208 Driver’s license suspension policies: a transportation-related source of health inequity

Purpose Driver’s license suspension policies have been an effective means of removing high-risk drivers from the road and credited with reducing motor vehicle crashes. However, states have used these policies since the 1990s to incentivize compliance with laws and regulations unrelated to traffic safety (e.g., drug offense, failure to pay fine). Recent media reports point to potentially negative health impacts of such policies—particularly on low-income drivers. However, there are few systematic studies on this issue. As a first step, we estimated state-level prevalence of non-driving-related (NDR) suspensions and examined variation by individual- and neighborhood-level characteristics. Methods We utilized the New Jersey Safety and Health Outcomes (NJ-SHO) warehouse, which includes full driver’s licensing history, geocoded residential addresses, census tract-level socioeconomic measures, and systems-level resources for NJ drivers licensed during 2018. Results In 2018, 386,929 (5%) of all NJ drivers had an NDR license suspension—accounting for 90% of all suspensions. Drivers with NDR suspensions were younger than drivers without suspensions (mean: 39 vs 47 years) and more likely to be male. The prevalence of NDR suspensions was seven times greater in the lowest income (vs. highest income) neighborhoods, five times greater in neighborhoods with the highest percent of black and Hispanic residents, and twice as high in neighborhoods with the greatest walkability and access to public transportation. Conclusion Drivers with NDR suspensions were more likely to live in lower SES areas. Future research is critically needed to determine whether these suspensions affect risk of negative health outcomes, as well as whether greater access to systems-level resources can mitigate this risk. Significance of Contributions Although six states recently passed legislation banning NDR suspensions, others may be hesitant to do so given lack of available information on this population and effects of suspensions. Our study’s findings directly inform this health equity issue.