   |  | | Why in-person driver's license renewal might be a good idea | By Mike Magee, MD
More than 40,000 Americans die each year in motor vehicle crashes. Many of the drivers involved in fatal crashes are over age 65, even though seniors account for only about eight percent of the miles driven each year in the United States. And motor vehicle fatality rates among senior drivers are on the rise, particularly for those 85 or older.1,2
According to the Insurance Institute for Highway Safety, "Drivers aged 65 and older …are expected to account for as much as 25 percent of total driver fatalities in 2030, compared to 14 percent currently." As baby boomers age and more seniors get behind the wheel, how can we prevent rising fatalities?2
Many states have looked for the answer in stricter license laws for elderly individuals. A comprehensive study of all fatal car crashes involving seniors in the 48 contiguous states between 1990 and 2000 was published in 2004 in the Journal of the American Medical Association. The study analyzes the effects of the following on motor vehicle fatality rates among seniors: frequency of license renewal, whether license renewal must be in-person, and whether vision and road tests are required.2
Other general motor vehicle laws that vary from state to state and could affect fatalities among older drivers were also taken into account in the study. These included primary and secondary seatbelt laws, speed limits, blood alcohol level restrictions, and license suspensions.2
The study revealed that, of all of these measures, only one showed a definitive preventive impact on senior fatalities, and that was the in-person renewal of motor vehicle licenses. The positive impact primarily affected those over 85.3
Why should auto fatalities among very elderly drivers decline with in-person renewals? Experts have offered two explanations. First, in-person renewal requirements provide an opportunity for license inspectors to either refuse to grant licenses to obviously impaired drivers or to refer them for medical evaluation prior to receiving a new license.2
And the second theory suggests that the requirement to appear in person deters some seniors from seeking a renewal. This theory is supported by the common tendency among seniors to impose restrictions on their own driving behavior, including not driving at night, in poor weather, on highways, at rush hour, after having an accident, or after loss of spatial or depth perception. An in-person license renewal requirement might be one more thing that older drivers consider as a reason not to drive.2,4
Focusing on motor vehicle safety among seniors makes good sense. First, the elderly population is rapidly growing. Second, the elderly are the most vulnerable - they're more likely to die from crash injuries. And third, solutions are relatively simple and not unduly harsh, such as in-person license renewal requirements for the oldest segment of the senior population.
Establishing sensible guideposts will trigger timely choices that are realistic and can enhance roadway safety for everyone.
For Health Commentary, I'm Mike Magee.
References
1. Lyman S, Ferguson SA, Braver ER, Williams AF. Older driver involvement in police reported crashes and fatal crashes: trends and projections. Inj Prev. 2002;8:116-120.
2. Grabowski DC, Campbell, CM, Morrisey, M. Elderly licensure laws and motor vehicle fatalities. JAMA. 2004;291:2840-2846.
3. Fatality Analysis Reporting System. Department of Transportation, National Highway Safety Administration Web site. Accessibility verified July 9, 2004. Cited in Grabowski DC, Campbell, CM, Morrisey, M.
4. Ball K, Owsley C, Stalvey B, Roenker DL, Sloane, ME, Graves, M. Driving avoidance and functional impairment in older drivers. Accid Anal Prev. 1998;30:313-322. Cited in Grabowski DC, Campbell, CM, Morrisey, M.
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