Promoting Driver Safety & Mobility Options in Livable, Senior-Friendly Communities

1. Promoting Driver Safety & Mobility Options in Livable, Senior-Friendly Communities North Carolina Conference on Aging September 11, 2007 Fran Carlin-Rogers, Carlin Rogers Consulting, Orlando, Florida Suzanne LaFollette-Black, North Carolina AARP Jane Stutts, UNC Highway Safety Research Center Phyllis Bridgeman, NC Division of Aging & Adult Services

2. Goals of Today’s Workshop • Have a basic understanding of how promoting driver safety and mobility issues are integral to advancing livable, senior friendly communities • Become familiar with the array of safe driving and mobility programs, resources and options available to older adults in their communities

3. White House Conference on Aging 2005 Select Top Ranked Recommendations • # 3 Transportation Options: “ Ensure that Older Americans have transportation options to retain their mobility and independence” • # 47 Capacity for Safe Driving: “ Support Older Drivers to Retain Mobility and Independence through Strategies to Continue Safe Driving” Source: www.whcoa.gov

4. National Overview • More older people • More of them will be driving • Driving more miles than ever before • Driving at older ages than ever before • More women driving • Few real alternatives to driving

5. The Issue…

6. Consider This… • As a group, older drivers are safe • Self-regulation & necessary reductions in driving work for most • Still, due to increased frailty, older adults are more likely to die when involved in car crashes • Increased frequency of medical conditions at about age 55 • Increased frailties of age put elder @ greater risk for serious injury or death

7. 2001 National Household Transportation Survey • 90% of all trips taken in automobile • For individuals who stop driving, 1% use public transportation • 1-2% of all seniors use of public transportation • Bus use increases for long distance trips (1% for 25-54 y.o to 6% for 75+) • 9% of Americans walk to their destinations • Non drivers take far fewer & shorter trips

8. Important Issues • Most radical increase of at risk crashes comes with medical conditions which impact cognitive skills • Identification of drivers who are medically at risk • Testing should be focused on ability, not age!

9. It’s Not The Years….. It’s The Mileage!

10. Many diseases & conditions may impair driving skill: • Medication use • Effects of anesthesia & surgery • Vision (cataract, macular degeneration, glaucoma) • Cardiovascular (arrhythmias, CHF,Vavular HD) • Cerebrovascular (stroke, TIA, etc) • Neurologic (Brain tumor, Dementia,Migraine, Head injury, Parkinson’s,MS, sleep disorders,seizures,etc) • Metabolic ( diabetes, hyper/hypothyroidism) • Respiratory (COPD, respiratory failure) Source: NHTSA

11. Drivers with Cognitive Decline • May not restrict driving as others do • Lack of recognition of traffic situations • Confusion about environment • Driving environment is more complex • Crash risk is 7.6 times higher than healthy drivers ( age matched) • Loss of appropriate reactions

13. Why a focus on driving?

14. At least two reasons: • Older adults (like everyone else) are highly dependent on cars for meeting their transportation needs • The safety of older drivers presents special challenges.

15. Mode of Travel by Age Source: 2001 NPTS, Unpublished Data

16. Older Drivers Have Fewer Crashes Crashes per 100,000 drivers (Source NCSA, 2000)

17. Fatalities per 100 Crashes 9 8 7 6 5 4 3 2 1 0 16-19 20-24 25-34 35-44 45-54 55-64 65-74 75-84 85+ Source: Li, Braver and Chen, 2003

18. Projections of Fatal Crash Involvements by Age of Driver 24.9% 20.0% 14.8% 13.7% Source: Lyman et al., 2002

19. Projected Growth in NC Population Age 65+ Population X1000

20. Safety of NC Older Drivers • Drivers age 65+ are 8% of all drivers in crashes, but 18% of those killed in crashes. • Over 27,000 older drivers are involved in crashes each year in NC. • On average, 150+ older drivers are killed in crashes each year. • These numbers have remained fairly stable over the past several years – but this may be changing.

21. (2001-2004 NC Crash Data) Statewide: 28.6

22. What we want • Enable older drivers to make appropriate driving choices that: • Maximize personal and community safety • Utilize community options, when needed, to maintain mobility

23. Our Goals • Keep older adults driving as long as they can do so safely. • Maximize personal and community safety. • Provide transportation options , when needed, to maintain mobility.

24. Today’s Situation • Most older adults modify driving behavior voluntarily, but….. • Some not soon enough • Some too soon • Some in the wrong way

25. Why is this important? • If they give up driving earlier they may create MOBILITY problems • If they continue to drive when they shouldn’t they will create SAFETY problems

26. What Can Be Done? • Roadway improvements • Vehicle safety and design • Driver licensing • Driver education and awareness • Public awareness • Alternative transportation • Land use planning

27. Thank You! Jane Stutts Jane_Stutts@unc.edu

28. NC Senior Driver Safety Coalition • Initiated by the UNC-CH Highway Safety Research Center under a grant from the Governor’s Highway Safety Program • Initial partners in 2004 [AARP and the Division of Aging and Adult Services] soon became 20 partners

29. NC Senior Driver Safety Coalition • NC DOT traffic engineers • NC DMV, Medical Evaluation Branch • Physicians and Occupational Therapists • NC Assistive Technology Program • NC MS Society • AAA Carolinas • University researchers • Law enforcement

30. NC Senior Driver Safety Coalition • September 2005 – new role for the Coalition • NC Executive Committee for Highway Safety, Older Driver Working Group • Examples of other issue groups: • Aggressive driving • Unlicensed drivers • Inattentive drivers • Speeding

31. NC Senior Driver Safety Coalition • Identification of needs and ways a coalition might respond • Mission and membership • Sharing of current programs & activities

32. NC Senior Driver Safety Coalition • Immediate focus on roadway improvements and community awareness • Promoting safer roadways for older drivers, especially signage • Raising general awareness among not only older drivers and families, but also planners, engineers, doctors, and other health care professionals

33. NC Senior Driver Safety Coalition • Roadway improvements • Identification of locations where older drivers were over-involved in crashes • 5 sites selected for greater examination • Characteristics of crashes to identify common factors for older drivers • Identifiable “fixes”?

34. NC Senior Driver Safety Coalition • Raising community awareness • Toolkit of resources and information • Broad array of information useful to many different audiences • Community forums • DMV license examiner offices • Senior centers

35. NC Senior Driver Safety Coalition • Raising community awareness - 5 community forums across NC in 2006 • Wilmington • Greensboro • Waynesville • RTP • Southern Pines

36. NC Senior Driver Safety Coalition • Strategies of the Older Driver Working Group currently in process • Signage • Roadway and driving environment • Hazardous intersections for older drivers • Senior driver safety website for NC • Law enforcement capacity building

37. NC Senior Driver Safety Coalition • Accomplishments to date • Community forums in five pilot locations and development of community toolkits • CarFit events • Training for DOT engineers on federal guidelines for highway design for older drivers and pedestrians • Identification of hazardous intersections to serve as pilot for systematic upgrading to improve safety • Law enforcement training

38. NC Senior Driver Safety Coalition • Future work • Working with health care professionals to identify and assist high-risk drivers • Public education through a web site, DMV materials, and adaptations of tool kit for special audiences • Assistance to communities in forming local coalitions

39. GAO Report: Older Driver Safety07-413 April, 2007 “Older Driver Safety: Knowledge Sharing Should Help States Prepare for Increase in Older Driver Population” www.gao.gov/new.items/d7413.pdf • The title says it all! • Risk will increase with ↑ population;↑ ages; ↑ mileage • Drivers with dementia is a particular concern • States should be allowed to share information & best practices • Coalition & partnership strategies

40. Recommend: Coordinated approach Innovative strategies Mobility management initiatives Target Areas: Safe (r) road users: Mgmt of at risk drivers Licensing procedures Education & training Safe (r) vehicles: ↑crashworthiness Occupant protection ITS technology Safe (r) roads: Alternative transportation options Monash University Elderly & Mobility: Literature Review

41. Florida Community Center model Summits Training Community events Legislative change California Coalition Pilot of 3 tier testing Missouri Coalition team Saturation strategy Outcome measurement North Carolina Coalition Proactive Summit Community events Varying Approaches to Action…

43. Customer Satisfaction Safety Access Affordability Choices Best Practices Sustainability Outcomes: Right Time Right Places Right Price Coordination Accountability Partnerships Community Transportation Critical Success Factors

44. It is Time for Your Community To Take Action! • Gather key stakeholders • Create partnerships • Coordinate efforts • Don’t reinvent the wheel! • Identify your community’s critical success factors • Create sustainability • Measure the outcomes of your efforts

46. Driver Safety Education Programs • AARP- on-line and classroom- 8 hours • AAA- Roadwise on-line and classroom-8 hours • AARP “We Need to Talk”-30-60 minute seminar on family conversations about older drivers • Carfit-12 point assessment checklist of how driver fits in own car • DriveWell- community education

47. Resources Available • Driver education brochures from AARP/AAA/DMV and others • Medical Transportation Toolkit and best practices • Inventory of older adult resources • Livable Communities Evaluation Guide • AARP Mobility Toolkit/packet-forum planning, riding the bus and pedestrian guide, publications

49. What can you do in your community? • Provide driver safety education and programs in your community • Advocate to expand and enhance federal, state and local laws about mobility options. • Implement “best practices” to engage community partners to improve options • Use the Livable Communities Evaluation Guide to assess mobility, drivability and walking accessibility