Getting to Zero Alcohol-Impaired Driving Fatalities A Comprehensive Approach to a Persistent Problem (2018) / Chapter Skim
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7 Generating Action
7 Generating Action
Pages 377-410
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The chapter begins with a discussion of the role of historic and current social movements. This is followed by sections that explore the role of community-based approaches, the media environment and media advocacy, and discussions of stakeholder accountability and recommendations for action to reduce alcoholimpaired driving fatalities.
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MADD has a compelling history. Founded in 1980, it received early on more seed money from the federal government (National Highway Traffic Safety Administration [NHTSA]
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Currently, a new or renewed social movement to end deaths from alcohol-impaired driving could emerge and carry the work forward. Sociologists generally view social movements as oppositional to the existing order.
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In addition to alcohol-impaired driving no longer being normative, media attention to the issue has waned. MADD's competitor, Remove Intoxicated Drivers, received differential treatment for its advocacy of advertising restrictions, while MADD's avoidance of that issue was key to the organization's success in the news media, particularly television news, in the 1980s (Mosher and Jernigan, 1989)
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. While multiple authors have pointed to protecting the public's health as the frame most likely to succeed MADD in movements to reduce alcohol-impaired driving (Reinarman, 1988; Ross, 1997)
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Available by request from the National Academies of Sciences, Engineering, and Medicine's Public Access Records Office (PARO@nas.edu)
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. MADD's frame on alcohol-impaired driving, while novel in 1981, is no longer capturing media attention and as such it is less resonant, at least in the media environment.
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. Lessons from Previous Community-Based Funding Efforts There is a significant history of federal funding of communitybased efforts in tobacco control from which efforts to reduce alcoholimpaired driving deaths can benefit.
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Applying such an approach to alcoholimpaired driving at the community level would require a willingness to invest significant government and/or private philanthropic dollars in the effort. This willingness in and of itself may be a measure of the degree to which there is a general commitment to addressing and reducing alcoholimpaired driving fatalities.
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Community-level collaboration has been identified as a key element of efforts to reduce alcohol-impaired driving fatalities. The Community Preventive Services Task Force conducted a systematic review of multicomponent interventions with community mobilization for reducing
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Other challenges include gaining and sustaining consensus among group members, inefficiency in implementing decisions and interventions, ideological differences between member organizations, competition over resources, power imbalances, and existing sociocultural tensions among the various actors. Alcohol tax coalitions Coalitions can also facilitate progress on a lcohol-impaired driving fatalities by focusing their efforts on population-based preventive interventions such as increasing alcohol taxes 3 Multicomponent programs here are defined as the implementation of interventions or policies in multiple settings (e.g., responsible beverage service in bars and sobriety checkpoints)
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. As referenced in Chapter 3, one barrier to the implementation of alcohol tax increases is the lack of awareness of the efficacy of taxes to reduce harmful drinking and related consequences such as alcohol-impaired driving fatalities (Jernigan and Waters, 2009)
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The organizing effort led to institutional policy changes in all seven intervention communities including changes in retailer policies, media coverage, and law enforcement practices (Wagenaar et al., 1999)
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. Content analyses of the current news media environment are essential to inform media advocacy efforts to reframe coverage of health-related issues in ways that advance public health goals (Dorfman, 2003)
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. Media advocacy involves the strategic use of the news media in support of community organizing to increase public and policy-maker awareness of public health problems, identify effective systems and policy changes to address them, and support progress toward their passage and implementation (Wallack et al., 1993)
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. Evidence of Media Advocacy Effects in Shaping Favorable News Coverage A few studies have moved beyond case study reports to describe systematic changes in the volume and nature of news media coverage in response to media advocacy intervention featuring multiple communities.
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The authors recommended caution in interpreting group differences as evidence of media advocacy effects. The strongest evidence in support of media advocacy effects in promoting favorable news coverage comes from a community trial to reduce alcohol-related injury (largely focused on alcohol-impaired driving fatalities)
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Yanovitzky (2002b) found that increased news media coverage of alcohol-impaired driving was associated with increased policy attention (measured by the number of congressional hearings about alcohol-impaired driving and the number of anti-alcohol-impaired driving bills introduced to Congress in a particular month)
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. Media advocacy efforts in the future will need to monitor and adapt to the changing media environment in an effort to shape the nature of public and policy-maker discussions of policy approaches to reduce a lcohol-impaired driving fatalities, and exclusive reliance on traditional news media will likely be insufficient to change the national conversation on this issue.
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. Based on the stagnation in progress to reduce alcohol-impaired driving fatalities and the growing movement toward zero deaths in the traffic safety community, the committee concludes: Conclusion 7-1: In the development of Healthy People 2030 objectives, a more ambitious target for alcohol-related deaths per 100 million vehicle miles traveled would better align with "zero deaths" initiatives across the country.
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is one of many that could take on an expanded role in preventing alcohol-impaired driving fatalities.
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• Share and link injury data with public health agencies to identify high-risk or vulnerable groups. • Work with communities to identify sources of alcohol that con tribute to alcohol impairment.
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approach to alcohol-impaired driving, it is important to note that local and state public health agencies do not generally receive much funding to address alcohol-related harms in contrast to other health issues such as tobacco, which often has several dedicated funding streams.
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. With respect to alcohol-impaired driving specifically, the 1989 Surgeon General's Workshop Proceedings on Drunk Driving very clearly outlines the interventions that are supported by the available research base.
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A content analysis of 97 industry actions on alcohol-impaired driving concluded that nearly all (97.9 percent) 11 were either ineffective or of unknown effectiveness (Babor et al., 2018)
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20) To that end, based on the literature, documented practices of the alcohol industry, and the committee's expertise, the committee concludes: Conclusion 7-2: Alcohol companies and alcohol-related businesses could assist efforts to reduce alcohol-impaired driving fatalities by reducing the alcohol content of existing products, refraining from marketing including sponsorships that are likely to influence excessive alcohol use, and supporting or at least not opposing effective alcohol-impaired driving countermeasures.
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in the 1980s. A new, multisector group is needed to coordinate and reinvigorate progress to reduce alcohol-impaired driving fatalities.
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Based on extensive evidence and experience in the use of community coalitions both in the alcohol field and in other areas of public health, the committee recommends: Recommendation 7-3: The National Highway Traffic Safety Administration, other federal partners, and private funding
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Furthermore, traditional and novel stakeholders need to be engaged in efforts to reduce alcohol-impaired driving fatalities to fulfill their various accountabilities. With support for
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Paper commissioned by the Committee on Accelerating Progress to Reduce Alcohol-Impaired Driving Fatalities (see Appendix C)
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Paper com missioned by the Committee on Accelerating Progress to Reduce Alcohol-Impaired Driving Fatalities (see Appendix B)
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NHTSA (National Highway Traffic Safety Administration)
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2009. Effectiveness of multicomponent programs with community mobilization for reducing alcohol-impaired driving.
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2016. Texas Impaired Driving Task Force.
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