Accelerating Progress to Reduce Alcohol-Impaired Driving Fatalities

Consensus

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Alcohol-impaired driving is an important health and social issue as it remains a major risk to Americans' health today, surpassing deaths per year of certain cancers, HIV/AIDS, and drownings, among others, and contributing to long-term disabilities from head and spinal injuries. Progress has been made over the past decades towards reducing these trends, but that progress has been incremental and has stagnated more recently.

Getting to Zero Alcohol-Impaired Driving Fatalities examines which interventions (programs, systems, and policies) are most promising to prevent injuries and death from alcohol-impaired driving, the barriers to action and approaches to overcome them, and which interventions need to be changed or adopted. This report makes broad-reaching recommendations that will serve as a blueprint for the nation to accelerate the progress in reducing alcohol-impaired driving fatalities.

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606 pages · 6 x 9 · paperback
ISBN Paperback: 0-309-46826-4
ISBN Ebook: 0-309-46827-2
DOI: https://doi.org/10.17226/24951

Suggested citation

National Academies of Sciences, Engineering, and Medicine. 2018. Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem. Washington, DC: The National Academies Press.

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Steven M. Teutsch

Steven M. Teutsch, M.D., M.P.H. (Chair) is an independent consultant, Adjunct Professor at the Fielding School of Public Health, UCLA; Senior Fellow, Public Health Institute; and Senior Fellow, Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California. Until 2014 he was the Chief Science Officer, Los Angeles County Public Health where he continued his work on evidence-based public health and policy. He had been in Outcomes Research and Management program at Merck since October 1997 where he was responsible for scientific leadership in developing evidence-based clinical management programs, conducting outcomes research studies, and improving outcomes measurement to enhance quality of care. Prior to joining Merck he was Director of the Division of Prevention Research and Analytic Methods (DPRAM) at CDC where he was responsible for assessing the effectiveness, safety, and the cost-effectiveness of disease and injury prevention strategies. DPRAM developed comparable methodology for studies of the effectiveness and economic impact of prevention programs, provided training in these methods, developed CDC’s capacity for conducting necessary studies, and provided technical assistance for conducting economic and decision analysis. The Division also evaluated the impact of interventions in urban areas, developed the Guide to Community Preventive Services, and provided support for CDC’s analytic methods. He has served as a member of that Task Force and the U.S. Preventive Services Task Force which develops the Guide to Clinical Preventive Services as well as on Americas Health Information Community Personalized Health Care Workgroup and the Evaluation of Genomic Applications in Prevention and Practice (EGAPP) Workgroup. He chaired the Secretary's Advisory Committee on Genetics Health and Society, and has served on and has chaired IOM panels, Medicare’s Evidence Development and Coverage Advisory Committee, and on several subcommittees of the Secretary’s Advisory Committee on Healthy People 2020 and 2030.
Dr. Teutsch joined CDC in 1977, where he was assigned to the Parasitic Diseases Division and worked extensively on toxoplasmosis. He was then assigned to the Kidney Donor and subsequently the Kidney Disease Program. He developed the framework for CDC's diabetes control program. He joined the Epidemiology Program Office and became the Director of the Division of Surveillance and Epidemiology where he was responsible for coordinating CDC's disease monitoring activities. He became Chief of the Prevention Effectiveness Activity in 1992.
Dr. Teutsch was born in Salt Lake City, Utah. He received his undergraduate degree in biochemical sciences at Harvard University in 1970, an M.P.H. in epidemiology from the University of North Carolina School of Public Health in 1973, and his M.D. from Duke University School of Medicine in 1974. He completed his residency training in internal medicine at Pennsylvania State University, Hershey. He was certified by the American Board of Internal Medicine in 1977, the American Board of Preventive Medicine in 1995, and is a Fellow of the American College of Physicians and American College of Preventive Medicine. Dr. Teutsch has published over 200 articles and 8 books in a broad range of fields in epidemiology, including parasitic diseases, diabetes, technology assessment, health services research, and surveillance.

Julie A. Baldwin

Julie Baldwin, Ph.D. earned her doctorate in Behavioral Sciences and Health Education in 1991 from the Johns Hopkins University School of Hygiene and Public Health. From 1994-2004, she served as a tenured faculty member at Northern Arizona University (NAU), with a joint appointment in the Mel and Enid Zuckerman Arizona College of Public Health. She joined the faculty at the University of South Florida (USF) College of Public Health in the Department of Community and Family Health in 2005. She returned to Northern Arizona University’s department of Health Sciences in August 2015, where she now directs the Center for Health Equity Research.
Dr. Baldwin’s research over the years has focused on both infectious and chronic disease prevention. Cross-cutting themes which have characterized her work include: utilizing community-based participatory research approaches, working with underserved and/or marginalized populations, and addressing health disparities by developing and implementing culturally competent public health interventions.
As an enrolled member of the Cherokee Nation of Oklahoma, she has made a life-long commitment to serving diverse communities and to advocating for health promotion programs for children, adolescents and families.

Linda C. Degutis

Linda Degutis, Dr. P.H., MSN is Executive Director of Defense Health Horizons, sponsored by the Henry M. Jackson Foundation and based at the Uniformed Services University of the Health Sciences (USUHS), which envisions and develops promising ideas to assist the Assistant Secretary of Defense (Health Affairs), the Service Surgeons General, and the Defense Health Agency achieve the goals outlined in the Military Health System Quadruple Aim. In addition to holding an appointment as Adjunct Professor at Rollins School of Public Health, Emory University, she serves as the Chief Science Officer (pro bono) for The Avielle Foundation, which focuses its efforts on the relationships between brain health, compassion and violence. Her research has focused on substance abuse prevention, SBIRT, alcohol policy, alcohol impaired driving and injury and violence prevention.
Previously, Dr. Degutis was Director of the National Center for Injury Prevention and Control at the CDC. She came to Atlanta from Yale University where she was on the faculty of the Department of Emergency Medicine, and the Department of Environmental Health at the School of Public Health, where she was Director of the Research Division in Emergency Medicine, and Director of the Yale Center for Public Health Preparedness. She served as a Robert Wood Johnson Foundation Health Policy Fellow in the office of the late Senator Paul Wellstone (D-MN). She has held multiple leadership roles in state and national organizations and currently serves on the boards of the Pacific Institute for Research and Evaluation (PIRE), the Society for the Advancement of Injury and Violence Research (SAVIR) and the advisory board of the College of Sciences and Health at DePaul University; is Past President of the American Public Health Association; and a member of the National Academy of Medicine.

Mucio K. Delgado

Mucio Kit Delgado, M.D., M.S. is an emergency physician investigator committed to discovering innovative approaches to improve the outcomes of acutely ill and injured patients and also reduce the occurrence of injuries and the short-sighted behaviors that lead to them in the first place. Dr. Delgado has two complementary lines of research. First, he analyses large existing datasets and uses decision analytic modeling to guide policy aimed at improving trauma and emergency care. Second, he is developing a novel research program leveraging smartphones, connected devices, and insights from behavioral economics for injury prevention. He is currently testing smartphone-based "nudge" interventions to reduce cellphone use and drinking and driving. With relevance to reducing drinking and driving he is leading studies: 1) to determine the effect of the uptake of smartphone-enabled ridesharing on alcohol-involved crashes and mortality in the U.S.; 2) to verify the test-accuracy of commercially available smartphone-paired breathalyzers in a lab setting; 3) to conduct a pilot trial of smartphone-paired breathalyzers, rideshare credits, and incentives to promote designated driving and more moderate alcohol consumption. Prior to joining the tenure-track faculty in Emergency Medicine and Epidemiology at the University of Pennsylvania (Penn), Dr. Delgado completed an NHLBI K12 Career Development Award at Penn with a focus on clinical epidemiology and an AHRQ T32 post-doctoral fellowship in health services research at Stanford University. He has joint faculty appointments in the Center for Health Incentives and Behavioral Economics and the Penn Injury Science Center at Penn, and the Center for Injury Research and Prevention at the Children's Hospital of Philadelphia.

David H. Jernigan

David H. Jernigan, Ph.D. is an associate professor in the Department of Health, Behavior and Society at the Johns Hopkins Bloomberg School of Public Health. Dr. Jernigan has 30 years of experience researching and implementing effective alcohol policies. He was a founding member of the National Alliance to Prevent Impaired Driving in the 1990s, formed in response to Surgeon General C. Everett Koop’s 1989 recommendations on preventing impaired driving. He was principal author of the World Health Organization’s first Global Status Report on Alcohol and Health, and for subsequent reports has taken the lead on the reporting and analysis of policy responses being taken by WHO member states. As such, he has a broad familiarity with policy approaches regarding alcohol use and related problems being taken in other countries as well as the research base that informs those interventions. His work has encompassed development, dissemination, implementation and evaluation of public health approaches to excessive alcohol use and related problems, and he has authored more than 100 peer-reviewed articles and numerous book chapters and reports on those topics. He is also well-versed in community-based prevention, and has provided training and technical assistance to thousands of individuals and coalitions across the US and around the world in methods for implementing effective prevention strategies. He is a recipient of the Award of Excellence from the National Association of State Alcohol and Drug Abuse Directors, and the Addiction book prize for his co-authorship of Alcohol in Developing Societies: A Public Health Approach. He is also an expert in media advocacy, and serves or has served as an expert advisor to numerous organizations and campaigns, including the SAMHSA Underage Alcohol Use Prevention Media Campaign, the World Bank, the World Health Organization (including the Director-General’s Alcohol Policy Strategy Advisory Committee), the UK Center for Tobacco and Alcohol Studies, and the Cancer Research UK/Bupa Foundation Cancer Prevention Initiative.

Katherine Keyes

Katherine Keyes, Ph.D., M.P.H. is an associate professor of epidemiology at the Columbia University Mailman School of Public Health. Dr. Keyes’ research focuses on life course epidemiology with particular attention to psychiatric disorders, including examination of fetal origins of child and adult health, long-term outcomes of adverse childhood environments, and cross-generational cohort effects on substance use, mental health, and chronic disease. She is particularly interested in the development of epidemiological theory to measure and elucidate the drivers of population health. Dr. Keyes is an expert in methodological issues in age-period-cohort effect estimation, and her empirical work in age-period-cohort effect has examined a range of outcomes including obesity, perinatal outcomes, substance use disorders, and psychological distress. She is the author of more than 170 peer-reviewed publications as well as two textbooks published by Oxford University Press with co-author Sandro Galea: "Epidemiology Matters: A New Introduction to Methodological Foundation" published in 2014 and "Population Health Science" published in 2016.

Ricardo Martinez

Ricardo Martinez, M.D., FACEP is the Chief Medical Officer of Adeptus Health. Prior to that he served as Chief Medical Officer of North Highland Worldwide Consulting, a global consulting company. A recognized healthcare innovator, he provides thought leadership, strategic advisory, program design, and front line implementation activities across North Highland’s four main healthcare transformations – digital, clinical, financial and organizational. He has served in senior roles in academics, federal government and business including faculty at both Emory and Stanford University Schools of Medicine; President of Division East and EVP of Medical Affairs for the Schumacher Group, an emergency medicine practice management company, serving over 170 hospitals in 22 states with over 3000 providers and 3 million patients; and as the federal Administrator of the National Highway Traffic Safety Administration (NHTSA), 1994-1999, in Washington, DC. He also developed and served as the Executive Director of the Medical Leadership Academy, emphasizing patient-centered teamwork, data-driven quality care, systems thinking, continuous learning and dynamic leadership. He was elected to the National Academy of Medicine of the National Academy of Sciences in 2004.

Timothy Naimi

Timothy Naimi, M.D. is a clinician-investigator at Boston Medical Center and an Associate Professor in the Boston University Schools of Medicine and Public Health. Prior to coming to Boston Medical Center, he served as a Senior Medical Epidemiologist on the Excessive Alcohol Use Prevention Team in the National Center for Chronic Disease Prevention and Health Promotion at CDC. His areas of expertise include alcohol epidemiology and alcohol policy. He has authored and co-authored many papers on binge drinking, alcohol impaired driving, and the relationship between the two, and is currently working on an NIH-funded grant to assess the relationship between state alcohol control policies (e.g., alcohol taxes) and alcohol-related mortality, including motor vehicle crash fatalities. Dr. Naimi completed a combined internal medicine-pediatrics residency program at Massachusetts General Hospital in Boston, and served as a Preventive Medicine Resident and Epidemic Intelligence Service (EIS) Officer at the CDC. He is board-certified in Internal Medicine, Pediatrics, and Preventive Medicine.

Jeff Niederdeppe

Jeff Niederdeppe, Ph.D. is an Associate Professor in the Department of Communication at Cornell University. His research examines the mechanisms and effects of mass media campaigns, strategic health messages, and news coverage in shaping health behavior, health disparities, and social policy. He has published over 95 peer-reviewed articles in communication, public health, health policy, and medicine journals, and his work has been funded in recent years by the National Institutes of Health, National Science Foundation, United States Department of Agriculture, and Robert Wood Johnson Foundation. He is an associate editor of Communication Methods and Measures serves on the editorial boards for eight other peer-reviewed journals.

Charles P. O'Brien

Charles P. O’Brien, M.D., Ph.D. received his MD and PhD degrees from Tulane University, and received residency training in psychiatry, neurology, and medicine at Harvard, the University of London, Tulane and the University of Pennsylvania (Penn). He is board-certified in psychiatry, neurology and addiction psychiatry.
One of the most prominent addiction researchers in the world, Dr. O'Brien has made many important discoveries and contributions over the past 30 years that have become the standard of care in addiction treatment throughout the world. He pioneered the use of Naltrexone as a treatment for alcoholism, ushering in a new era of alcoholism treatment. Dr. O’Brien also conducted research on genetic variations in alcoholism and discovered genes that determine the extent of pleasure one feels when drinking alcohol. Aside from developing medications to treat alcohol, opioid, and cocaine dependence, his work has also increased the understanding of the clinical aspects of addiction and the neurobiology of relapse.
Among his numerous honors, Dr. O'Brien was elected to the National Academy of Medicine of the National Academy of Sciences in 1991, and received the Nathan B. Eddy award for research from the College on Problems of Drug Dependence in 2003. He has advised our national government on drug policy for decades, and was the President of the American College of Neuropsychopharmacology, and the Association for Research in Nervous and Mental Disease.
Dr. O'Brien is the Vice-Chair of Psychiatry at Penn, and the founding director of the prestigious Center for Studies of Addiction.

Jody L. Sindelar

Jody Sindelar, Ph.D. is a professor of public health and a health economist in the Department of Health Policy and Management at the Yale School of Public Health (YSPH). Dr. Sindelar is also a Research Associate at the National Bureau Economic Research (NBER), Research Fellow at IZA (Institute for the Study of Labor), and Associated Faculty at the Institution for Social and Policy Studies (ISPS) at Yale. She has been the President-elect, President, Past President & founding member of the American Society of Health Economists (ASHEcon). She serves on several editorial, advisory and review boards nationally and internationally.
Dr. Sindelar is an expert on the economics of substance abuse, including alcohol misuse, illicit drugs misuse and smoking. Within these areas a focus is on social costs and policy issues. She has published over 100 papers and studies. Her focus is on policy-related issues in economics, addiction, and health. She has published in health economics, addiction, policy and medical journals. She has served on numerous editorial, review, advisory and other boards and committees; has presented her research at seminars and conferences both nationally and internationally; and has been a visiting faculty member nationally and internationally.
Currently, she heads a project on economics and health issues related to regulation of tobacco products (NIH, FDA). Recently, she headed a multi-year project funded by the Centers for Medicare and Medicaid Services via the Connecticut Department of Social Services and the National Institute on Drug Abuse (NIDA). She has also been the Principal Investigator and a collaborator on numerous past research projects funded by the Agency for Healthcare Research & Quality (AHRQ), The Robert Wood Johnson Foundation (RWJF), National Institute on Aging (NIA), National Institute of Alcohol Abuse and Alcoholism (NIAAA), National Institute of Mental Health (NIMH), Yale Center for Clinical Investigation (YCCI), Veteran's Administration (VA), and NIDA among others.

Joanne Thomka

Joanne Thomka, J.D. is a Program Counsel at the National Association of Attorneys General (NAAG). NAAG staff works to help attorneys general respond effectively – individually and collectively – to emerging state and federal issues. Mrs. Thomka is staff liaison to the attorney general community for traffic safety, substance abuse and elder issues.
Prior to coming to NAAG, Mrs. Thomka served as the Director of the National Traffic Law Center of the National District Attorneys Association in Alexandria, Virginia. The NTLC provides technical assistance, legal research and training support to prosecutors, law enforcement and other traffic safety professionals across the country. Prior to NDAA, she was a Senior Assistant District Attorney for the Onondaga County District Attorney’s Office in Syracuse, New York. She was the Bureau Chief of the DWI Unit. The DWI Bureau is responsible for the prosecution of all alcohol - related crimes and all vehicular fatalities. Mrs. Thomka was previously a member of both the Special Victims and Violent Felony Bureaus within the Onondaga County District Attorney’s Office.
Mrs. Thomka is a graduate of Salem State College (now Salem State University) and Vermont Law School. She was the President of the Onondaga County Bar Association in 2003. Mrs. Thomka continues to be an instructor to assistant attorneys general, prosecutors, law enforcement officers and other traffic safety personnel on all issues pertaining to impaired driving, other highway safety issues, trial advocacy and various other areas of criminal law and procedure. She is one of the authors of the New York Prosecutors Training Institute’s Vehicular Homicide Manual for Prosecutors, and the National Traffic Law Center and National Highway Traffic Safety Administration’s manuals: DWI Prosecutor’s Notebook, The Criminal Justice System: A Guide For Law Enforcement Officers and Expert Witnesses in Impaired Driving Cases, Cross Examination for Prosecutors and the Traffic Safety Resource Prosecutor’s Manual. In addition, she is a co-author of a manual developed with The Century Council: Hardcore Drunk Driver Prosecutorial Guide.
Mrs. Thomka is a member of several committees which pertain to traffic safety: Transportation Research Board’s Traffic Law Enforcement Committee, National Sheriff’s Association’s Traffic Safety Committee, Highway Safety Coalition, and the Traffic Injury Research Foundation’s DWI Working Group, She is also the recipient of the 2013 J. Stannard Baker Award, presented by the National Sheriffs’ Association and the National Highway Traffic Safety Administration in Recognition for Outstanding Achievement in Highway Safety and a 2016 Public Service Award from the National Highway Traffic Safety Administration for protecting communities and enhancing traffic safety through legal information and training to the Nation’s criminal justice community.

Douglas Wiebe

Douglas Wiebe, Ph.D., M.A. is Associate Professor of Epidemiology in the Perelman School of Medicine at the University of Pennsylvania, is an expert in injury epidemiology and research on the impact of places and policies on health and injury outcomes. Having completed his PhD in social ecology at the University of California at Irvine and postdoctoral studies in injury epidemiology at the University of California at Los Angeles, Dr. Wiebe brings a unique multidisciplinary and place-based perspective to bear in his research on injury prevention science. His recent national study, published this summer in the American Journal of Public Health, is one example that found that alcohol-impaired driving fatalities declined significantly in states upon passing universal ignition interlock legislation. It is likely that the study influenced the universal ignition interlock law that was passed in Pennsylvania just weeks after this work was published. Dr. Wiebe has contributed significant to the science of injury prevention for the past 15 years. His research has been federally funded continually over that time with grants from the National Institutes of Health, the National Institute of Justice, and the Agency for Healthcare Research and Quality. He serves on study sections for the Center for Scientific Review, the National Science Foundation, and the Social Sciences and Humanities Research Council of Canada. He is Past President of the Society for Advancement of Violence and Injury Research and is incoming Director of the Penn Injury Science Center, one of 12 injury control research centers in the US funded by the Centers for Disease Control and Prevention.

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Accelerating Progress to Reduce Alcohol-Impaired Driving Fatalities

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Accelerating Progress to Reduce Alcohol-Impaired Driving Fatalities

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Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem

Description

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