Abstract
This cohort study examines an increase in motor vehicle fatality rates for Black individuals in the US beginning in 2014 compared with White individuals.
Motor vehicle crashes are a leading cause of death for individuals in the US younger than 55 years.1 A 2022 study2 found that Black and Hispanic individuals in the US had higher mortality per mile traveled, but temporal trends in motor vehicle fatality disparities are not well understood.
Methods
We studied longitudinal death certificate data from the US Centers for Disease Control and Prevention and identified a steep increase in motor vehicle deaths for Black individuals in the US beginning in 2014. We then estimated a series of difference-in-differences models to compare longitudinal changes in crash characteristics, risky driving behaviors, interactions with law enforcement, and time spent driving for Black and White decedents between January 1999 and December 2013 and between January 2014 and December 2020. Racial and ethnic data on death certificates were determined by the funeral director, either as provided by an informant (ie, next of kin) or on an observational basis. Data analysis was performed in January 2024 using Stata, version 15.0 (StataCorp). Detailed descriptions of data sources and statistical analyses are in the eMethods in Supplement 1.
All data in this analysis were obtained from US government data sources. Under federal regulations for human subjects research, institutional review board approval was not required, as the data were publicly available and contained no identifying information.
Results
In the US, death rates in motor vehicle crashes among Black and White individuals were strikingly similar before 2014, but the death rate for Black individuals steeply increased after 2014 (Figure 1) and, by 2020, reached levels last seen in 1990. In 2016, the death rate for Black individuals surpassed that of White individuals for the first time since 1973.
Figure 1. Crude per Capita Motor Vehicle Fatality Rates for Black and White Decedents in the US from 1999-2020.
Rates are normalized to the mean death rate from 1999-2013. Death rates are from the US Centers for Disease Control and Prevention’s Wide-Ranging Online Data for Epidemiologic Research (WONDER) database. Each series is divided by its mean in the years 1999-2013. The mean annual crude death rates (deaths per 100,000 population) from 1999-2013 were 13.5% for Black individuals and 15.0% for White individuals.
Several crash characteristics changed for Black decedents relative to White decedents after 2014 (Figure 2). Black individuals in the US spent relatively more time in vehicles than White individuals. The increase in deaths primarily affected younger Black individuals and was greater late at night. Several risky behaviors relatively increased for Black decedents after 2014, including speeding, unlicensed driving, and traveling without a seatbelt. In addition, positive blood test results for alcohol, cannabis, and opioids relatively increased for Black decedents from 2014-2020.
Figure 2. Changes in Driving Behavior, Police Interactions, and Crash Characteristics for Black Individuals Relative to White Individuals in the US After 2014.
Point estimates and 95% CIs are marginal effects from a difference-in-differences model described in the eMethods in Supplement 1. All values are percentages except for driving time, which is in minutes. BAC indicates blood alcohol concentration.
Discussion
This longitudinal analysis of racial disparities in traffic fatalities builds on prior reports2 by highlighting the recent and rapid divergence in rates of Black and White motor vehicle deaths. The speed of this change is more consistent with changes in driving behavior than with changes in the built environment or automotive engineering.
While the mean crash mortality rate per capita for White individuals decreased by 13% from 1999-2014 to 2015-2020, the rate for Black individuals increased by 7%. If the per capita death rate for Black individuals continued to follow trends for White individuals, there would have been approximately 7900 fewer Black deaths in motor vehicle crashes from 2014-2020. In addition, if the per capita death rate for Black individuals had remained constant after 2014, there would have been approximately 9300 fewer Black deaths during this period. While no single risk factor was clearly associated with the increase in deaths, driving time rose by 1% for Black individuals and fell by 5% for White individuals after 2014. If the risk of a fatal motor vehicle crash remained constant for each additional minute driven, this 4-minute relative increase in driving time would explain approximately 40% of the observed increase in deaths.
This report has some important limitations. Race is a socially constructed variable with complex associations with risk factors for motor vehicle fatalities. Race-specific changes in risk factor assessments cannot be ruled out, particularly for drug and alcohol testing, which had a large proportion of missing data.
Decreasing motor vehicle fatalities was one of the triumphs of US public health in the 20th century. The increase in motor vehicle deaths from 2014 to 2020 reversed nearly 3 decades of steady improvement in transportation safety for Black individuals in the US. Identifying and addressing the causes of this recent increase in preventable fatalities must be a public health priority.
eMethods
eReferences.
Data Sharing Statement
References
- 1.US National Center for Injury Prevention and Control . Web-based Injury Statistics Query and Reporting System (WISQARS) homepage. US Centers for Disease Control and Prevention . Accessed August 18, 2024. https://wisqars.cdc.gov/
- 2.Raifman MA, Choma EF. Disparities in activity and traffic fatalities by race/ethnicity. Am J Prev Med. 2022;63(2):160-167. doi: 10.1016/j.amepre.2022.03.012 [DOI] [PubMed] [Google Scholar]
Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Supplementary Materials
eMethods
eReferences.
Data Sharing Statement
