People age 50 and older make 85 percent of their local trips by private vehicle. The vast majority of them hold a driver’s license. Over 90 percent of adults age 50–64 drive, as do nearly three-quarters of people age 75 and older. Older road users are overrepresented in both vehicle and pedestrian crash fatalities. This is in large part due to their increased fragility and frailty. A motor vehicle occupant age 65 or older who is in a crash is 20 percent more likely to die than is someone under age 65. And an older pedestrian who is struck by a vehicle is 35 percent more likely to die than a younger pedestrian. In recent years, pedestrian deaths have increased for people of all ages. Still, they have disproportionately affected older adults, people of color, and people with low incomes.
One reason older people rely on driving is that they live in communities in which driving is required. Residential housing is located far from grocery stores, medical offices, and other community features. Too often, no public transportation options are available. Residents should not have to rely on driving for transportation. Public transportation and sidewalks are essential features of safe, accessible communities. More can be done to ensure that walking and biking are safe, viable, accessible, and pleasant transportation alternatives for all. Doing so can increase health and cost savings over the long term. In addition, careful planning for e-bikes can ensure that they help more older adults (and other users, such as those carrying children) to remain mobile via bicycle as they age.
Safe driving: More than 36,000 people were killed in traffic crashes in the U.S. in 2018. That is an increase of 12 percent over 2014. While deaths among motor vehicle occupants increased by 9 percent during that timeframe, pedestrian fatalities increased 29 percent, and far more people were injured. A recent study by the National Transportation Safety Board (NTSB) found that speeding was the main factor in 31 percent of all traffic fatalities—nearly the same percentage of fatalities that are caused by intoxicated drivers. Trends are improving for drivers age 70–79, according to a study by the Insurance Institute for Highway Safety. Drivers in this age range are now less likely to be involved in a fatal crash than drivers age 35–54. Drivers in their 70s also have fewer police-reported crashes per mile traveled than middle-aged drivers.
According to the National Highway Traffic Safety Administration, motor vehicle crashes cause more than $871 billion a year in societal harm. Addressing road fatalities will require a multi-pronged, evidence-based approach, including design innovations for infrastructure and vehicles, adequate law enforcement, a cultural shift within our transportation institutions, and a change in public attitudes toward road safety.
States typically have measures in place to identify at-risk or unsafe drivers of all ages. These measures include regular vision testing or self-reporting of medical conditions. Additional testing may be required before they are issued or allowed to renew a driver’s license. All states allow health professionals, law enforcement officials, friends, and family members to refer potentially unsafe drivers to the motor vehicle department. In addition, motor vehicle department personnel in many states are trained to identify individuals who may need further testing.
Most states and the District of Columbia include specific licensing provisions for older drivers. Provisions include increasing license renewal frequency, requiring in-person renewal or restricting mail and online renewal, requiring medical certification, and imposing additional testing (such as vision, knowledge, or road tests). However, driving ability varies greatly at any given age. It is more appropriate to assess all drivers’ ability to be safe on the road rather than specifically targeting older drivers.
Policymakers can also promote safe driving through other mechanisms. These include speed management and measures to reduce distracted driving. Speeding vehicles can also deter walking, bicycling, and other alternatives to driving. As a result, the overall livability of a neighborhood is compromised. Officials help manage excessive motor vehicle speed by setting and enforcing appropriate speed limits, including through the use of automatic enforcement mechanisms. These include speed and red-light cameras on high-risk roads.
There are myriad distractions: using a cell phone, eating and drinking, talking to passengers, grooming, reading maps, using a navigation system, watching a video, changing the radio station, and the like. In-car WiFi and voice-recognition software make driver distraction even more of a concern.
Although all distractions can compromise safe driving, texting on a smartphone or other device is especially alarming because it involves all three types of distractions. Drivers who use handheld devices are four times more likely to get into crashes serious enough to injure themselves. Using a cell phone while driving, whether handheld or hands-free, delays a driver’s braking reactions. It is similar to having a blood-alcohol concentration at the legal limit of .08 percent.
There were 2,841 fatalities and an estimated 400,000 additional injuries due to driver distraction in 2018. Distracted driving is a factor in 15 to 30 percent of all vehicular crashes. Experts suspect that these statistics may underestimate the role of distraction in fatal crashes. Putting in place measures to decrease distractions, such as banning texting while driving, helps promote safe driving. Driver surveys show that two-thirds of motorists report using cell phones while driving, and one-eighth of them report texting while driving.
No federal laws govern distraction in private vehicles using private devices. But a 2009 executive order bans federal employees from texting while driving while in government-issued vehicles or using a government-issued phone. Federal employees also may not text while driving using their personal vehicle and phone if they are using either to conduct government business. In 2011, the NTSB recommended that all states and the District of Columbia ban the nonemergency use of portable electronic devices (other than those designed to support the task of driving) while driving. And the Fixing America’s Surface Transportation Act offers incentive grants to states that prohibit text messaging by all drivers and ban cell phone use by teen drivers.
Many states have responded to the call to ban texting while driving. As of 2020, 25 states, the District of Columbia, and three territories have banned handheld personal electronic use for all drivers, according to the National Conference of State Legislatures. Most of the remaining states ban texting by drivers. Only Montana has no ban in place.
Livable travel environments: More livable communities can reduce people’s dependence on driving. “Complete streets” are designed for everyone, including pedestrians, bicyclists, motorists, and transit riders of all ages and abilities. Walking and bicycling promote physical and mental health. They are essential to the complete streets model. And walking is the second most popular means of getting around (after driving). Safe pedestrian pathways are a key component in transit systems since walking is the most common mode of traveling to bus and rail systems. As such, it is Department of Transportation policy to incorporate safe, convenient walking and bicycling facilities into all surface transportation projects unless exceptional circumstances exist. Many communities are not designed to promote walking and bicycling. Residential areas are often far from commercial facilities. Sidewalks are often nonexistent or in poor condition. And crosswalk signals are often not timed for the slower pace of older pedestrians. Unsafe conditions for pedestrians are most pronounced in lower-income communities and communities of color, in particular, Black, Native American, and Alaska Native communities. Older adults are also overrepresented in deaths involving people walking. People age 65 and older accounted for 19 percent of pedestrian fatalities, even though they made up just 16 percent of the population in 2018.
Communities are increasingly seeking to address road safety. Vision Zero is a program that aims to design and manage roads and other transportation infrastructure to eliminate traffic fatalities and serious injuries. Vision Zero assumes that people will sometimes make mistakes and sets up the road system to default to safety despite such mistakes. As such, it minimizes the risk of death and severe injury, including for pedestrians, cyclists, and others outside the vehicle. Vision Zero addresses the many factors that affect safe mobility. These include designing roads to promote the safety of pedestrians and cyclists rather than focusing primarily on convenience for drivers, setting and enforcing appropriate speed limits, and using technology to improve safety.
Signal timing: The walking speed set for signal operations is one of the most important design and operational parameters affecting pedestrian safety, particularly for older pedestrians, who have an average slower walking speed. Federal law requires states to upgrade substandard traffic control devices and to comply with the standards in the Manual of Uniform Traffic Control Devices.
Signs and pavement markings: Safety can be enhanced through a variety of signs and markings on the pavement. The Federal Highway Administration (FHWA) has published guidelines for road and highway design to improve safety for older drivers.
Supportive programs: Prompt medical attention following a crash is a strong determinant of survival. This is particularly the case for older adults because of their increased risk of fragility and frailty. The “yellow dot” program is an example of a voluntary driver-safety initiative that provides first responders with vital information about motorists who have been involved in a crash and cannot communicate. These types of programs can limit the risk of fatality or severe injury after car crashes. However, before instituting such a program, implementing agencies should be aware of potential concerns such as privacy, legal liabilities, and lack of information about the program by people outside the jurisdiction.
MicromobilitySmall, very lightweight personal vehicles that typically travel under 15 MPH. They include electric bikes, scooters, and skateboards. devices both expand mobility options and present challenges for communities. On the positive side, they offer low-cost and flexible alternatives to driving. For example, they may give people who live too far to walk to a transit station the ability to get there without a car, enabling them to use a robust public transit system to commute rather than driving. They are therefore especially valuable in areas that are underserved by the current transportation system. However, they can also make it more challenging for pedestrians. For example, dockless rental bikes and scooters can be left anywhere and do not have to be attached to a docking station. They are sometimes parked on the sidewalk in a manner that obstructs passage for people with disabilities and other pedestrians. In addition, people sometimes ride micromobilitySmall, very lightweight personal vehicles that typically travel under 15 MPH. They include electric bikes, scooters, and skateboards. devices on sidewalks at fast speeds. Some also ride them without a helmet.
SAFE DRIVING AND LIVABLE TRAVEL ENVIRONMENTS: Policy
SAFE DRIVING AND LIVABLE TRAVEL ENVIRONMENTS: Policy
Policymakers should use effective, evidence-based assessment models to identify at-risk drivers of all ages. They should receive counseling or referrals, and appropriate action should be taken. This includes issuing licenses tailored to the individual based on road test results. Policymakers should adopt policies that promote safe driving. They should put in place automated controls to decrease speeding in high-risk areas and prohibit the use of wireless devices for voice or text communication while driving.
License renewal: State and local governments should improve public safety by requiring all drivers to renew licenses in person at regular intervals. The licensing agency should:
- require assessment of functional impairments Constraints on normal physical functioning, as measured by limits in an activity of daily living (see separate entry). For example, people may be functionally impaired if they have difficulty performing activities such as bathing, transferring from bed or a chair, dressing, toileting,…, such as reduced vision or cognitive skills;
- provide counseling and referrals that enable individuals to seek professional evaluation and remediation for functional impairment;
- require that individuals who exhibit functional impairments Constraints on normal physical functioning, as measured by limits in an activity of daily living (see separate entry). For example, people may be functionally impaired if they have difficulty performing activities such as bathing, transferring from bed or a chair, dressing, toileting,… be given a road test tailored to identify impediments to safe driving; and
- take appropriate action, including issuing licenses tailored to the individual, based on road test results.
Denial appeals: State and local governments should create and use appropriate procedures for drivers who want to appeal license denials, suspensions, and revocations.
Model licensing systems: Federal agencies should cooperate in encouraging states to develop, implement, and evaluate model driver licensing systems. This could include improved driver assessment, individualized licensing options, and uniform medical guidelines for counseling and licensing functionally impaired drivers.
Public education: Governments should support the expansion of public education programs on safe driving, including programs that encourage self-assessment and self-regulation. They should also increase the number of qualified professionals performing scientifically based driver assessment, rehabilitation, and education.
Identification of at-risk drivers: Federal and state policymakers should support training for law enforcement personnel that emphasizes identification of at-risk drivers and referral to licensing authorities for further screening and assessment. They should encourage medical professionals to screen and assess at-risk drivers and to directly encourage patients to seek rehabilitation, education, limitations on driving, or other measures to promote driver safety as needed. Medical professionals should have the ability to report voluntarily patients who may pose a threat to the safety of themselves or the public yet ignore the professional’s advice to stop driving. These medical professionals should be immune from liability when they act in good faith.
Livable travel environments
Policymakers should create communities that provide a range of safe mobility options. They should adopt and fully implement complete streets policies to enable safe access for users of all ages and abilities. This includes pedestrians, bicyclists, motorists, and public transit users. Pedestrians, including people with disabilities, must have priority on sidewalks. For example, dockless bikes and scooters should not be parked in a manner that obstructs passage on the sidewalk. Policymakers should adopt the Vision Zero program for road safety. They should set ambitious, yet achievable, interim road safety targets to improve performance and accountability toward the goal of zero deaths.
Intentional planning is needed to balance the need for emerging transportation options (such as e-scooters and dockless bike shares) with the goal of ensuring safe passage for all. These options should be expanded in underserved areas while ensuring safety.
Local governments should expedite upgrades to substandard traffic control devices and install needed devices to conform to the crosswalk signal-timing revisions in the 2009 federal Manual on Uniform Traffic Control Devices.
Congress and the National Highway Traffic and Safety Administration should support the development of standards for driver assessment, education, and rehabilitation certification.
Policymakers should focus on pedestrian safety and security in the design and operation of transportation facilities.
State and local governments should adopt and implement transportation plans that accommodate pedestrians and bicyclists. Implementation of transportation plans should include:
- evaluating roads and sidewalks to confirm their ability to accommodate safely all users, especially as innovations change how they are used;
- updating design, planning, and policy manuals;
- training planning personnel in the design of complete streets; and
- creating and implementing performance measures for transportation projects.
State and local governments should require and fund safe, well-maintained facilities and environments for non-drivers. These include sidewalks, crosswalks, benches (i.e., resting places for pedestrians), and bike paths, as well as emergency communications systems and traffic management plans.
Congress should strengthen requirements that support the safety of infrastructure for walking and bicycling.
Traffic Enforcement: Traffic enforcement practices should be administered equitably, regardless of demographic or socioeconomic factors.
Highway safety manual: Policymakers responsible for road design should apply Federal Highway Administration (FHWA) Highway Safety Manual methodologies to their safety management and project development processes.
Supportive Programs: Policymakers should support programs to promote the safety of vehicle occupants after car crashes.
Driver and highway safety: State and local policymakers should:
- make technological improvements;
- ensure the maintenance of and improved placement and visibility of highway signs, roadway markers, and pedestrian signs; and
- pursue engineering practices that increase public safety for all. This can be accomplished, in part, by adopting and implementing recommendations found in the FHWA’s Highway Design Handbook for Older Drivers and Pedestrians and by implementing a complete streets policy.
State policymakers should inventory high-risk locations of all paved roads with posted speed limits of 40 mph or greater for skid resistance and establish priorities for correction.
Congress should provide financial incentives for design modifications that improve the travel environment for older adults. Design modifications should incorporate complete streets principles.
Congress should require federally funded highways and roads to have clearly visible markings and signs, more lighting, and safe entries and exits.
Improved Street Design: Policymakers should improve street design by incorporating design elements from the following publications:
- the American Association of State Highway and Transportation Officials’ Green Book,
- the National Association of City Transportation Officials’ Urban Street Design Guide and Urban Bikeway Design Guide,
- the FHWA 2014 Handbook for Designing Roadways for the Aging Population, and
- the Institute for Transportation Engineers’ Designing Urban Walkable Thoroughfares Guide.
Alternatives to driving: State and local governments should provide information and counseling on alternative modes of transportation.