Last reviewed and revised on October 8, 2009
By Claire McCarthy, M.D.
Boston Children's Hospital
It terrifies me when my teenaged children drive. It's not that they are bad drivers; they are both responsible and careful. But they are teen drivers, and that, in and of itself, is terrifying. According to the American Academy of Pediatrics (AAP), I have good reason to be scared.
Its December 2006 policy statement, "The Teen Driver," has some sobering statistics:
- Motor vehicle crashes are the leading cause of death for 16 to 20 year-olds. They kill around 5,500 people each year.
- Teens don't just kill themselves. While teenagers account for only 6% of drivers, they are responsible for 14% of fatal crashes.
- The crash rate for 16- to 19-year-olds is twice that of 20- to 24-year-olds, three times that of 25- to 29-year-olds, and four times that of 30- to 69-year-olds.
- The first year of driving is the most dangerous: 16-year-olds get in 35 crashes per 1 million miles, compared with 20 crashes per 1 million miles for 17-year-olds. The rate for the general population, on the other hand, is 4 crashes per 1 million miles.
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Risk Factors for Crashes
Inexperience is the major reason for these grim realities. Crashes are even more likely when you mix inexperience with risk-taking behavior that is part of being a teenager, such as speeding. Here are other risk factors for car crashes:
- Having other teenagers in the car "The most dangerous way a teenager can get to and from school," the report says, "is by driving in a car with a teenaged driver." If just one other teenager gets in the car with a 16- or 17-year-old driver, the risk of a crash goes up 40% compared with driving alone. If two friends get in, the risk doubles; with three or more teens, the risk quadruples.
- Alcohol and marijuana use Teenagers are less likely to drink and drive than adults, but are more likely to crash if they do drink and drive. Marijuana use is more common than alcohol use in some areas of the country, and the alcohol/marijuana combination is particularly deadly.
- Nighttime driving 58% of fatal crashes occur between 9 p.m. and midnight. Fatigue, teenaged passengers, alcohol, and inexperience with night driving are factors.
- Safety-belt use Many teenagers think that it's uncool to wear a seatbelt or that they don't need to wear one for short distances, or they worry about a safety belt wrinkling their clothes.
- Type of vehicle driven Teenagers tend to drive smaller cars, which have less crash protection, and older models, which have fewer safety features.
- Distractions Driving with a cell phone multiplies the crash risk four-fold. Interestingly, using a hands-free cell phone doesn't really decrease that risk. It's the distraction that's the problem with inexperienced drivers, which explains why eating, drinking, and adjusting the radio or climate controls cause more crashes than cell phones.
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What's a Parent To Do?
So what can we parents do to save lives? The American Academy of Pediatrics strongly favors graduated driver licensing (GDL) laws. Most states now have two stages for teen drivers. First, they get their learner's permit, and then they get a full license. GDL laws add a stage in between called an intermediate or provisional driver's license. Each stage has specific restrictions and minimum time requirements to give the teen more time to gain experience behind the wheel while driving under low-risk conditions to keep them safe.
Many variations of the in-between stage are possible, but data show that the GDL approach works best when:
- There are limits on nighttime driving
- The number of passengers allowed during the intermediate stage is limited
- There is a requirement that the teen be crash-free and violation-free for a certain time before passing to the next stage
Even if a state doesn't have GDL laws, legal restrictions on night driving and the number of passengers for new drivers can make a big difference. And improved (and enforced) safety belt laws as well as strict penalties for drinking and driving are always a good idea for drivers of any age.
We need to take a closer look at Drivers Education programs, too. Research has shown that such programs in high schools actually encourage early licensure of the youngest and most dangerous drivers and can increase the number of crashes, injuries and deaths. Most programs would benefit from more education time for young drivers as well as more supervised time on the road. Supervised road time has been shown to be more effective in reducing crashes than in-class education time.
Parents don't need to wait for laws, though. A recent study based on surveys of over 5,000 teen drivers showed that teens whose parents set and enforced rules were more likely to use their seatbelts and obey speed limits. And those whose parents set and enforced rules but were also warm and supportive had the lowest risk of crashing and were the least likely to drive drunk or use a cell phone while driving.
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Teen Driver Contract
One way for parents to get actively involved in their teens driving is to have them sign a written contract. The AAP suggests that this contract specify:
- When, where and how they will drive
- What they will contribute toward insurance and gas
- That they will maintain good grades at school and meet other family obligations
- What the penalties will be (including losing driving privileges) for violating aspects of the contract
- What additional privileges the teen can gain by driving responsibly
You can see a sample contract and read the entire policy statement in the journal Pediatrics.
The same survey of teen drivers found something else that is important, and worrisome: Compared to teens who shared a car, teens with their own car had twice the crash risk, and were more likely to speed or use their cell phone while driving. Given that 70% of the respondents who said they drove alone said that they were the main driver of their vehicle, this is scary.
Parents who are thinking about letting their teens have their own car should think again. It may make your teen happy, and it may be convenient for you, but is either one worth doubling his risk of crashing? Teens should only have their own car if it is absolutely necessary (for example, if it's the only possible means of transportation to school) and driving should be limited and closely monitored.
As parents, we usually want our kids to drive. It can make our life easier as parents and it's a rite of passage. But this rite of passage is a particularly dangerous one. Talk to your kids, set rules, be involved. Their lives could depend on it.
Claire McCarthy, M.D., is an assistant professor in pediatrics at Harvard Medical School, an attending physician at Children's Hospital of Boston, and medical director of the Martha Eliot Health Center, a neighborhood health service of Children's Hospital. She is a senior medical editor for Harvard Health Publications.