. Mass Media
Programs to increase Seat Belt Use

• All studies were conducted in pre-law situations
  when baseline use rates were very low
• Although some media programs were of high
  quality, the studies were of moderate quality.
• Very little evidence of impact greatest evidence
  comes from MII study which showed a 4.4 pct. pt
  increase from a 12 baseline rate.
• This result is not all that different from foreign

84
Summary of Research on Effectiveness of Mass
Media to Increase Seat Belt Use

• Foreign (multi-year) studies showed 10-20 point
  increases from low baselines (average of 4-5 pts
  per campaign)
• U.S. studies also found 4-5 percentage point
  gains from similar pre-law, low use baselines
• Community programs show some impact
• High vs. Low Use Communities
• Model Communities
• CDC review of mass media programs to reduce
  impaired-driving suggest impact of mass media in
  the context of other prevention efforts (Elder et
  al., in process).

85
Mass Media An Essential Component of Any Program

• Legislation
• requires public awareness
• Enforcement
• requires public awareness
• Sanctions
• require public awareness
• Incentives
• require public awareness

86
Legislation/Penalties

• Safety Belt Laws Have Been Effective
• Increased U.S. Use from lt15 to nearly 50
• Primary Laws Have Been Most Effective
• Generally Result in 10-15 point increase
• Fines Make a Difference
• Much Weaker Research Base
• Points Would Likely Make a Difference
• Still Less Weaker Research Base

87
Average Changes in Usage Among 25 Initial States
Enacting Safety Belt Laws(Campbell et al. 1987)
88
Average Changes in Usage Among 25 Initial States
Enacting Safety Belt LawsPrimary vs. Secondary
Laws(Campbell et al. 1987)
89
Changes in U.S. Usage Rate Estimatesas States
Enacted Safety Belt Laws
90
Primary Laws Have Clearly Been Most Effective
91
Changes in Usage In MarylandAfter Upgrading to a
Primary Law
92
Changes in Usage In MichiganAfter Upgrading to a
Primary Law
93
Pre/Post Difference in Safety Belt Use
Rates States Upgrading from Secondary to Primary
Laws
Median Point Change 12
MI 14
MD 12
NJ 11
IN 9
CA 18
DC 16
OK 8
GA 4
AL 13
LA 16
Source NHTSA published research reports on state
changes to a primary enforcement law
94
Summary of Effect of Laws

• Initial Seat Belt Laws Gained Average of 30 pts
• Primary Law upgrades have gained an average of
  12-14 points (over pre-existing 2nd law levels)
• Although some decay results without follow-up,
  all states have continued to show increases with
  continued enforcement
• Intensive media is an essential component of both
  the law and enforcement interventions

95
Enforcement

• As with DWI, there is strong consistent evidence
  of impact
• Checkpoints have been most effective as have
  highly visible waves of enforcement
• Saturation patrols and regular patrols can also
  be effective
• Intensive media is an essential component
• Major obstacle in competing priorities
• Enforcement Zones are providing new energy

96
Effect of Click It or Ticket Program in North
Carolina in 1993(Observed Driver Seat Belt Use)
97
Effect of Click It or Ticket Program in South
Carolina in 2000(Observed Driver Seat Belt Use)
98
Effect of Click It or Ticket Program in 8
Southeastern States in 2001(Observed Driver Seat
Belt Use)
99
Effect of Click It or Ticket Program in 12
States Across the U.S. in 2002(Observed Driver
Seat Belt Use)
100
SummaryImpact of (Highly Visible) Enforcement
Efforts

• Capable of immediate gains in safety belt use
• Require intense media efforts
• Enhance impact of laws (secondary and primary)
• Must be periodically repeated (ratchet effect).
• Responsible for recent gains in U.S. (and in
  Mich.)
• Typical gains are 8-16 percentage points
• Require full implementation to be effective

101
Safety Belt Use and Alcohol-Impaired Driving

• Can they be Linked?
• Should they be Linked?

102
Restraint Use Among A/R Crash Victims4 out of 5
Victims are Unbuckled
103
Seat Belt Use Among FatalitiesTime of
DayMcCartt et al., 2002
104
Seat Belt Use Among Fatalitiesby Driver
GenderMcCartt et al., 2002
105
Seat Belt Use Rates in a Region V StateA
Comparison of Various Groups
106
Summary

• Most important need is to create new energy and
  focus on these issues.
• Many combinations of efforts are likely to work,
  given sufficient effort
• Enforcement is an essential component
• Swift and certain sanctions are effective
  (especially with impaired driving)
• Media will be key to future success.

107
Summary (continued)

• Impaired driving efforts may wish to start with
  the seat belt model and expand
• Make Use of Special Tools for Youth
• Progressive Sanctions for Repeat Offenders
  (particularly impaired drivers)
• Integrate DUI and Seat Belt Efforts?
• New enforcement approaches for safety belts may
  help impaired driving as well.

108
End
109
Appendix A

• A Summary of Potential for Alcohol-Impaired
  Driving Countermeasures

110
Summary of Research EvidenceRegarding Prevention
Efforts
Research Strength Specific Effect? General Effect?
Mass Media Weak Yes? Yes?
Alcohol Education
Didactic Moderate KA Not likely
Normative Moderate KA (B) Not likely?
Alcohol Policy Weak to strong Yes Yes
111
Summary of Research EvidenceRegarding
Intervention Efforts
Ride Service Weak Yes Not clear
Designated Driver Weak Yes (users) No evidence
Server Training Moderate To Weak Yes (server) Likely (1 study)
Server Liability Weak Yes (seller) Likely (1 study)
Enforce ABC Weak Yes Likely
112
Summary of Research EvidenceRegarding Traffic
Law System/Legislation Efforts
Legislation Research Strength Specific Effect? General Effect?
MDA-21 Strong Yes Yes
Zero BAC Moderate Likely Likely
ALR Mandatory Strong Yes Yes
Vehicle Moderate Yes Likely
.08 BAC Moderate Yes Yes
113
Summary of Research EvidenceRegarding Traffic
Law System/Legislation Efforts (continued)
Legislation Research Strength Specific Effect? General Effect?
Per Se moderate probably Yes
Implied Consent weak Likely Likely
Jail mixed possibly possibly
Alternativeto Jail weak Yes Likely
114
Summary of Research EvidenceRegarding Traffic
Law System/Enforcement Efforts
Enforcement Research Strength Specific Effect? General Effect?
Checkpoints Strong Yes Yes
Saturation Patrols Moderate Yes Yes
Fix System Problems Empirical data Likely Very Likely
Publicize Consistent Likely Likely
115
Summary of Research EvidenceRegarding Traffic
Law System/Sanction Efforts
Research Strength Specific Effect? General Effect?
License Strong Yes Yes
Vehicle Moderate Yes Likely
Interlocks Strong Yes Unknown
Jail Mixed Possibly Possibly
Alternatives Weak to Moderate Yes Likely (w/media)
116
Summary of Research EvidenceRegarding
Treatment/Rehabilitation Efforts
Research Strength Specific Effect? General Effect?
Assessment Moderate Not clear Not likely
Education Moderate to Strong Modest (KA) Not likely
Treatment Moderate to Strong Modest Not likely
Brief Intervention Weak Unk. Not likely
117
Appendix B

• A Summary of Priority Target Groups for
  Alcohol-Impaired Driving

118
Priority Target Populations

• Under 21
• 21-34
• Repeat Offenders

119
Under Age 21

• Inexperience in Drinking and Driving
• Affected More By Lower BACs
• More Tools Available (e.g., MDA, ZT)
• Tools Not Being Used
• Difficulties in Arrest and Charging Process

120
Under Age 21Potential Solutions

• MDA and Zero Tolerance Laws (work
  out problems in process)
• Alcohol Sales and Serving Laws/Practices
• Seat Belt Use
• Graduated Driver Licensing

121
21-34 Age Group

• Legal to Use Alcohol
• Most Drive
• Account for about ½ of all A/R Fatalities
• Have Not Matured Out

122
21-34 Age GroupPotential Solutions

• General Deterrence
• Special/Strategic Messaging?
• Responsible Alcohol Service?
• Alternative Transportation?

123
Repeat Offenders

• High Risk Individuals
• 1/3 of DWI Arrests
• Involved in 10-25 of A/R Fatal Crashes
• Most Never Identified
• Need Special Emphasis (Sanctions/Treatment)

124
Repeat OffendersPotential Solutions

• Special Enforcement Efforts
• Interlocks?
• Vehicle Sanctions (administrative?)
• Assessment and Treatment?
• Incarceration?
• Alternatives (Probation and Monitoring)