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Elliott, Michael R., K.R. Ginsburg, and F.K. Winston. 2008. "Unlicensed Teenaged Drivers: Who Are They, and How Do They Behave When They Are Behind the Wheel?" Pediatrics, 122(5): E994-E1000.
OBJECTIVE. The objective of this study was to determine the prevalence and associated risk factors for unlicensed driving among 9th- through 11th-graders. METHODS. A nationally representative school-based survey of 5665 9th-, 10th-, and 11th-graders ascertained whether students engaged in unlicensed driving and determined associated driving behaviors, risk behaviors, and demographic factors. Unlicensed driving, defined as not having any type of license and "driving on [one's] own" as opposed to learning to drive, or not driving yet was ascertained. RESULTS. One (4.2%) in 25 US 9th- through 11th-graders reported that they drove at least 1 hour/week without a license. Unlicensed drivers were more likely to identify as being black or Hispanic, to live in rural or central city districts, and to report lower grades in school. No relationship was found between license status and reported crashes; however, unlicensed teenaged drivers were less likely to report seat belt use, more likely to report driving while under the influence of alcohol or drugs, and more likely to report more trips without a purpose. One fourth (28%) of them had taken a driver's education class, and one half (50%) reported parents as most helpful in learning to drive. Two thirds (66%) of the unlicensed drivers reported most often using a vehicle that others usually drive. CONCLUSIONS. Considering the high burden of teen crashes, it is important to reach and deliver effective anticipatory guidance to unlicensed teenaged drivers who are at high risk for unsafe driving practices. Parents and driver's education instructors have contact with many of these unlicensed drivers. Clinicians, particularly those in rural and central city districts, should discuss unlicensed driving starting before the legal age of driving while screening for other health risk behaviors. Additional research is needed for better understanding of barriers to licensing among the teen population of licensing age. Pediatrics 2008; 122: e994-e1000