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Suggested Citation:"Road User Safety: Women s Issues." National Academies of Sciences, Engineering, and Medicine. 2011. Women’s Issues in Transportation: Summary of the 4th International Conference, Volume 1: Conference Overview and Plenary Papers. Washington, DC: The National Academies Press. doi: 10.17226/22901.
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Suggested Citation:"Road User Safety: Women s Issues." National Academies of Sciences, Engineering, and Medicine. 2011. Women’s Issues in Transportation: Summary of the 4th International Conference, Volume 1: Conference Overview and Plenary Papers. Washington, DC: The National Academies Press. doi: 10.17226/22901.
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Suggested Citation:"Road User Safety: Women s Issues." National Academies of Sciences, Engineering, and Medicine. 2011. Women’s Issues in Transportation: Summary of the 4th International Conference, Volume 1: Conference Overview and Plenary Papers. Washington, DC: The National Academies Press. doi: 10.17226/22901.
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Suggested Citation:"Road User Safety: Women s Issues." National Academies of Sciences, Engineering, and Medicine. 2011. Women’s Issues in Transportation: Summary of the 4th International Conference, Volume 1: Conference Overview and Plenary Papers. Washington, DC: The National Academies Press. doi: 10.17226/22901.
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Suggested Citation:"Road User Safety: Women s Issues." National Academies of Sciences, Engineering, and Medicine. 2011. Women’s Issues in Transportation: Summary of the 4th International Conference, Volume 1: Conference Overview and Plenary Papers. Washington, DC: The National Academies Press. doi: 10.17226/22901.
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Suggested Citation:"Road User Safety: Women s Issues." National Academies of Sciences, Engineering, and Medicine. 2011. Women’s Issues in Transportation: Summary of the 4th International Conference, Volume 1: Conference Overview and Plenary Papers. Washington, DC: The National Academies Press. doi: 10.17226/22901.
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Suggested Citation:"Road User Safety: Women s Issues." National Academies of Sciences, Engineering, and Medicine. 2011. Women’s Issues in Transportation: Summary of the 4th International Conference, Volume 1: Conference Overview and Plenary Papers. Washington, DC: The National Academies Press. doi: 10.17226/22901.
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Suggested Citation:"Road User Safety: Women s Issues." National Academies of Sciences, Engineering, and Medicine. 2011. Women’s Issues in Transportation: Summary of the 4th International Conference, Volume 1: Conference Overview and Plenary Papers. Washington, DC: The National Academies Press. doi: 10.17226/22901.
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Suggested Citation:"Road User Safety: Women s Issues." National Academies of Sciences, Engineering, and Medicine. 2011. Women’s Issues in Transportation: Summary of the 4th International Conference, Volume 1: Conference Overview and Plenary Papers. Washington, DC: The National Academies Press. doi: 10.17226/22901.
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94 Road User Safety Women’s Issues lidia P. Kostyniuk, University of Michigan Transportation Research Institute every year about 1 million people are killed and between 20 and 50 million are injured world-wide in motor-vehicle-related crashes (Peden et al. 2004). Although males in the most economically active age group make up the largest proportion of reported casualties, women’s fatality and injury rates appear to be increasing with motorization (Ghee et al. 1997). Motorization accompanies development, as do changes in women’s traditional roles. The changes vary by coun- try and culture, but in general, there are overall increases in the numbers of women who drive motor vehicles and who die of motor vehicle crashes. Differences between men and women in vehicle crash involvement have long been recognized, but much about gender differences in traffic safety remains unknown. This resource paper examines vehicle crash patterns and trends by gender in the united States and discusses their implications for traffic safety. The primary reason for looking only at the united States is the availability of data on crashes, licensing, and amount of travel. Another reason is that the united States has undergone the process of motorization and has faced some of the issues and chal- lenges that accompany the growth of automobile use in a society. Although, some gender issues in traffic safety are specific to a particular culture, many others are uni- versal. Insights on gender differences in risks of crashes, injuries, and deaths in an environment where automobiles are the main transportation mode of a large proportion of women can increase knowledge of women’s issues in traf- fic safety worldwide. This resource paper first presents an overview of trends in the number of motor vehicle crashes over time and then examines rates based on licensing and vehicle use. Risky driving behaviors are examined, and the risks of death and injury in crashes are discussed. The final section addresses research needs. Motor vehicle fatalities Motor-vehicle-related crashes in the united States have contributed to about 40,000 deaths annually for the past two decades. The number of injuries from motor vehicle crashes has decreased considerably over this time, from a high of about 3.5 million injuries in 1996 to about 2.3 million in 2008 (Figure 1). About one-third of the vehicle-crash fatalities involved women. Table 1 shows the number of persons killed in traffic crashes in 2008 by mode (nHTSA 2008, 2009a). It is interesting to note that women account for about one-half of passenger fatalities and about 30% of driver fatalities, a pattern that has been evident for the past two decades (Figure 2). This pattern suggests that there may be many reasons behind these differences by gender and that they are centered on driver exposure, risk-taking behaviors, and injury outcomes in crashes. exPosure The issue of exposure includes licensing, the amount of driving, and also the types of driving. The propor- tion of women licensed to drive in the united States has increased over time. Figure 3 shows the growing trend of driver licensing of women in the united States over the

95RoAD uSeR SAFeTY past half century by charting the ratio of licensed women relative to licensed men by age at 10-year intervals from 1965 to 2005. Half a century ago, young women under the age of 20 were not getting licensed to drive as early as young men. At that time, the ratio of licensed women to men for that age group was about 0.7. From ages 20 to about 50, there were about 0.8 women to each man with a driver’s license. At the other end of the scale, the ratio of licensed women to men age 70 and older was 0.3. By about 1995, the ratio of licensed women to men was equal for every age group. By 2005, the ratio of licensed women to licensed men exceeded 1.0 for people age 65 and older. This shows that women now constitute more than half of the aging driver population, or at least the majority of older persons holding drivers licenses, and will do so in the future. When rates of crash involvement by licensed driver are considered, men’s rates for both fatal and injury crashes 3,600,000 50,000 45,000 40,000 35,000 30,000 25,000 20,000 15,000 10,000 5,000 0 3,400,000 3,200,000 3,000,000 2,800,000 2,600,000 2,400,000 2,200,000 2,000,000 Injuries Deaths 19 88 19 90 19 92 19 94 19 96 19 98 20 00 20 02 20 04 20 06 20 08 FIGURE 1 Injuries and deaths from vehicle crashes in the United States: 1988–2008. TABLE 1 Persons Killed in Traffic Crashes, by Mode and Gender: 2008 Gender Car Driver Car Passenger Motorcyclist Pedestrian Pedicyclist Men 12,969 3,876 4,642 3,053 622 Women 5,226 3,297 448 1,321 92 Total 18,195 7,172 5,090 4,374 717 note: Detail may not add to total because of rounding. 18,000 16,000 14,000 12,000 10,000 8,000 6,000 4,000 2,000 0 D ea th s 19 88 19 90 19 92 19 94 19 96 19 98 20 00 20 02 20 04 20 06 20 08 Male Driver Female Driver Male Passenger Female Passenger FIGURE 2 Driver and passenger fatalities in the United States, by gender: 1988–2008.

96 WoMen’S ISSueS In TRAnSPoRTATIon, voluMe 1 exceed those of women. The rate for women’s fatal crash involvement per licensed driver is about one-third that of men. Figure 4 shows the trend in injury and fatal crash involvements per 100,000 licensed drivers from 1988 to 2008. The next consideration is the amount of driving. Fig- ure 5 shows the average annual mileage driven by age and gender as estimated by the 1969 and 1983 nationwide Personal Transportation Survey and the 2001 national Household Travel Survey. While annual mileage has increased for all, men clearly drive more than women. Fatal crash involvements by gender and age for 1995 and 2001 are shown in Figure 6. examining fatal crash involvements per vehicle miles traveled (vMT) shows a very clear effect of age for both genders, with high rates for drivers under age 20 and again for drivers over age 70. The fatal crash rate per vMT for men is higher than for women, except in some of the older age categories. It should be noted that the annual mileage for drivers over age 70 is quite low com- pared with the mileage driven by middle-aged drivers, so a very few cases can affect the rate shown here. Rates of nonfatal crash involvements per miles driven have been reported to be about 12% higher for women than men (Ferguson and Braitman 2006). However, it was noted that the estimates did not control for variables such as area type and road type. Women have differ- ent activity and travel patterns than men (Rosenbloom 2000), and there is evidence that the locations of crashes of men and women are different (levine, in press). These 1.60 1.40 1.20 1.00 0.80 0.60 0.40 0.20 0 R at io o f W om en to M en Age Group U.S. Pop. 2005 2005 1995 1985 1975 1965 <2 0 20 –2 4 25 –2 9 30 –3 4 35 –3 9 40 –4 4 45 –4 9 50 –5 4 55 –5 9 60 –6 4 65 –6 9 70 + FIGURE 3 U.S. gender trends in driver licensing, by age: 1965–2005. 3,500 3,000 2,500 2,000 1,500 1,000 500 0 60 50 40 30 20 10 0 In ju rie s D ea th s Injury Crashes–men Fatal Crashes–men Injury Crashes–women Fatal Crashes–women 19 88 19 90 19 92 19 94 19 96 19 98 20 00 20 02 20 04 20 06 20 08 FIGURE 4 Injury and fatal crash involvement per 100,000 licensed drivers, by gender: 1988–2008.

97RoAD uSeR SAFeTY factors influence exposure and risks of crashes and should be considered when making comparisons. risky driving behaviors Men’s confidence in their driving ability in general is higher than women’s, and they tend to exhibit riskier driving behavior than women. Surveys that ask drivers to rate their driving ability compared with others’ con- sistently find that overall, drivers rate themselves above average and that men of all ages are more likely to do so than women (e.g., Kostyniuk et al. 2000; Sivak et al. 1989). Men are more likely to drive under the influence of alcohol than women. Figure 7 shows the number of fatally injured drivers with a blood alcohol concentra- tion (BAC) exceeding .08 grams per deciliter by gender over the past two decades. over this period, approxi- mately 84% of these drivers were men. The numbers of these drivers decreased from about 8,000 in 1988 to about 5,200 in 2008 for males, and from 1,500 in 1988 and to about 1,000 in 2008 for females. of all drivers killed in traffic crashes in 2008, 40% of the male drivers 25,000 20,000 15,000 10,000 5,000 0 Av er ag e An nu al V M T Age Group Female, 1969 Female, 1983 Female, 2001 Male, 1969 Male, 1983 Male, 2001 16 –1 9 20 –2 4 25 –2 9 30 –3 4 35 –3 9 40 –4 4 45 –4 9 50 –5 4 55 –5 9 60 –6 4 65 –6 9 70 –7 4 75 –7 9 80 –8 4 85 + FIGURE 5 Average annual vehicle miles driven, by age and gender: 1969–2001. (Note: VMT for drivers over age 70 was collapsed into one category in the 1969 and 1983 NPTS reports, while in 2001, VMT was reported through age 84 and collapsed into one category for drivers over age 85.) 14.00 12.00 10.00 8.00 6.00 4.00 2.00 0F at al C ra sh es p er 1 00 m illi on V M T Male, 2001 Female, 2001 Male, 1995 Female, 1995 Age Group 16 –2 0 21 –2 5 26 –3 0 31 –3 5 36 –4 0 41 –4 5 46 –5 0 51 –5 5 56 –6 0 61 –6 5 66 –7 0 71 –7 5 76 –7 9 80 –8 4 FIGURE 6 Fatal crash involvement per VMT, by age and gender: 1995 and 2001.

98 WoMen’S ISSueS In TRAnSPoRTATIon, voluMe 1 and 21% of the female drivers had a BAC of >.08 grams per deciliter (derived from nHTSA 2009b). Speed was attributed to about 30% of all fatal crashes in 2008 (nHTSA 2009a), and men were more likely to speed than women. Figure 8 shows the percentage of driv- ers of each age group and gender who were involved in fatal crashes related to speeding. Men exceeded women in all age groups, but there is a clear effect of age; of all fatal crashes of drivers under age 21, approximately 35% involving male drivers and 24% involving female drivers were related to speeding. For ages 21 to 24 years, 35% of fatal crashes involving men and about 20% of fatal crashes involving women were related to speeding. An analysis of speeding-related crashes of all severities in Michigan found that crash rates were about 7 per 1,000 licensed drivers for men and about 3 per 1,000 licensed drivers for women (Kostyniuk et al. 1996). These crashes also showed a clear age effect, with the most speeding crashes attributed to the youngest age group of drivers. Following too closely or tailgating is another form of risky driving behavior that is more often reported for men than for women drivers. Results of a study by evans and Wasiliewski (1983) conducted in Michigan and ontario, Canada, found that men tended to maintain shorter headways than women when driving. If rear-end collisions can be considered a consequence of following too closely, then a study conducted by Kostyniuk et al. (1996) provides additional evidence. Kostyniuk et al. found that the rate of rear-end collisions in Michigan for male drivers was greater than that for female drivers (12 collisions per 1,000 licensed drivers for males and 8 collisions per 1,000 licensed drivers for females). Analy- 9,000 8,000 7,000 6,000 5,000 4,000 3,000 2,000 1,000 0 N um be r o f F at al iti es Male Female 19 88 19 90 19 92 19 94 19 96 19 98 20 00 20 02 20 04 20 06 20 08 FIGURE 7 Fatally injured drivers with BAC of >0.8 grams per deciliter, by gender: 1998–2008. 40 35 30 25 20 15 10 5 0 15–20 21–24 25–34 35–44 45–54 55–64 65–74 75+ Pe rc en t S pe ed in g Age Group Male Female FIGURE 8 Speeding drivers in fatal crashes, by age and gender: 2008.

99RoAD uSeR SAFeTY ses of car-following behaviors using naturalistic driving data from field operational tests in which 78 drivers were given instrumented vehicles for a month and told to drive as they normally do also identified gender effects in car following (Fancher et al. 1998). The analysis was based on the distance between cars and the rate of change of the distance. Short headways and rapid closure of the following distance were associated with young subjects (20 to 30 years) of both genders. ultraconservative driv- ing, so named because of large headways and a slow rate of closure, was associated with female drivers in the old- est age group (60 to 70 years). Distraction Driver distraction can also contribute to risky driving. In 2008, 16% of all fatal crashes and 21% of all injury crashes in the united States involved driver distraction (nHTSA 2009b). When a driver engages in other activi- ties, attentional resources are diverted from driving, in some cases to a level below that necessary for safe driving. use of mobile phones and other electronic communica- tions devices provides an opportunity for driver distrac- tion. Driver use of mobile phones has been reported to be associated with a fourfold risk increase of being involved in a crash (Mcenvoy et al. 2005; Redelmeier and Tib- shirani 1997). use of mobile phones and other commu- nications technology is growing, however. According to estimates from the national occupant Protection use Survey, about 3% of drivers in the united States were using hand-held mobile phones during daylight hours in 2000 (Glassbrenner 2004) and 6% were using hand-held mobile phones in daylight hours in 2008 (nHTSA 2009b). of all drivers in 2008, 5% of males and 8% of females were using hand-held mobile phones, 0.6% of males and 0.5% of females were using visible headsets, and 0.5% of males and 0.9% of females were manipulating hand-held devices (nHTSA 2009c). Male drivers do not dominate this risky behavior to the extent that they dominate the other risky driving behaviors. There is nationwide con- cern about the distracting effects of communications tech- nology on driving safety, and how gender differences in these behaviors will evolve remains to be seen. Use of Safety Belts not using a safety belt is also risky behavior. If a crash occurs, safety belts and other in-vehicle occupant protec- tion measures serve to mitigate the effect of the crash on the occupant. However, the safety belt requires action on the part of the occupant, in that the driver or passenger has to “buckle up.” observational safety belt surveys consistently show higher safety belt usage by women than by men. The overall u.S. safety belt rate in 2007 was reported as 86% for women and 79% for men (Ye and Pickrell 2008). Safety belts have been reported to reduce the risk of death in crashes involving passenger cars by about 45% for both men and women (Kahane 2000). Women’s higher safety belt use rates are reflected in fatal crash records. of all persons killed in vehicle crashes in 2003, 62% of the men and 47% of the women were not using safety belts (nHTSA 2004). survivability in crashes There is evidence of gender differences in the risk of injury and fatal crashes, and also in patterns of injuries for the same types of crashes. evans (2004) reports that for a crash of a given force, the risk of death is higher for women than for men to about age 60. using a double- pair comparison method, he calculated that the relative risk of death for women as compared with men (for a crash of the same force) was about 1.2 at age 20, about 1.3 at age 40, and about 1 at age 60. In an analysis of driver deaths by age and gender, li et al. (2003) identi- fied a very strong fragility effect of age for both genders. When compared with driver deaths in crashes at ages 30 to 59, the likelihood of dying was 2.1 for women drivers ages 65 to 69 years, 2.7 for women ages 75 to 79 years, and 5.2 for women age 80 years and older. For men, this likelihood was about 1.5 for ages 65 to 69 years, 3.5 for ages 75 to 79 years, and 4.3 for age 80 years and older. The results of these two studies are not inconsistent. evans’s analysis compared crashes of the same force, while the study by li et al. examined records of all crashes and did not control for equal forces in crashes. As noted earlier, travel patterns, including which roads are used and which areas are traveled in, are most likely different for men and women. Furthermore, speeding, which contributes to the forces in a crash, is more prevalent among male drivers than female driv- ers. Thus, although women are at greater risk of death in a crash, more men than women die of vehicle-related crashes because they drive more miles and because their crashes are of higher severity. Differences by gender in patterns of injuries in the same types of crashes have also been noted by research- ers. Women are reported to sustain a higher incidence of spine and leg injuries (Welsh and lenerd 2001). Women are at greater risk of head, thorax, and lower leg injuries in frontal crashes (Makay and Hassan 2000); of neck injuries in rear-end crashes (Chapline et al. 2000); and of head, face, and neck injuries in near-side-impact crashes (IIHS 2003). People of shorter stature, which includes a large proportion of women, were also reported to be at higher risk of lower limb injuries in head-on crashes (Crandall et al. 1998).

100 WoMen’S ISSueS In TRAnSPoRTATIon, voluMe 1 Crashworthiness and occupant protection are part of motor vehicle design. Because women are more prone to injury in crashes of the same severity, and because of women’s smaller size, they are affected differently by various safety systems than are men. However, these dif- ferences are increasingly being taken into consideration. An example of this is the design of frontal air bags. The first generation of airbags did not consider the effect of the aggressivity of the airbag on people of short stature sitting very close to the airbag. of the 84 drivers who died as a result of airbag deployment, 64 were women. This lead to changes in the design of airbag systems, including the ability to turn them off, and to the devel- opment of devices that sense occupant size and adjust the force of the airbag. The recognition of the higher risk of neck injuries among women in rear-end crashes is also influencing the design of head restraints. Among advancements in crashworthiness is the devel- opment of better crash test dummies and computational models for both men and women for testing the effective- ness of crashworthiness design and occupant protection systems in the laboratory. There still is a need for bet- ter understanding and modeling of some of the special conditions of women (e.g., osteoporosis in older women, pregnancy) in the design of safety systems. At any given time, about 10% of female car occu- pants ages 15 to 45 are pregnant (Klinich et al. 2005). Although the number of fetal deaths from maternal involvement in vehicle crashes is not known, conserva- tive estimates place the number at about 370 per year (Klinich et al. 2005). The number of children who are born with disabilities from in utero crashes is not known, but indications are that the number is quite large (Klinich et al. 2005). Safety belt usage among pregnant women is reported to be quite low, at 66% (Ikossi 2005), and the nonuse of safety belts increases the risk of injury to the mother in the event of a crash. The risk of fetal injury from airbag deployment increases when the mother is unrestrained. There is a need for better understanding of the effects of safety belt use and airbag deployment on the fetus in utero and on the mother. Researchers have been study- ing and modeling pregnant vehicle occupants, and bet- ter computational models such as MAMA-2B are being developed. However, there still is much to be done in this field. suMMary and research needs An overview of vehicle crash trends and patterns in the united States shows that currently the rates of driver licensing of men and women are about equal. Among drivers over age 70, the number of women licensed to drive exceeds that of men. overall, women drive fewer miles than men. The number of people killed in vehicle- related crashes and the per capita rate of these deaths is much lower for women than for men. When expo- sure in terms of vMT is considered, women’s and men’s fatal crash involvements follow the same u-shaped age pattern, that is, high for young ages, lowest through the middle ages, and increasing again starting at about age 65. overall, the fatal involvement rate for women is lower than for men. However, in some years, the rate for women exceeded that for men in a few of the older age categories. This may be just a spurious effect or part of a new trend as the gender mix of the older driving population changes. Women engage in less risky driving behaviors than men. Women are less likely to drive under the influence of alcohol, speed, or tailgate. They are more likely to use safety belts. However, early evidence from observation surveys of mobile phone use indicates that women are more likely than men to use a hand-held mobile phone while driving. Again, this is a trend that needs to be monitored. Women are more vulnerable in crashes than men and more likely to die in crashes of equal force. The patterns of injuries sustained by women in vehicle crashes are also different from those sustained by men in the same type of crash. vehicle crashworthiness and occupant protection systems are increasingly considering the dif- ferences between men and women in their designs. How- ever, much is still unknown and further research is still needed. More research is needed on occupant protection. More accurate computational models and more accurate crash test dummies that represent women of all ages are needed. There is a particular need to better understand the effects of vehicle protection systems on the pregnant woman and her fetus. There is also a need for better modeling of the conditions of older women drivers, such as osteoporosis. Another area of needed research is that of driving behaviors with regard to the new technologies that are being introduced, including various in-vehicle assistance systems and communications devices. There is a need to understand how these devices affect driving perfor- mance and safety, whether women are using them differ- ently than men, and their implications for driving safety. naturalistic driving studies offer promising and exciting approaches to this research question. While much of the research on crashworthiness and the design of occupant protection systems for women can be applied universally, research on the behavioral aspects of vehicle use might be more culturally specific. Good, consistent, and reliable data on crashes, travel, and behavior are not readily available in the developing world, nor is the collection of such data a priority. In the united States and in other developed countries, however,

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Women’s Issues in Transportation: Summary of the 4th International Conference, Volume 1: Conference Overview and Plenary Papers Get This Book
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TRB’s Conference Proceedings 46: Women’s Issues in Transportation: Summary of the 4th International Conference, Volume 1: Conference Overview and Plenary Papers includes an overview of the October 2009 conference and six commissioned resource papers, including the two keynote presentations.

Women’s Issues in Transportation: Summary of the 4th International Conference, Volume 2: Technical Papers includes 27 full peer-reviewed papers that were presented at the October 2009 conference. The conference highlighted the latest research on changing demographics that affect transportation planning, programming, and policy making, as well as the latest research on crash and injury prevention for different segments of the female population. Special attention was given to pregnant and elderly transportation users, efforts to better address and increase women’s personal security when using various modes of transportation, and the impacts of extreme events such as hurricanes and earthquakes on women’s mobility and that of those for whom they are responsible.

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