All-terrain vehicles: Epidemiology & policy strategies for saving lives

Background: Evidence shows All-Terrain Vehicles (ATVs) impact morbidity and mortality at increased levels when safety policies are absent. Five states, including Mississippi, lack ATV safety legislation. Methods: Mixed qualitative and quantitative analyses of stakeholders, trauma registry, vital statistics, and hospital discharge data. Results: Mississippians are 3.5 times more likely (p<.01) to die from ATV accidents compared to the nation. ATV injuries rose five-fold over eight years, significantly (p <.01) so for children under sixteen, of which public insurance paid one-third of claims. Head injury, site of the highest percentage (41%) of ATV injuries statewide, is significantly (p<.01) higher than other locations. Helmet use reduces risk of ATV related deaths by nearly half and head injury risk by 64%. States without ATV safety legislation have twice the death rates (p<.01) of states with ATV safety legislation. Stakeholder scans revealed consensus ATV safety is a state health policy issue. Discussion: Children under sixteen are at highest risk and risks are increasing statewide. Injuries driving morbidity and mortality rates can be curtailed via policy intervention shown effective in reducing these trends. Policymakers demonstrated understanding of the issue by calling a legislative hearing where findings were discussed. Several ATV-related bills were subsequently authored and research findings directly utilized in public policy debates and media. An ATV safety law passed effective July 2011 mandating helmet use and safety training for children under 16 riding on public lands. Evidence utilized could serve as a model for states facing similar challenges framing public health issues targeting policymakers.