By Ashley Tollefson, Medical Student, University of Minnesota Medical School; and Samantha Gerhardson, Medical Student, University of Minnesota Duluth Medical School
Motor vehicle collisions are the number one killer of teens and young adults in the country, causing 23 percent of deaths among 10- to 24-year-olds, according to the CDC. Although the number of 16- to 17-year old drivers involved in fatal motor vehicle crashes continues to decrease, Andrew Kiragu, MD, medical director of the PICU at HCMC, asserts that the number of teen crashes remains a significant concern in our communities.
CDC data cites the most common factors in crashes as speed or unsafe driving practices (25 percent), distractions (12 percent), driver inexperience (14 percent), over-correction (9 percent), and impaired driving (3 percent).
In an effort to reduce teen driving fatalities, Minnesota and other states have implemented the Graduated Driver’s License (GDL) program, granting privileges to new drivers in phases. The CDC has found this program to be effective in reducing teen crash fatalities by as much as 20 to 40 percent.
Last year in Minnesota, there were 12,384 motor vehicles crashes involving a teen driver, representing nearly 16 percent of all crashes. This number is down from 2007, when teen drivers accounted for nearly 21 percent of all crashes. Teen fatalities have also decreased from 15.5 percent of all traffic fatalities in Minnesota in 2004 to 8.5 percent in 2013.
Still, many of those crashes can be prevented.
The AAP recognizes that pediatricians play an important role in preparing teens for safe driving habits. A 2006 policy statement includes recommendations for pediatricians to employ during clinic visits, utilizing this time as an appropriate setting to begin discussions on safe driving.
“In the teen years, it is often a non-parent figure of authority (physician, teacher, etc) who can make an impact on a teenager,” said Thomas Wyatt, MD, emergency medicine physician at Mercy Hospital in Coon Rapids.
Pediatricians can jump start a conversation between teens and parents to discuss and practice safe driving techniques and facilitate participation in teen driving programs. Introducing safe passenger and safe driving behaviors early, recommended at age 11 and 13, respectively, may lay the foundation for a conscious teen driver.
Minnesota Laws
It is important for pediatricians to be aware of key teen driving laws and reinforce them with families. Currently, the GDL in Minnesota has specific restrictions for teens and, if violated, will result in delayed licensing.
“Pediatricians should share the importance of following Minnesota traffic laws,” Dr. Kiragu said.
• Passenger limitations: Teens with instructional permits are required to be accompanied by a licensed driver 21 years of age or older. However, there are no passenger restrictions until the teen has earned a provisional license, when only one passenger under age 20 is permitted for the first six months, unless accompanied by a parent or guardian. For the second six months of licensure, no more than three passengers under age 20 are permitted. (Immediate family members are exempt from this rule.)
Parents are advised to develop their own rules for teens, as the risk of fatal crashes with 16-year-old drivers increases with the number of passengers, up to 182 percent with three passengers by some estimates.
• Cell phone use restriction: It is illegal for drivers under age 18 to use a cell phone, whether hand-held or hands-free, except to call 911. Although texting and accessing the Internet is illegal for drivers of any age, 41 percent of teen drivers admit to texting or emailing while driving.
Phone use while driving increases the crash risk fourfold in teens. The Institute for Highway Safety Fatality Facts estimates that eleven teens die each day as a result of texting while driving.
• Restraint use: Seat belts are required of drivers and all passengers, regardless of the level of licensure. Two-thirds of teens killed in motor vehicle crashes were unbelted, according to the Fatality Analysis Reporting System.
“The way I explain it to teenagers is that when a car is traveling 55 mph and it comes to an abrupt stop–if you’re not wearing a belt, your body continues to go that same speed in the compartment of your vehicle. The possible damage inflicted seems to make more sense to them when I explain it that way,” Dr. Wyatt said.
• Time of day: Teens are encouraged to gain experience driving at night with the instructional permit. In general, during the first six months with a provisional license, teens are prohibited from driving between the hours of midnight and 5 a.m. There are exceptions to this law, however. Teens experience 39 percent of their fatal crashes between 9 p.m. and 5:59 a.m, according to the Journal of Public Health Policy.
An active parental role is critical in preparing responsible drivers, with close monitoring and open discussions at the forefront of generating safe driving behaviors. Pediatricians should encourage parents to utilize the readily available parent resources and to teach good skills at a young age. They should also encourage parents to take parent awareness classes, which will soon be offered by all driver education providers in Minnesota under a new law.
Helpful Resources
• Safe driving contracts: These contracts function to outline expectations of both new drivers and parents during the three phases of licensing. This can include rules of car use, passenger limits (beyond the legal requirements), and penalties if the teen breaks the contract. Parents are able to legally withhold their teen’s license until age 18 if they feel it is not safe for the teen to drive.
• Interactive websites: Parents are the Key (www.cdc.gov/parentsarethekey/) and CheckpointsTM (www.youngdriverparenting.org) provide useful resources to parents and clinicians, including contract drafts, laws, and teen driving stats.
• Good role-modeling: Remind parents to set a good example. A survey released by Liberty Mutual and SADD (Students Against Destructive Decisions) found that 91 percent of teens observe their parents talking on the phone and 59 percent observe texting while driving. They also admit parents are the primary influence on their driving.
• Increased supervised experience: The Minnesota Department of Public Safety reports that the first 6 to 12 months of licensure present the greatest risk for crashes. Advise parents to drive with teens as frequently as possible during this time. A gradual increase in distractions better prepares teens to react appropriately in common situations.
Physicians, parents, and government officials must work together to address teen driving safety. Interactions at all levels must persist to ensure that we better prepare youth for the privilege of a driver’s license and the responsibility inherent in this. Pediatricians can help lay the groundwork for safe driving by knowing and reinforcing current laws, encouraging good role modeling, fostering two-way communication, and recommending key resources.
