The Excess Mortality Risk and Prevalence of Drinking-and-Driving in the United States: 1983–2017

Drinking-and-driving remains a leading cause of preventable mortality and morbidity in the United States, yet reliable estimates of its prevalence and the increased risk it imposes on other road users remain elusive. The tendency of respondents to under-report illicit and socially stigmatized behavior and the likelihood that they select out of random sample designs suggests survey-based prevalence estimates are biased downward, resulting in upward biased estimates of excess mortality risk. Moreover, in 2015 the House of Representatives voted to prohibit the use of federal funds to plan or administer the National Roadside Survey (NRS). Therefore, in this article, we apply a statistical approach to document how the excess mortality risk, prevalence, and externality of drinking-and-driving in the United States has evolved over the past four decades. We find that drinking-and-driving declined significantly between 1983 and 1992, but has since plateaued. We also find that the excess mortality risk of drinking drivers rose steadily between 1983 and 2012, but the associated external cost of drinking drivers decreased, suggesting that ‘sober-biased technical change’ may have made all driving less dangerous, but had a smaller impact on drivers influenced by alcohol. For the latest five-year period, however, we identify a sharp reversal in both these trends.