To Educate or Not to Educate Is Not the Question

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To Educate or Not to Educate Is Not the Question In 1976, 87 per cent of all deaths of 15 to 19 year old males was due to accidents. Sixty per cent of those deaths resulted from motor vehicle accidents.' Although deliberated in recent issues of this Journal,2-5 there should be no question that a responsible society systematically must strive to provide effective education about such a singularly hazardous activity as driving for those most susceptible to related injury or death. Rather, the questions of concern in light of evidence presented should be: why are current driver education programs seemingly ineffective, and; (how) can we improve their ef-

fectiveness? Postulations about why driver education programs appear ineffective require some understanding of the programs evaluated. Such programs might be identified more accurately as driver training in that they are principally formulated upon theories of knowledge transfer, and are primarily designed to facilitate development of psychomotor driving skills and cognitive understandings about vehicular operations in complex settings. The effectiveness of such programs is properly determined by comparing scores on state driving licensure examinations among those trained by various formal and informal procedures. The literature about fatal vehicular accidents among youth, however, suggests that acquired levels of driving skills and cognitions are of minor conAJPH February 1981, Vol. 71, No. 2

sequence in comparison to other variables. Drinking and driving, and reckless driving (including speeding) combined account for the vast majority of fatal vehicular accidents. The degree to which driving skills and cognitions are associated with morbidity and mortality resulting from vehicular accidents suggests the extent to which standards for driving licensure are a matter of health policy. But since one cannot be licensed to drive without achieving a level of proficiency sufficient to meet such standards, whether schools should provide driver training is a matter of educational policy. The more critical point to consider in discussions about health and educational policies is that driver training programs have not been designed to influence those behaviors that lead to injurious or fatal accidents. Health education programs, based on current understandings about health-related behaviors, first should be designed to influence specifically those behaviors associated with fatal accidents. These programs then need to be implemented and evaluated before we can make valid assumptions about the potential for such educational interventions to influence relevant health outcomes. Given the magnitude and seriousness of the health problem addressed, support for the design, implementation, and evaluation of such programs should be provided by health and education officials alike. Our young people deserve no less. Lloyd J. Kolbe, PhD Director of Evaluation School Health Education Project National Center for Health Education 901 Sneath Lane, Ste. 315 San Bruno, CA 94066

REFERENCES 1. Brown SS: The health needs of adolescents. IN: Healthy People: The Surgeon General's Report on Health Promotion and Disease Prevention, Background Pa-

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pers. Washington, DC: Office of the Assistant Secretary for Health, DHEW (PHS) Pub. No. 79-55071A, 1979. Robertson LS and Zador PL: Driver education and fatal crash involvement of teenaged drivers. Am J Public Health 1978; 68:959-965. Robertson LS: Crash involvement of teenaged drivers when driver education is eliminated from high school. Am J Public Health 1980; 70:599-603. Green LW: To educate or not to educate: Is that the question? Am J Public Health 1980; 70:625-626. Robertson LS: Fact and fancy in the formation of public policy. Am J Public Health 1980; 70:627.

Driver Education and Hazards of the Road Dr. Leon S. Robertson's article "Crash Involvement of Teenaged Drivers When Driver Education is Eliminated from High School" left me wondering: What was the crash involvement of parents, older siblings and friends of those teenagers-who remained unlicensed-as a result of the elimination of driver education in high schools? Not all teenaged driving is "joy riding." When licensure is denied a 16 or 17 year old, an older friend, sibling or parent must act as chauffeur, thus exposing two individuals to the hazards of the road. Subsequent research should include measures of crash involvement of 16 or 17 year olds as passengers as well as drivers. When driver education in high schools is eliminated, the latter may decrease but the former may go up. Crash involvement of the "chauffeurs" must also be included. One should determine the net effect. Carolyn Harman graduate student Department of Health Care Administration School of Pharmacy University of Mississippi University, MS 38677 171