Teen driving crashes can cause lifelong effects on the brain

Lori Johnston
Teens are encouraged to think before they get behind the wheel. That’s because even if they survive crashes – the leading cause of death for teens – the effect of the collisions could damage the organ that controls thinking: the brain.
More than 30 percent of the 55,000 teen drivers and their passengers injured in crashes in 2009 and 2010 experienced concussions, skull fractures and traumatic brain injuries, according to a 2012 report by The Children’s Hospital of Philadelphia and State Farm.
Head injuries are an overlooked result of teen driver crashes, says Dr. Dennis Durbin, the report’s lead author and co-scientific director for the Center for Injury Research and Prevention at the children's hospital. The federal Centers for Disease Control and Prevention reports that car crashes are the leading cause of deaths related to traumatic brain injury among 15- to 19-year-olds.
“Traumatic brain injuries suffered by teens in automobile crashes are a very significant contributor to health care costs and adverse health outcomes,” says Durbin, who is a pediatric emergency physician. “In number of deaths, hospitalizations and numbers of ER visits, they lead the way for teens.”
Survivors typically don't recover fully from brain injuries, which occur when a teen's brain still is growing. The injuries can have lasting effects, including the inability to socialize and the financial burden from medical bills.
Covering the cost of brain injuries
Teen drivers already have higher auto insurance rates and higher-than-average claims. Their crashes, though, contribute to the cost of claims and, ultimately, insurance premiums, according to the nonprofit Insurance Information Institute.
A basic auto insurance policy includes medical payments coverage, also known as personal injury protection. The insurer pays for treatment of injuries to the driver and passengers of the policyholder's car, according to the Insurance Information Institute.
Coverage amounts vary, says Chris Mullen, director of technology research at State Farm. The Insurance Information Institute notes that the broadest policies cover medical payments, lost wages and costs for replacing services, such as household chores, normally performed by the injured person.
The prices for teen driver policies, which can be part of a family policy, or separate, differ dramatically among insurers, according to the Insurance Information Institute. Parents and teens should research prices and policy limits regarding medical coverage.
The medical costs paid by an auto insurance policy are "pretty low” when examining the total costs of care for brain injuries, says Dr. Gregory O'Shanick, medical director of the Center for Neurorehabilitation Services in Richmond, Va., and a member of the Brain Injury Association of America. If a brain-injured person ends up in an emergency room or an ICU, the amount of money paid through the auto insurance policy often is "gobbled up,” he says.
If a teen driver's crash injures other drivers, passengers or pedestrians, a policy's bodily injury liability coverage kicks in. The Insurance Information Institute recommends maintaining more than the required minimum amount of liability insurance to provide financial protection in case a crash-related lawsuit is filed. In California, the minimum liability insurance requirements are up to $15,000 for one person injured or killed in an accident, $30,000 for two people and $5,000 for property damage. In Florida, minimums are up to $10,000 for one person injured or killed in an accident, $20,000 for two people and $10,000 for property damage.
Uninsured and underinsured motorist coverage is an option offered by auto insurers. The costs of medical care are reimbursed if a policyholder or family member in a car is hit by an uninsured or underinsured driver or by a hit-and-run driver. The coverage also applies to policyholders who are injured as pedestrians.
O’Shanick says auto insurance typically isn’t enough to handle all medical costs stemming from an accident that results in brain injuries. People typically have to rely on their health insurance to cover those expenses.
Graduated driver's licensing
Graduated driver's licensing (GDL) laws and seat belt use are tapping the brakes on traffic crashes and deaths, according to the report from The Children’s Hospital of Philadelphia and State Farm. All states have passed some form of GDL laws to give teen drivers more time to improve their driving skills.
The report, "Miles to Go: Monitoring Progress in Teen Driver Safety," found:
• The number of teen drivers who died in crashes from 2005 to 2010 dropped 46 percent. • The number of passenger deaths in teen driving accidents from 2005 to 2010 declined 41 percent. • The national average was 9.5 deaths per 100,000 teens in 2009-10. • Massachusetts had the lowest teen death rate for car crashes, and Montana had the highest.
Laws in all states except New Hampshire require adult drivers to wear seat belts.
Graduated driver’s licensing programs vary from state to state; research shows that states with strong GDL laws boast lower death rates than those with weaker laws. A dozen states with comprehensive GDL policies and other safe driving programs reduced their rates of teen death rates in crashes by more than 50 percent in just six years. “The most comprehensive laws are showing the most improvements,” Mullen says.
State Farm and The Children's Hospital of Philadelphia recommend that states with teen crash death rates above the national average – 9.5 deaths per 100,000 – close gaps in their GDL laws.
The strongest GDL laws require at least 50 hours of adult-supervised practice for teen drivers; limit the number of teen passengers for the first year of independent driving; restrict unsupervised nighttime driving; require seat belt use for everyone in a car driven by a teen; and prohibit cellphone use by drivers.
In addition to states enacting GDL laws, efforts are under way to educate parents who may not recognize how GDL gives teens the time and experience to be safe drivers.
Sometimes parents allow teens to break GDL laws because they are ignorant of why it exists, says Kelly Browning, executive director of Impact Teen Drivers, a nonprofit based in California. She says the challenge is creating outreach efforts that inspire changes in attitudes about GDL.
“GDL is about as exciting about talking about STDs, but just as important,” Browning says.
Durbin says efforts such as GDL laws and safe belt use have helped save lives.
“I think the issue of head injuries and the other types of injuries suffered by teens highlight that we certainly haven't solved the problem yet,” he says. “We know that strong GDLs are a key to making further progress.”

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