Research In Practice Blog
Driving offers several benefits for adolescents, including increased independence, mobility, and access to social and economic opportunities. However, motor vehicle crashes remain a leading cause of death among this age group. To address this risk, Graduated Driver Licensing (GDL) policies implement learner’s permits and restrict adolescents' driving privileges. While there is evidence these policies are effective at reducing crashes, they often only apply to new drivers under age 18. Research shows that around 80% of all 15-year-olds, regardless of their location, plan to learn to drive within the next year. However, by the time they reach ages 17 to 18, data indicates that the likelihood of obtaining a driving permit or license varies based on where they live.
Study Design and Findings
A new analysis conducted by researchers at Clinical Futures, PolicyLab, the Possibilities Project, and the Center for Injury Research and Prevention at Children’s Hospital of Philadelphia (CHOP) examined disparities in the driving intentions and licensure of adolescents based on their neighborhood opportunities. Clinical Futures experts Stephanie Mayne, PhD, MHS, Ngwi Tayong, MPH, Maura Powell, MPH, MBA, Brian Jenssen, MD, MSHP, Alexander Fiks, MD, MSCE, and their colleagues utilized electronic health record (EHR) data from adolescents aged 15 to 18 years from CHOP’s 31-site Primary Care Network, covering the period from February 2022 to November 2025. The findings were published today in JAMA Pediatrics.
Adolescent participants were included in the study if they completed their annual Adolescent Health Questionnaire (AHQ), a confidential pre-visit assessment that covers various health-related topics, including their intention to learn to drive and their licensure status, at ages 15 and again at ages 17-18 during the study period. To evaluate neighborhood conditions that are related to children's health, the research examined the Child Opportunity Index (COI) of each adolescents’ home census tract. Within the cohort, 57.8% of participants lived in neighborhoods classified as "very high" COI, while 11.2% resided in "very low" COI neighborhoods.
In neighborhoods categorized as “very low” in terms of Community Opportunity Index (COI):
- 80.0% of 15-year-olds had the intention to drive
- 31.6% reported having a permit or license at age 17 to 18
In contrast, in neighborhoods identified as “very high” in COI:
- 89.0% of 15-year-olds had the intention to drive
- 91.1% reported having a permit or license at age 17 to 18
Clinical Implications
Adolescents from low-opportunity neighborhoods are 42% less likely to obtain a driver's license or permit by the age of 17 or 18, despite a desire to learn to drive. This delay in licensure could limit their access to the protections provided by Graduated Driver Licensing (GDL) policies.
“Our results clearly show that some teens who really want to get their driver’s license are facing barriers. It is crucial that we conduct further research to uncover these specific barriers. In the clinical setting, we can work to address these barriers by incorporating safe driving information into usual care,” said first study author Stephanie Mayne, PhD, an Assistant Professor of Pediatrics and Epidemiology with Clinical Futures and PolicyLab at Children’s Hospital of Philadelphia.
Funding/Support: This work was supported by the Possibilities Project of the Children’s Hospital of Philadelphia (CHOP) and a gift to CHOP from NJM Insurance Group.
Additional information:
CHOP has resources available to help parents and teens navigate the learning to drive process. Teen Driving Plan is CHOP’s evidence-based program for supervised driving practice and can be found at teendriversource.research.chop.edu. CHOP primary care patients also receive educational materials on driving and can take the virtual driving assessment at their primary care practice. Learn more in this CHOP news brief.
Clinical Futures author(s): Stephanie Mayne, PhD, MHS, Ngwi Tayong, MPH, Maura Powell, MPH, MBA, Brian Jenssen, MD, MSHP, Alexander Fiks, MD, MSCE