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Objectives. New York City (NYC) maintains a population-based registry of people with human immunodeficiency virus (HIV) infection to monitor the epidemic and inform resource allocation. We evaluated record linkages with the National Death Index (NDI) and the Social Security Administration's Death Master File (SSDMF) to find deaths occurring from 2000 through 2004. Methods. We linked records from 32,837 people reported with HIV and not previously known to be dead with deaths reported in the NDI and the SSDMF. We calculated the kappa statistic to assess agreement between data sources. We performed subgroup analyses to assess differences within demographic and transmission risk subpopulations. We quantified the benefit of linkages with each data source beyond prior death ascertainment from local vital statistics data. Results. We discovered 1,926 (5.87%) deaths, which reduced the HIV prevalence estimate in NYC by 2.03%, from 1.19% to 1.16%. Of these, 458 (23.78%) were identified only from NDI, and 305 (15.84%) only from SSDMF. Agreement in ascertainment between sources was substantial (kappa = [K] 0.74, 95% confidence interval [Cl] 0.72, 0.76); agreement was lower among Hispanic people (K=0.65, 95% Cl 0.62, 0.69) and people born outside the U.S. (K=0.60, 95% Cl 0.52, 0.68). We identified an additional 13.62% of deaths to people reported with HIV in NYC; white people and men who have sex with men were disproportionately likely to be underascertained without these linkages (p<0.0001). Conclusion. Record linkages with national databases are essential for accurate prevalence estimates from disease registries, and the SSDMF is an inexpensive means to supplement linkages with the NDI to maximize death ascertainment. [ABSTRACT FROM AUTHOR]

The authors discuss the relationship between suspension of drivers' licenses and access to health care. They mention the increase in license suspensions for non-driving-related offenses, the need of access to a vehicle to meet medical appointments, and the need to incorporate public health concerns into transportation policy.

Background: Medications are one of the most easily modifiable risk factors for motor vehicle crashes (MVCs) among older adults, yet limited information exists on how the use of potentially driver-impairing (PDI) medications changes following an MVC. Therefore, we examined the number and types of PDI medication classes dispensed before and after an MVC., Methods: This observational study included Medicare fee-for-service beneficiaries aged ≥67 years who were involved in a police-reported MVC in New Jersey as a driver between 2008 and 2017. Analyses were conducted at the "person-crash" level because participants could be involved in more than one MVC. We examined the use of 36 PDI medication classes in the 120 days before and 120 days after MVC. We described the number and prevalence of PDI medication classes in the pre-MVC and post-MVC periods as well as the most common PDI medication classes started and stopped following the MVC., Results: Among 124,954 person-crashes, the mean (SD) age was 76.0 (6.5) years, 51.3% were female, and 83.9% were non-Hispanic White. The median (Q 1 , Q 3 ) number of PDI medication classes was 2 (1, 4) in both the pre-MVC and post-MVC periods. Overall, 20.3% had a net increase, 15.9% had a net decrease, and 63.8% had no net change in the number of PDI medication classes after MVC. Opioids, antihistamines, and thiazide diuretics were the top PDI medication classes stopped following MVC, at incidences of 6.2%, 2.1%, and 1.7%, respectively. The top medication classes started were opioids (8.3%), skeletal muscle relaxants (2.2%), and benzodiazepines (2.1%)., Conclusions: A majority of crash-involved older adults were exposed to multiple PDI medications before and after MVC. A greater proportion of person-crashes were associated with an increased rather than decreased number of PDI medications. The reasons why clinicians refrain from stopping PDI medications following an MVC remain to be elucidated., (© 2023 The American Geriatrics Society.)

Objective: Our objective was to describe the development of the New Jersey Safety and Health Outcomes (NJ-SHO) data warehouse-a unique and comprehensive data source that integrates state-wide administrative databases in NJ to enable the field of injury prevention to address critical, high-priority research questions., Methods: We undertook an iterative process to link data from six state-wide administrative databases from NJ for the period of 2004 through 2018: (1) driver licensing histories, (2) traffic-related citations and suspensions, (3) police-reported crashes, (4) birth certificates, (5) death certificates and (6) hospital discharges (emergency department, inpatient and outpatient). We also linked to electronic health records of all NJ patients of the Children's Hospital of Philadelphia network, census tract-level indicators (using geocoded residential addresses) and state-wide Medicaid/Medicare data. We used several metrics to evaluate the quality of the linkage process., Results: After the linkage process was complete, the NJ-SHO data warehouse included linked records for 22.3 million distinct individuals. Our evaluation of this linkage suggests that the linkage was of high quality: (1) the median match probability-or likelihood of a match being true-among all accepted pairs was 0.9999 (IQR: 0.9999-1.0000); and (2) the false match rate-or proportion of accepted pairs that were false matches-was 0.0063., Conclusions: The resulting NJ-SHO warehouse is one of the most comprehensive and rich longitudinal sources of injury data to date. The warehouse has already been used to support numerous studies and is primed to support a host of rigorous studies in the field of injury prevention., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.)

Objective: Racial and ethnic disparities and/or inequities have been documented in traffic safety research. However, race/ethnicity data are often not captured in population-level traffic safety databases, limiting the field's ability to comprehensively study racial/ethnic differences in transportation outcomes, as well as our ability to mitigate them. To overcome this limitation, we explored the utility of estimating race and ethnicity for drivers in the New Jersey Safety and Health Outcomes (NJ-SHO) data warehouse using the Bayesian Improved Surname Geocoding (BISG) algorithm. In addition, we summarize important recommendations established to guide researchers developing and implementing racial and ethnic disparity research., Methods: We applied BISG to estimate population-level race/ethnicity for New Jersey drivers in 2017 and evaluated the concordance between reported values available in integrated administrative sources (e.g., hospital records) and BISG probability distributions using an area under the receiver operator curve (AUC) within each race/ethnicity category. Overall AUC was calculated by weighting each AUC value by the population count in each reported category. In an exemplar analysis using 2017 crash data, we conducted an analysis of average monthly police-reported crash rates in 2017 by race/ethnicity using the NJ-SHO and BISG sets of race/ethnicity values to compare their outputs., Results: We found excellent or outstanding concordance (AUC ≥0.86) between reported race/ethnicity and BISG probabilities for White, Hispanic, Black, and Asian/Pacific Islander drivers. We found poor concordance for American Indian/Alaskan Native drivers (AUC= 0.65), and concordance was no better than random assignment for Multiracial drivers (AUC = 0.52). Among White, Hispanic, Asian/Pacific Islander, and American Indian/Alaskan native drivers, monthly crash rates calculated using both NJ-SHO reported race/ethnicity values and BISG probabilities were similar. Monthly crash rates differed by 11% for Black drivers, and by more than 200% for Multiracial drivers., Conclusion: Findings of excellent or outstanding concordance between and mostly similar crash rates derived from reported race/ethnicity and BISG probabilities for White, Hispanic, Black, and Asian/Pacific Islander drivers (98.9% of all drivers in this sample) demonstrate the potential utility of BISG in enabling research on transportation disparities and inequities. Concordance between race/ethnicity values were not acceptable for American Indian/Alaskan Native and Multiracial drivers, which is similar to previous applications and evaluations of BISG. Future work is needed to determine the extent to which BISG may be applied to traffic safety contexts.

This retrospective cohort study investigated whether unilateral vision impairment (UVI) or amblyopia are associated with driver licensing and crash risk among young adults. Electronic health records for New Jersey residents who were patients with the Children's Hospital of Philadelphia's healthcare network were linked to statewide driver licensing and crash data. We compared young adults with a diagnosis of UVI and/or amblyopia to peers without such a diagnosis. Young adults with UVI or amblyopia were less likely to acquire a driver's license than those without these conditions. However, among licensed drivers, the risk of a police-reported crash was similar in all three groups., (Copyright © 2019 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.)

Purpose: The Federal Highway Administration (FHWA) collects and publishes annual state-based counts of licensed drivers, which have been used to estimate per-driver crash rates and document a decline in young licensed drivers. The accuracy of these data has been questioned., Methods: We compared the number of young licensed drivers as reported by the FHWA (2006-2012) with that generated directly from New Jersey (NJ) administrative licensing data. Census data were used to estimate the proportion of NJ adolescents who were licensed., Results: FHWA data showed a decline in the proportion of licensed 17- to 20-year olds over the 7-year period (77%-63%), whereas analysis of NJ licensing data revealed a more stable trend (75%-74%)., Conclusions: We advise against use of FHWA licensing data for research purposes and encourage FHWA to work with state licensing agencies to review and enhance data collection and quality control procedures with the goal of ensuring the accuracy of licensing data., (Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Background: Decal laws have been implemented internationally to facilitate police enforcement of graduated driver licensing (GDL) restrictions (e.g., passenger limit, nighttime curfew) but have not been evaluated. New Jersey implemented the first decal law in the U.S. on May 1, 2010., Purpose: The aim of this study was to evaluate the effect of New Jersey's law on the rate of citations issued for violation of GDL restrictions and police-reported crashes among probationary drivers aged <21 years and to estimate the number of probationary drivers whose crashes were prevented by the law., Methods: New Jersey's licensing and crash databases were linked from January 1, 2008 to May 31, 2011, and each driver's license status, age, and outcome status were ascertained for each month. Monthly rates were calculated as the proportion of probationary drivers who experienced the outcome in that month. The pre-law period was defined as January 2008-January 2010 and the post-law period as May 2010-May 2011. Negative binomial regression models with robust SEs were used to determine the law's effect on crash and citation rates (adjusted for gender, seasonal trends, and overall trends) and estimate prevented crashes. Analyses were conducted in 2012., Results: In the first year post-law, there was a 14% increase in the GDL citation rate (adjusted rate ratio 1.14 [95% CI=1.05, 1.24]); a 9% reduction in the police-reported crash rate (adjusted rate ratio 0.91 [95% CI=0.86, 0.97]), and an estimated 1624 young probationary drivers for whom a crash was prevented., Conclusions: Findings suggest that the law is positively affecting probationary drivers' safety. Results contribute to building the evidence base for the effectiveness of decal laws and provide valuable information to U.S. and international policymakers who are considering adding decal laws to enhance existing GDL laws., (Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.)