Risk Factors And Decision-Making In Potentially Injurious Motor Vehicle Activities

Abstract

Objective: Driving a motor vehicle can be a dangerous experience. Motor vehicle crashes were the leading cause of unintentional injury death for individuals aged 5-29 in the United States in 2020. The pursuit of a fleeing motor vehicle and the use of a motor vehicle crash as a method of suicide are two specific driving activities that have the potential to lead to injury; in the case of the latter, an intentional injury to the driver can result in the unintentional injury of a bystander. Previous research has examined several risk factors of both these activities, but further exploration remains. This research aims to approach these activities through the lens of hermeneutic phenomenology to mold the research questions and methods to greater explore how the world experiences or lifeworlds of individuals involved in pursuits and motor vehicle suicides may impact the decisions made leading to and during the event. Methods: Each of the three studies in this research addresses potential risk factors or influence on the phenomena of pursuits or motor vehicle crashes as a method of suicide through different methods. Semi-structured interviews with law enforcement officers (n=9), public defenders(n=9), and individuals who had fled from the police (n=20) were analyzed with a previously utilized framework to incorporate hermeneutical phenomenological analysis to identify essential themes of influences that influenced decision-making prior to and during a pursuit. A survey on perceived restrictiveness of pursuit policy was sent to the law enforcement agencies across Minnesota to be used in concert with data from the Uniform Crime Report (UCR) from the Minnesota Bureau of Criminal Apprehension (BCA) to understand further the relationship between perceived restrictions of a policy and the number of reported pursuits by the agency. Collected policy data for State Patrol was utilized with their incident level data to understand further the association between increased policy restrictions and the outcome of pursuits. The final study of this research utilized data from the National Violent Death Reporting System (NVDRS) to analyze the prevalence of different demographics and psychosocial circumstances that may differ within suicides utilizing motor vehicle crashes as compared to another method. Results: Findings from the interviews with officers found how policy and personal experience drive officers' decision-making when deciding to pursue and actions during the pursuit. Likewise, interviews with public defenders and offenders showed prior experience with law enforcement and their current legal situation drive the decision to flee officers, and the desired outcome of pursuits influences the decisions during the pursuit. Within pursuit policy, only policies perceived to discourage pursuits outright resulted in an impact on reported pursuits. State Patrol's policy update remained the same proportion of pursuits ending in non-initiation or law enforcement disengagement.Criminal/legal problems along with a history of suicidal attempts or thoughts and disclosure of suicidal intent were all circumstances that had a higher prevalence in motor vehicle crashes than in non-motor vehicle crash methods. History of mental health disorders, substance use/alcohol abuse, physical health problems, family/friend death, and job/financial problems all were more prevalent in non-motor vehicle crash suicides compared to motor vehicle crash suicides. Conclusion: Each study of this research showed how addressing traffic safety and injury prevention topics through the lens of phenomenology and lifeworlds can provide a new way to address research questions and the context of findings. While not mutually exclusive to phenomenology, this way of thinking may help guide future research questions to bring a more integrated approach to understanding risk factors and injuries.