Self-Reported Motor Vehicle Injury Prevention

Self-Reported Motor Vehicle Injury Prevention Strategies, Risky Driving Behaviours, and Subsequent Motor Vehicle Injuries: Analysis of Canadian National Population Health Survey

Self-Reported Risky Driving Behaviours and Injury Prevention Strategies 

S69

Evelyn Vingilis

Population and Community Health Unit, Department of Family Medicine University of Western Ontario, London

Piotr Wilk

School of Nursing, Faculty of Health Sciences University of Western Ontario, London

L’étude avait pour but d’examiner les interventions de prévention des blessures causées par les accidents de la route signalées par les conducteurs (empêcher les conducteurs dont les facultés sont affaiblies de prendre le volant, faire appel à des conducteurs désignés, obliger les passagers à porter leur ceinture de sécurité), la vitesse et la conduite avec les facultés affaiblies ainsi que les effets de la vitesse et de la conduite avec les facultés affaiblies sur les blessures ultérieures causées par une collision, au moyen de l’Enquête nationale sur la santé de la population (ENSP). Les dispositifs de protection des passagers, les interventions menées auprès des conducteurs aux facultés affaiblies et le recours aux chauffeurs désignés étaient fréquemment mentionnés. Pourtant, une minorité importante, plus particulièrement de jeunes hommes, ont affirmé avoir des comportements dangereux au volant, comme la vitesse et la conduite avec les facultés affaiblies. Les conducteurs qui conduisent trop vite et ceux dont les facultés sont affaiblies qui signalent leur comportement avaient des chances beaucoup plus élevées de signaler une blessure survenue à la suite d’une collision. En particulier, ceux qui ont signalé respecter quelquefois, rarement ou jamais les limites de vitesse étaient 2,5 fois plus susceptibles de signaler une blessure ultérieure alors que ceux qui ont signalé avoir conduit avec les facultés affaiblies une fois ou plus était deux fois plus susceptibles de signaler une blessure ultérieure. Ces conclusions confirment qu’il faut continuer de se concentrer sur la vitesse, la conduite avec les facultés affaiblies et les autres comportements à risque au volant afin de réduire le nombre de collisions au Canada. Mots clés : sécurité routière, excès de vitesse, alcool au volant, blessures, Enquête nationale sur la santé de la population Canadian Public Policy – Analyse de politiques,  vol. xxxvi, supplement/numéro spécial 2010

S70  Evelyn Vingilis and Piotr Wilk The purpose of this study was to examine self-reported motor vehicle injury prevention strategies, speeding and impaired driving, and the effects of speeding and impaired driving on subsequent motor vehicle collision injuries, using the Canadian National Population Health Survey (NPHS). Strategies commonly reported were preventing impaired drivers from driving, using designated drivers, and requiring passengers to use seatbelts. Yet a substantial minority, particularly young males, reported engaging in risky driving behaviours such as speeding and impaired driving. Self-reported speeders and impaired drivers had significantly higher odds of reporting injuries from subsequent motor vehicle collisions. Specifically, those who reported sometimes/rarely or never obeying the speed limits were two and a half times more likely to report a subsequent motor vehicle injury, while those who reported impaired driving one or more times in the past 12 months were two times more likely to report a subsequent motor vehicle injury. These findings support the need for continued focus on speeding, drinking and driving, and other risky driving behaviours to reduce collisions in Canada. Keywords: road safety, speeding, drinking driving, impaired driving, injuries, National Population Health Survey

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n Canada, about 3,000 persons die and over 200,000 are injured in motor vehicle collisions (MVC) each year (Transport Canada 2007). The Public Health Agency of Canada (1998) has estimated the economic health-related burden of unintentional injuries to be $8.7 billion per year, with MVCs being a major contributor to injuries. Jacobs, Lier, and Schopflocher (2004) estimated that long-term medical costs attributable to MVCs for Alberta were over $117 million in 1999. Similarly, Smartrisk (2006) calculated that MVCs cost Ontario more than $1.1 billion in health care burden in 1999. More recently, Vodden et al. (2007) estimated the social costs of MVCs for Ontario in 2004 at $18 billion or 3.5 percent of Ontario’s GDP, while estimates for Canada were $63 billion. Other studies have examined total economic impact. For example, Blincoe and colleagues (2002) examined MVC costs, including medical and other costs, in the United States. They calculated the total economic costs to be $230.6 billion for 2000. Moreover, the World Health Organization has projected that MVC injuries will move in the ranked order of leading causes of disease burden from ninth place in 1998 to third place by 2020 (World Bank Group

2008). The recognition of this high economic bur­ den of injury-related morbidity and mortality has led international organizations, such as the World Health Organization and the World Bank, to conduct surveillance, identify issues, and recommend and support interventions to reduce injuries and their consequences. For example, in 1999 the World Bank launched the Global Road Safety Partnership (2008) under its broader Business Partners for Development initiative in response to the yearly high motor vehicle morbidity and mortality rates in developing countries. These studies would suggest that MVC injuries are a major economic burden in Canada and other industrialized countries, and in developing jurisdictions. Contributors to MVCs are many, but Blincoe and colleagues (2002) identified three major contributing factors to MVC injuries: drinking and driving, speeding, and non-seatbelt use. In their analysis of American data for 2000, they found $230.6 billion in injury total costs. Drinking and driving accounted for 22 percent of these economic costs, while speeding accounted for 18 percent. Although seatbelt use prevented fatalities, serious injuries, and $50 billion in injury-related costs, non-seatbelt use by about

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Self-Reported Risky Driving Behaviours and Injury Prevention Strategies  30 percent of Americans was associated with 9,200 unnecessary fatalities, 143,000 serious injuries, and $26 billion in preventable injury-related costs. In Canada, drinking and driving, excessive speeding, and non-seatbelt use have also been identified as risk factors for MVC injuries, although Canada has a higher seatbelt utilization rate (Transport Canada 2004, 2006; Vanlaar, Emery, and Simpson 2007; Vanlaar, Robertson, and Marcoux 2007). In response to these findings, numerous strat­ egies have been introduced to reduce MVC injuries. Educational, enforcement/legislative, and rehabilitation activities have been implemented with various levels of success (e.g., Mann et al. 1983; Mann et al. 1986; Tay 2005; Vingilis et al. 1988). Yet, population-based information is limited on how frequently Canadians engage in personal strategies to prevent motor vehicle injuries (e.g., preventing impaired drivers from driving, using designated drivers, requiring passengers to use seat-belts). Moreover, information is also limited on the relationship between risky driving behaviours and subsequent MVCs among large, nationally representative samples. Three different datasets have examined risky driving behaviours and MVC injuries: (a) clinical, (b) official police, and (c) social survey data (Gelles 2000; Roberts et al. 2007). Most studies have been based on clinical emergency room or hospitalization data (Cherpitel 1988; Stoduto et al. 1993; Tavris, Kuhn, and Layde 2001) or on police collision reports (Abdel-Aty and Abdelwahab 2000; Ulfarsson and Mannering 2004). Studies using clinical and police data are limited in the number and type of variables they can include, while studies based on social surveys can examine a wider range of factors, although the rarity of MVC injuries means that surveys examining MVC injuries require large sample sizes. Thus, few population-based survey studies have been conducted, and of those that have been conducted, most have used cross-sectional surveys, making it impossible to assess directionality among variables (Chipman 1995).

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All three data sources have validity challenges. Clinical or police data have been criticized for potentially having biased samples (e.g., Alsop and Langley 2001; Elvik and Mysen 1999), while selfreport surveys have been criticized for having poor event recall (Jenkins et al. 2002; Mock et al. 1999), although memory for salient events, such as MVCs, has been found to be good (Schwarz and Oyserman 2001; Sudman and Bradburn 1983). For example, Begg, Langley, and Williams (1999) assessed the validity of self-report of MVCs and serious injuries among young adults, and they found high concordance between self-report and clinical and police data sources. The purpose of this study was to examine selfreported motor vehicle injury prevention strategies, prevalence of speeding behaviour and impaired driving, and the effects of speeding and impaired driving behaviour on subsequent MVC injuries, using the longitudinal dataset from the Canadian National Population Health Survey (NPHS). In particular, this study examined the prevalence of self-reported motor vehicle injury prevention strategies (preventing impaired drivers from driving, using designated drivers, requiring passengers to use seatbelts), speeding, and impaired driving, as well as the relationship between the two risky driving behaviours—speeding and impaired driving—and subsequent MVC injuries. The study was limited by the constrained nature of the questions used in the survey instrument. For example, only questions about MVC injuries, and not collisions per se, are included, and so it is not possible to assess collisions per se and to determine whether the respondents were drivers or passengers. Nor were questions on driving exposure asked, so that it is not possible to control for kilometres travelled. Additionally, some questions were poorly worded, such as the seatbelt use question, which is “double-barrelled.” Finally, the questions relating to road safety behaviours were included only in Cycle 2, 1996–97 of the NPHS, although interestingly, no one has published these data. However, the strengths of the NPHS are the large sample size, the representativeness and

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S72  Evelyn Vingilis and Piotr Wilk generalizability of the sample, and the prospective nature of the survey.

Method The National Population Health Survey The NPHS is an ongoing, biennial survey, based on an existing Canadian sample frame (from the Labour Force Survey), in which households are selected for participation in a prospective, population-based, longitudinal study of health and injury status, use of health services, lifestyles, psychosocial factors, and sociodemographic information; only Cycle 2 includes road safety questions (Statistics Canada 2004). This analysis includes 1996–97 (Cycle 2) and 1998–99 (Cycle 3) data. For the first Cycle (1), 17,276 respondents, selected from across Canada by a two-staged, stratified, random sampling procedure, completed the general component of the survey. Strata were formed by dividing each province and further subdividing each province into three types of areas (major urban centres, urban towns, and rural areas). The original sample was obtained by selecting households via clustering techniques, with one member from each household randomly selected to complete the survey. In most strata, six clusters, usually Census Enumeration Areas, were selected with probability proportional to size. A rejective method, sampling technique was used to correct for underrepresentation of groups of people in the population and to account for the undersampling of people from large households, thus reducing bias for potentially oversampling young, single-member households and the elderly. The sample was non-renewed in subsequent waves, and contained no individuals who had immigrated to Canada after 1994–1995, nor anyone under the age of eight. The initial Cycle 1 interview was conducted face-to-face, and subsequent Cycle interviews were conducted primarily by telephone. High response rates were maintained after the initial 83.6 percent response rate for the first Cycle; Cycle

2 = 92.8 percent and Cycle 3 = 88.3 percent (Statistics Canada 2008). A more detailed description of the sampling and other methodological issues is available (see Statistics Canada 2004). In order to assess whether the self-reported injury rates in the NPHS were a valid measure of MVC injury rates in Canada, we compared the NPHS self-reported MVC injury rates for males and females for seven age groups with police collision reports of MVC injury rates, based on Transport Canada’s Traffic Accident Information Database (TRAID) for Canadian provinces and territories for 1994–96 (Roberts et al. 2007). We found no significant differences between males and females for any of the age categories. These findings suggest that self-reported MVC injury data for the NPHS are consistent in patterns and trends with the official data collected by Transport Canada.

Variables Included in Analyses Sociodemographic variables included age, gender, education, and household income. Gender was coded as a categorical variable with 1 = male, 0 = female. Age was coded continuously from 12 to 85 years. Education was measured on a 6-point scale ranging from elementary (1) to university (6). Household income was measured on an 11-point scale from no income (1) to $80,000+ (11). Cycle 2 (1996–97) included the following questions about motor vehicle injury prevention strategies: 1. In the past 12 months have you been a passenger with a driver who had too much to drink? (coded as a categorical variable, 1 = yes, 2 = no, 3 = don’t know) 2. On the most recent occasion did you try to prevent this person from driving? (coded as a categorical variable, 1 = yes, 2 = no, 3 = don’t know) 3. What did you do?

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Self-Reported Risky Driving Behaviours and Injury Prevention Strategies  4. How often, when you drive, do you insist that all passengers have seatbelts fastened and that all young children are in car seats? (coded as 1 = always, 2 = most of the time, 3 = sometimes, 4 = rarely or never) 5. Do you ever go out with friends or family to a place where you will be consuming alcohol? (coded as a categorical variable, 1 = yes, 2 = no, 3 = don’t know) 6. When you go out with friends do you arrange to have a designated driver? (coded as 1 = always, 2 = most of the time, 3 = sometimes, 4 = rarely or never) 7. How often do you make this arrangement? (coded as 1 = always, 2 = most of the time, 3 = sometimes, 4 = rarely or never) Additionally, risky driving behaviours were queried: 1. How often, when you drive, do you drive at or below the posted speed limits? (coded as 1  = always, 2 = most of the time, 3 = sometimes, 4 = rarely or never) 2. In the past 12 months, how many times did you drive when you perhaps had too much to drink? (coded as number of times) The MVC injuries measure was derived from the outcomes of two questions at Cycle 3 (1998–99): In the past 12 months, did you have any injuries that were serious enough to limit your normal activities? Participants who answered “yes” were then asked, What happened? Participants who cited a “transportation accident” as the cause of their injuries were coded as 1 (indicating an MVC), and all others were coded zero, that is, 1 = injured; 0 = not injured. The sample was limited to respondents 16 years and older who responded “yes” to the question: Do you have a valid licence for a motor vehicle?

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Statistical Analyses Frequencies, cross-tabulations, and logistic regression estimates were calculated using SPSS. The sample size (all individuals 16 years and older with a valid driver’s licence) was 10,887. Estimation was conducted using the sampling weights that were provided by Statistics Canada. Statistics Canada calculated these weights by post-stratifying the Cycle 1 stripped weight to the 1994–95 population estimates based on 1996 Census counts by age group and gender within each province.

Results Self-Reported Motor Vehicle Injury Prevention Strategies At Cycle 2, of the respondents who reported ­having a valid driver’s licence, 691 (6.38 percent; CI = 5.90–6.82 percent) reported having been a passenger with a driver who had too much to drink in the past year. Of the 691, 49.68 percent (N = 343; CI = 45.94–53.42 percent) tried to prevent this person from driving. Of the 343 respondents who tried to intervene, 26.08 percent (CI = 21.38–30.77 percent) drove the person home; 18.17 percent (CI = 14.04–22.29 percent) asked someone else to drive; 24.28 percent (CI = 19.69–28.86 percent) asked the person to take a taxi; 11.53 percent (CI = 8.12–14.95 percent) hid the car keys; 1.27 percent (CI = 0.07–2.46 percent) served the person coffee; 1.86 percent (CI = 0.42–3.31 percent) kept the person at home; and 26.13 percent (CI = 21.43–30.83 percent) engaged in other activities. The majority of drivers reported “always” insisting on passenger seatbelt use (85.01 percent; CI = 84.34–88.90 percent). However, as Table 1 shows, females and older drivers reported that they are more likely to do so. Among all drivers, 70.68 percent (CI = 69.82–71.53 percent) reported going out with friends or family to consume alcohol, yet 76.55 percent (CI = 75.60–77.50 percent) of this subgroup reported that they arranged to have a

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S74  Evelyn Vingilis and Piotr Wilk Table 1

Frequency and Percentage of Respondents Who Insist on Passengers Wearing Seatbelts, by Gender and Age Groups Always Gender

Age

Female

Male

Most of the Time

Sometimes

Never

n

%

n

%

n

%

n

%

16–29 30–59 60 and over

940 2,925 717

84.4 92.7 94.7

99 157 23

8.9 5.0 3.0

32 32 8

2.9 1.0 1.1

43 41 9

3.9 1.3 1.2

16–29 30–59 60 and over

812 2,865 860

64.2 82.8 88.1

159 342 51

12.6 9.9 5.2

103 99 23

8.1 2.9 2.4

191 153 42

15.1 4.4 4.3

Source: Statistics Canada (2008).

designated driver. Of those who reported arranging a designated driver, the majority reported “always” arranging a designated driver (74.46 percent; CI = 73.35–75.58 percent).

“rarely/never.” Only a small percentage of drivers (9.33 percent; CI = 8.78–9.88 percent) reported that in the past 12 months they ever drove when they had too much to drink; the mean number of times in the past year that respondents drove after drinking too much was 0.214 times (CI = 0.198–0.230).

Risky Driving Behaviours A minority (38.89 percent; CI = 37.97–39.80 percent) of drivers reported “always” driving at or below the speed limits, while 42.20 percent (CI = 41.27–43.13 percent) reported driving at or below the speed limits “most of the time”; 11.25 percent (CI = 10.65–11.84 percent) reported “sometimes,” and 7.67 percent (CI = 7.17–8.17 percent) reported

Table 2 presents the percentage of respondents who reported complying with the speed limits by age and gender. A numerical trend is visible, with young males the least likely of all age groups to report “always” obeying speed limits (20.3 percent). Additionally, the males tended to report obeying the

Table 2

Frequency and Percentage of Respondents Who Obey Speed Limits, by Gender and Age Groups Always Gender

Age

Female

Male

Most of the Time

Sometimes

Never

n

%

n

%

n

%

n

%

16–29.9 30–59.9 60 and over

358 1,417 478

32.2 44.9 63.1

507 1345 232

45.6 42.6 30.6

170 251 28

15.3 8.0 3.7

77 142 19

6.9 4.5 2.5

16–29.9 30–59.9 60 and over

257 1,106 554

20.3 32.0 56.7

525 1569 348

41.5 45.4 35.6

243 472 42

19.2 13.6 4.3

240 311 33

19.0 9.0 3.4

Source: Statistics Canada (2008).

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Self-Reported Risky Driving Behaviours and Injury Prevention Strategies 

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Table 3

Mean Number of Times with Confidence Intervals (CI) that Respondents Reported Driving after Drinking Too Much in Past Year, by Gender and Age Groups Gender

Age

Mean Number Times

CI

Females

16–29 30–59 60 and over

.202 .061 .001

0.152–0.252 0.031–0.091 –0.060–0.063

Males

16–29 30–59 60 and over

.510 .340 .063

0.463–0.557 0.312–0.369 0.009–0.118

Source: Statistics Canada (2008).

speed limit less than females. Table 3 shows the mean number of times within the past 12 months that respondents reported driving after they thought they had had too much to drink by age and gender. Young males reported the highest number of times they drank too much and drove. Females and older drivers showed lower trends of this behaviour.

Risky Driving Behaviours and MVC Injuries The relationship between Cycle 2 (1996–97) variables of obeying speed limits and impaired driving and subsequent Cycle 3 (1998–99) MVC injury was examined using cross-tabulations and logistic regression analysis. Of those who reported “always” or “most of the time” obeying the speed limits, 0.63 percent reported a subsequent MVC injury, while of those who reported “sometimes” or “rarely/never” obeying the speed limits, 1.85 percent reported a subsequent MVC injury, a significant difference (χ 2 = 26.976, df = 1, p < .0001). The results of the logistic regression (Table 4) show that, controlling for the effects of age, gender, education, and household income, those who reported “sometimes” or “rarely/never” obeying the speed limits were 2.544 (CI = 1.582–4.089) times more likely to report a subsequent MVC injury than those who reported “always” or “most of the time” obeying the speed limits. Interestingly, age was the only other significant predictor, showing an inverse relationship

between higher ages and reporting of subsequent MVC injury. Similarly, a significantly greater percentage (χ 2 = 8.513, df = 1, p < .004) of drivers driving one or more times within the last 12 months after they had too much to drink reported a subsequent MVC injury (1.69 percent), compared with drivers who reported driving no times after drinking too much (0.77 percent). The logistic regression results (Table 4) indicate that after controlling for the effects of age, gender, education, and household income, those who reported driving one or more times within the last 12 months after they had too much to drink were 2.119 (CI = 1.189–3.775) times more likely to report a subsequent MVC injury than those who did not report driving after drinking too much. Similarly, only age showed a significant inverse effect.

Discussion The study results showed that a very small percentage (6.4 percent) of respondents reported riding with an impaired driver, and half of them had tried to intervene. The most common self-reported interventions were ferrying the driver home by oneself, other driver, or taxi. The good news is that only 1.3 percent served coffee, which might suggest that

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S76  Evelyn Vingilis and Piotr Wilk Table 4

Logistic Regression: Speeding and Impaired Driving, Controlling for Gender, Age, Education, and Household Income

Obey Speed Limits Intercept Always/most of the time* Sometimes/rarely/never Age** Gender (male) Education** Income** Impaired Driving Intercept Never* One or more times Age** Gender (male) Education** Income**

Log Odds

SE

p

Odds

–5.289

0.204

0.000

0.005

0.934 –0.031 0.264 –0.120 0.006

0.242 0.009 0.232 0.089 0.052

0.000 0.001 0.254 0.178 0.910

2.544 0.970 1.302 0.887 1.006

–5.124

0.191

0.000

0.006

0.751 –0.034 0.237 –0.119 0.019

0.295 0.009 0.235 0.089 0.053

0.011 0.000 0.312 0.182 0.724

2.119 0.967 1.268 0.888 1.019

CI (Lower)

CI (Upper)

1.582 0.953 0.827 0.745 0.908

4.089 0.987 2.051 1.056 1.115

1.189 0.950 0.800 0.745 0.919

3.775 0.983 2.008 1.058 1.129

Notes: *The reference group. ** Covariates age, education, and income were centred at the population mean. Source: Statistics Canada (2008).

various public service announcements and educational materials have been successful in educating the public that coffee is an ineffective antidote for impairment (e.g., MADD Canada 2007). The results of this study also suggest that most Canadians insist on passenger seatbelt use, with 92.8 percent reporting always or most of the time insisting that their passengers or children are properly restrained. This self-reported rate is similar to a recent Canadian observational survey of seatbelt use that found an observed 90.5 percent seatbelt use among occupants of light-duty vehicles (Transport Canada 2006). Although 70.7 percent of respondents reported going out with family and friends to drink, they also commonly reported arranging a designated driver. However, 9.3 percent still reported driving one or more times in the past year when they had had too much to drink. These findings mirror those of a recent poll of Canadians in which 8.2 percent

of respondents reported driving when they thought they were over the legal limit in the past 12 months (Vanlaar, Emery, and Simpson 2007). Impaired ­driving is a serious risk factor for MVC injuries and fatalities. In 2005, 38.3 percent of all drivers killed in Canada had been drinking with close to 85 percent in excess of the Canadian Criminal Code legal limit of 80 percent mg (Mayhew, Brown, and Simpson 2005). The overrepresentation of impaired drivers in MVC injuries was also found in the current study: controlling for the effects of age, gender, education, and household income, over twice as many drivers who reported driving after drinking too much also reported a subsequent MVC injury compared with non-drinking drivers. Another significant risk factor is speeding. Onefifth of respondents reported sometimes or rarely/ never obeying the speed limits; only two-fifths reported always obeying the speed limits. Speeding also increased the odds of subsequent MVC injury. When controlling for the effects of age, gender,

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Self-Reported Risky Driving Behaviours and Injury Prevention Strategies  education, and household income, the odds of a reported subsequent MVC injury were two and a half times greater for respondents who reported sometimes/rarely/never obeying the speed limits compared with respondents who reported always or mostly obeying the speed limits. Speeding has been identified as the second most common contributor to motor vehicle fatalities, second to impaired driving: it is a factor in about 25 percent of Canadian MVC fatalities (Transport Canada 2008). The age and gender differences found in collision statistics and other studies were reflected in the results. Males and younger drivers reported more risky behaviours related to driving: young males were least likely to comply with the speed limit and the most likely to engage in impaired driving. Yet, interestingly, only age was a significant predictor of subsequent MVC injuries within the logistic regressions. Transport Canada’s (2008) data indicate that young males are the most typical speeders and drinking drivers; consequently, 40 percent of Canada’s speeding fatalities were represented by drivers aged 16–24 years of age, and 40 percent of these drivers had also been drinking. Other studies have found that young persons who were passengers of drinking drivers also reported more drinking, driving after drinking, non-seatbelt use, speeding, and leaving less distance between their and other vehicles, particularly when driving with peer passengers ­(Petridou et al. 1997; Simons-Morton, Lerner, and Singer 2005). Additionally, Williams and Shabanova (2002) found that adolescents, but not adults, decreased driver seatbelt use when the number of passengers increased, were less likely to wear seatbelts when driving with passengers in their twenties, but were most likely to wear seatbelts when driving with passengers over 30 years of age. Passenger seatbelt use also decreased among adolescents as the number of passengers in the vehicle increased.

Limitations There are major limitations with this study, and thus the results should be framed within these limitations. It is important to point out that these data are based

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on self-reported information. Thus, it is possible that some responses reflect social desirability. Another limitation is that all relevant questions to assess road safety were not available in the survey instrument. For example, no information was gathered on whether those who reported MVC injuries were drivers or passengers, and thus causal pathways cannot be clarified. Exposure data were also not available so it was not possible to control for kilometres driven. No information was collected on personal seatbelt use. Some of the questions were poorly worded. Finally, the time of the data collection is a challenge. Because the National Population Health Survey included road safety questions only in Cycle 2 and not in subsequent waves of the survey, the responses could be out of date and might not reflect current behaviours. Nevertheless, the results of this study are congruent with other studies and can be generalized to the Canadian population.

The Policy Context A Canadian opinion poll has shown that 59.8 percent of Canadians were very or extremely concerned about road safety among a range of social issues, such as pollution, global warming, and the health care system, ranking it in fourth place, above crime (Vanlaar, Robertson, and Marcoux 2007). Of various road safety issues, most respondents were very or extremely concerned about drinking drivers and excessive speeding (Vanlaar, Robertson, and Marcoux 2007). The majority supported legislative initiatives such as mandatory ignition interlock devices for convicted impaired drivers, immediate impoundment of vehicles of drivers who fail a breath test, more police spot checks, and stronger enforcement of speed limits (Vanlaar, Emery, and Simpson 2007; Vanlaar, Robertson, and Marcoux 2007). However, despite general public support for road safety initiatives, a “not in my backyard” attitude may still exist regarding road safety initiatives, and the political agenda may well reflect the public agenda. For example, on 19 November 2008, new road safety legislation was proposed for Ontario to further restrict the privileges of young drivers

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S78  Evelyn Vingilis and Piotr Wilk through the graduated licensing system with a total ban on alcohol consumption, a ban on more than one teenage passenger, and a zero tolerance for speeders with one ticket leading to licence suspension (Mandel 2008; Popplewell 2008). However, the legislation actually introduced for first reading was watered down; in response to Opposition party criticism and an online protest initiated by youth, it did not include a provision for zero tolerance for speeders or the ban on more than one teenage passenger (Bradley 2008; Leslie 2008). In summary, this study suggests that most Canadians engage in behaviours to reduce the risk of motor vehicle collisions. Requiring passengers to wear seatbelts, preventing impaired drivers from driving, and using designated drivers were commonly reported strategies. Yet, a substantial minority, particularly young males, engaged in a range of risky driving behaviours. Of concern is the finding that self-reported speeders and impaired drivers are significantly more likely to report an MVC injury within two years. These findings support the need for continued focus on speeding and drinking driving to reduce collisions in Canada. In addition, it would be important to encourage Statistics Canada to include questions specific to road safety in new waves of the ongoing NPHS survey.

Note This research was supported by a grant from AUTO21, a member of the Networks of Centres of Excellence program, which is administered and funded by the Natural Sciences and Engineering Research Council, the Canadian Institutes of Health Research, and the Social Sciences and Humanities Research Council in partnership with Industry Canada. Access to the National Population Health Survey microdata files was granted through an application to the CISS-ACCESS to the Research Data Centre Program. While the research and analysis are based on data from Statistics Canada, the opinions expressed do not necessarily represent the views of Statistics Canada.

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