Graduated drivers license programs and rural teenage motor vehicle fatalities.

CONTEXT Graduated drivers license (GDL) programs have been shown to reduce motor vehicle fatalities among 15- to 17-year-olds. However, the 20 most rural states have been the least likely to enact more stringent GDL policies. PURPOSE Estimate the relationship of GDL programs and the number of traffic fatalities among 15- to 17-year-olds on rural interstate and noninterstate roadways. METHODS Analysis of 1992-2002 Fatality Analysis Reporting System data and a compendium of state laws using a conditional negative binominal regression model with full fixed effects to control for unobservable differences across states and years. FINDINGS Overall, GDL programs were associated with a 7.8% reduction in rural traffic fatalities among 15- to 17-year-olds. Virtually all of this reduction took place on noninterstate roadways. The most stringent GDL programs were associated with a nearly 22% reduction in this age group and were the only programs associated with reductions in fatalities among 15- to 17-year-old drivers. CONCLUSIONS Rural states should consider enacting stringent GDL programs. Had the 19 of the 20 most rural states without such programs all adopted the most stringent GDL programs in 2002, the analysis suggests that 64 traffic deaths among 15- to 17-years-olds could have been prevented.