Sebring Sedan Accident 300x200 The Elderly and Motor Vehicle SafetyMotor vehicle crashes are one of the leading causes of death in the U.S.1 More than 2.3 million adult drivers and passengers were treated in emergency departments as the result of being injured in motor vehicle crashes in 2009.2 The economic impact is also notable: the lifetime costs of crash-related deaths and injuries among drivers and passengers were $70 billion in 2005.3

The Center for Disease Control’s (CDC) research and prevention efforts target this serious public health problem. They focus on improving car and booster seat and seat belt use and reducing impaired driving, and helping groups at risk: child passengers, teen drivers, and older adult drivers. CDC also works to prevent pedestrian and bicycle injuries.

Based on the magnitude of the health problem, and our ability to make significant progress in improving outcomes, Motor Vehicle Injury Prevention is a CDC Winnable Battle.

State-based Costs of Crash Deaths from CDC

The United Nations General Assembly has proclaimed 2011 to 2020 as the Decade of Action for Road Safety. CDC is excited to be part of this effort to enhance focus on protecting people on the road. As a first step, CDC is releasing fact sheets showing the tremendous cost burden of deaths from motor vehicle crashes in the United States, and highlighting strategies to prevent these deaths.

Over 30,000 people are killed in crashes each year in the United States. In 2005, in addition to the toll on victims’ family and friends, crash deaths resulted in $41 billion in medical and work loss costs.

A new CDC data analysis looked at the costs of crash deaths by state and found that half of all costs were found in 10 states. The ten states with the highest medical and work loss costs were California ($4.16 billion), Texas ($3.50 billion), Florida ($3.16 billion), Georgia ($1.55 billion), Pennsylvania ($1.52 billion), North Carolina ($1.50 billion), New York ($1.33 billion), Illinois ($1.32 billion), Ohio ($1.23 billion), and Tennessee ($1.15 billion).

In 2009, there were 33 million licensed drivers ages 65 and older in the United States.1 Driving helps older adults stay mobile and independent. But the risk of being injured or killed in a motor vehicle crash increases as you age. An average of 500 older adults are injured every day in crashes.2

Thankfully, there are steps that older adults can take to stay safer on the roads.

How big is the problem?

  • In 2008, more than 5,500 older adults were killed and more than 183,000 were injured in motor vehicle crashes. This amounts to 15 older adults killed and 500 injured in crashes on average every day.1
  • There were 33 million licensed older drivers in 2009, which is a 23 percent increase from 1999.2,3

Who is most at risk?

  • Per mile traveled, fatal crash rates increase starting at age 75 and increase notably after age 80. This is largely due to increased susceptibility to injury and medical complications among older drivers rather than an increased tendency to get into crashes.4
  • Age-related declines in vision and cognitive functioning (ability to reason and remember), as well as physical changes, may affect some older adults’ driving abilities.5
  • Across all age groups, males had substantially higher death rates than females.4

How can older driver deaths and injuries be prevented?

Existing protective factors that may help improve older drivers’ safety include:

  • High incidence of seat belt use: More than three in every four (77%) older motor vehicle occupants (drivers and passengers) involved in fatal crashes were wearing seat belts at the time of the crash, compared to 63% for other adult occupants (18 to 64 years of age).1
  • Tendency to drive when conditions are the safest:  Older drivers tend to limit their driving during bad weather and at night and drive fewer miles than younger drivers.6
  • Lower incidence of impaired driving: Older adult drivers are less likely to drink and drive than other adult drivers.7 Only 5% of older drivers involved in fatal crashes had a blood alcohol concentration (BAC) of 0.08 grams per deciliter (g/dL) or higher, compared to 25% of drivers between the ages of 21 and 64 years.1

Older adults can take several steps to stay safe on the road, including:

mvs seniors couple 02 0006 250w The Elderly and Motor Vehicle SafetyOlder adults can take several steps to stay safe on the road.
  • Exercise
    • Asking your doctor or pharmacist to review medicines–both prescription and over-the counter–to reduce side effects and interactions.
    • Having eyes checked by an eye doctor at least once a year. Wear glasses and corrective lenses as required.
    • Driving during daylight and in good weather.
    • Finding the safest route with well-lit streets, intersections with left turn arrows, and easy parking.
    • Planning your route before you drive.
    • Leaving a large following distance behind the car in front of you.
    • Avoiding distractions in your car, such as listening to a loud radio, talking on your cell phone, texting, and eating.

Considering potential alternatives to driving, such as riding with a friend or using public transit, that you can use to get around.

Additional Resources
                              AAA Foundation for Traffic Safety
                              Senior Driver Web Site
                             AAA National: AAA Roadwise Review
                             A Tool to Help Seniors Drive Safely Longer 
                             National Highway Traffic Safety Administration
                            Active Aging Programs
                             AARP
                             Driver Safety Program
                             Community Transportation Association of America
                             Senior Transportation
                             National Center on Senior Transportation

64px Stub doctors.svg  Communicating with Your DoctorGetting Started: Choosing a Doctor You Can Talk To

Finding a main doctor (often called your primary doctor or primary care doctor) that you feel comfortable talking to is the first step in good communication. It is also a way to ensure your good health. This doctor gets to know you and what your health is normally like. He or she can help you make medical decisions that suit your values and daily habits and can keep in touch with the other medical specialists and health care providers you may need.

If you don’t have a primary doctor or are not at ease with the one you currently see, now may be the time to find a new doctor. Whether you just moved to a new city, changed insurance providers, or had a bad experience with your doctor or medical staff, it is worthwhile to spend time finding a doctor you can trust.

People sometimes hesitate to change doctors because they worry about hurting their doctor’s feelings. But doctors understand that different people have different needs. They know it is important for everyone to have a doctor with whom they are comfortable.

Primary care doctors frequently are family practitioners, internists, or geriatricians. A geriatrician is a doctor who specializes in older people, but family practitioners and internists may also have a lot of experience with older patients.

The following suggestions can help you find a doctor who meets your needs:

Decide What you are Looking for in a Doctor

A good first step is to make a list of qualities that matter to you. Do you care if your doctor is a man or a woman? Is it important that your doctor has evening office hours, is associated with a specific hospital or medical center, or speaks your language? Do you prefer a doctor who has an individual practice or one who is part of a group so you can see one of your doctor’s partners if your doctor is not available?

After you have made your list, go back over it and decide which qualities are most important and which are nice, but not essential.

Identify Several Possible Doctors

Once you have a general sense of what you are looking for, ask friends and relatives, medical specialists, and other health professionals for the names of doctors with whom they have had good experiences. Rather than just getting a name, ask about the person’s experiences. For example: say, “What do you like about Dr. Smith?” and “Does this doctor take time to answer questions?” A doctor whose name comes up often may be a strong possibility.

If you belong to a managed care plan—a health maintenance organization (HMO) or preferred provider organization (PPO)—you may be required to choose a doctor in the plan or else you may have to pay extra to see a doctor outside the network. Most managed care plans will provide information on their doctors’ backgrounds and credentials. Some plans have websites with lists of participating doctors from which you can choose.

It may be helpful to develop a list of a few names you can choose from. As you find out more about the doctors on this list, you may rule out some of them. In some cases, a doctor may not be taking new patients and you may have to make another choice.

What are HMOs and PPOs?Members of a health maintenance organization (HMO) pay a set monthly fee no matter how many (or few) times they see a doctor. Usually there are no deductibles or claims forms but you will have a co-payment for doctor visits and prescriptions. Each member chooses a primary care doctor from within the HMO network. The primary care doctor coordinates all care and, if necessary, refers members to specialists.A preferred provider organization (PPO) is a network of doctors and other health care providers. The doctors in this network agree to provide medical services to PPO health plan members at discounted costs. Members can choose to see any doctor at any time. Choosing a non-PPO provider is called ‘going out of network’ and will cost more than seeing a member of the PPO network.

Consult Reference Sources

The Directory of Physicians in the United States and the Official American Board of Medical Specialties Directory of Board Certified Medical Specialists are available at many libraries. These books don’t recommend individual doctors but they do provide a list of doctors you may want to consider. MedlinePlus, a website from the National Library of Medicine, has a comprehensive list of directories (www.nlm.nih.gov/medlineplus/directories.html) which may also be helpful.

There are plenty of other Internet resources too—for example, you can find doctors through the American Medical Association’s website at www.ama-assn.org (click on “Doctor Finder”). For a list of doctors who participate in Medicare, visit www.medicare.gov (click on “Search Tools” then “Find a Doctor”). WebMD also provides a list of doctors at www.webmd.com (click on “Doctors”).

Don’t forget to call your local or State medical society to check if complaints have been filed against any of the doctors you are considering.

What Does “Board Certified” Mean?Doctors who are board certified have extra training after regular medical school. They also have passed an exam certifying their expertise in specialty areas. Examples of specialty areas are general internal medicine, family medicine, geriatrics, gynecology, and orthopedics. Board certification is one way to learn about a doctor’s medical expertise; it doesn’t tell you about the doctor’s communication skills.

Learn More About the Doctors you are Considering

Once you have narrowed your list to two or three doctors, call their offices. The office staff is a good source of information about the doctor’s education and qualifications, office policies, and payment procedures. Pay attention to the office staff—you will have to deal with them often!

You may want to set up an appointment to meet and talk with a doctor you are considering. He or she is likely to charge you for such a visit. After the appointment, ask yourself whether this doctor is a person with whom you could work well. If you are not satisfied, schedule a visit with one of your other candidates.

When learning about a doctor, consider asking questions like:

  • Do you have many older patients?
  • How do you feel about involving my family in care decisions?
  • Can I call or email you or your staff when I have questions? Do you charge for telephone or email time?
  • What are your thoughts about complementary or alternative treatments?

When making a decision about which doctor to choose, you might want to ask yourself questions like:

  • Did the doctor give me a chance to ask questions?
  • Was the doctor really listening to me?
  • Could I understand what the doctor was saying? Was I comfortable asking him or her to say it again?

Make a Choice

Once you’ve chosen a doctor, make your first actual health care appointment. This visit may include a medical history and a physical exam. Be sure to bring your medical records, or have them sent from your former doctor. Bring a list of your current medicines or put the medicines in a bag and take them with you. If you haven’t already met the doctor, ask for extra time during this visit to ask any questions you have about the doctor or the practice.

Summary: Choosing a Doctor You Can Talk To

  • Decide what you are looking for in a doctor.
  • Identify several possible doctors.
  • Consult reference sources, including the Internet.
  • Talk to office staff to learn more about the doctors you are considering.
  • Make a choice.

Photo: http://commons.wikimedia.org/wiki/File:Stub_doctors.svg

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