trends continue, a cumulative total of more than 100,000 adolescents and young adults (ages 16 to 24) who are alive today will die in car crashes in the next 10 years (Winston and Senserrick, 2006).3 Furthermore, nearly two of every three people killed in teen-driver crashes are people other than the teen driver (American Automobile Association, 2006). By any measure, then, automobile crashes are one of the most critical public health problems in the United States.

After Joshua’s death, his parents dedicated themselves to combating this problem, and they were by no means the first. States, counties, and school districts; the federal government; private organizations, such as the Insurance Institute for Highway Safety; advocacy groups, such as Mothers Against Drunk Driving; and others have addressed the problem in a variety of ways. Fatalities and injuries overall and for teenagers have been reduced substantially over the past 30 years as a result of changes in state laws, such as seat belt requirements and increases in the legal drinking age (National Highway Traffic Safety Administration, 2006a). Changes in licensure requirements, public information campaigns, and strategies for encouraging parent involvement in the training of new drivers are other valuable strategies that have been used to improve driving safety for teens. While the impact of these efforts is evident, novice drivers continue to have the highest rates of crashes, injuries, and fatalities of any group; the sheer magnitude of the injuries and fatalities that continue to result from teen crashes shows that current prevention efforts are inadequate.

Knowledge about how and why teen motor vehicle crashes happen is the key to developing countermeasures to reduce their number—and a significant body of applicable knowledge, produced over several decades, exists. However, few effective mechanisms are available for using that knowledge to directly influence teen behavior or to convert it into effective interventions. In addition, many of the efforts to reduce teen crashes that are in place are hampered by a lack of evidence as to which prevention strategies are most effective. Driving is a complex activity, mastery of which develops slowly over time, despite the fact that for most adults it seems largely automatic. It is a social activity as well as one that draws on a com-


Estimate based on an analysis of 2003 data for adolescents and young adults (ages 16 to 24) from the Fatality Analysis Reporting System (FARS). Fatality information derived from FARS includes motor vehicle traffic crashes that result in the death of an occupant of a vehicle or a nonmotorist within 30 days of the crash.

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