"Drivers over the age of 65 are the safest drivers of any age group. Even the commonly cited statistic of a higher risk of crash per kilometre among this group has been shown to be an artefact: low mileage is intrinsically risky, and studies show that when this is controlled for the older drivers perform as well as, if not better than, younger drivers (Transportation Research Part F: Traffic Psychology and Behaviour 2002;5: 271-4). Despite this evidence many European governments have enacted restrictive legislation directed at them. The negative perception extends to the American Medical Association's 2003 guideline Assessing Fitness to Drive in Older People. Although the guideline is clinically useful, its preface still emphasises the “risk” posed by older drivers. Much of the literature on older people's medical fitness to drive concentrates on risk rather than mobility. Might a negative image of elderly drivers in the media be an important factor in shaping public and medical opinion on the issue? To help answer this question we searched the electronic archives of 15 UK and Irish national and regional newspapers from January 1999 to May 2004 for references to older drivers. We assessed whether the articles were negative or positive to older drivers or balanced. We identified 51 relevant articles, of which we independently judged 17 to be negative, four positive, and 30 even handed. When we excluded brief reports on fatal crashes, we found the results for opinion or editorial articles to be 15 negative, four positive, and seven balanced. Headlines included “Keep the over-50s off our M-ways,” “Old dear trashes 7 cars,” “MP calls for old to get special licences,” “Silly old buggy,” and “Fanatic speed cop targets old folk.” Newspaper reporting of issues relating to older drivers in the United Kingdom and Ireland is largely negative in content and is at variance with the evidence. The potential consequences of such representation are to distort the political and societal context within which doctors practise medicine and promote healthy ageing. The media reflect and shape public opinion. In particular, the media can influence the public's perception of health related issues. One example is the inordinately high level of success with cardiopulmonary resuscitation in television series such as ER (New England Journal of Medicine 1996;334: 1578-82). This leaves professionals with two tasks. Firstly they need to be mindful of such prejudices when dealing with individual patients. When they are discussing resuscitation with their patients they should consider the unrealistic survival rate of cardiopulmonary resuscitation portrayed on television. So too, when discussing driving ability with older patients—and in particular with their relatives—doctors need to take into account the negative perception of older drivers among the general public and to strive to ensure that the mobility of older people is not prematurely and unnecessarily curtailed. The second task is for our professional bodies—doctors, geriatricians, transport planners—to work with journalists and opinion formers to educate them and make them aware that the major concern with transport and health for older people is usually access to transport rather than the imagined threat that older drivers represent to other road users. The Organization for Economic Cooperation and Development has recommended just such an approach (Ageing and Transport: Mobility Needs and Safety Issues, 2001), emphasising the need for information campaigns that prioritise mobility over risk. New medical curriculums are already well oriented to social and behavioural sciences; a brief taste of media studies may help doctors understand and combat negative perceptions among the public that shape their work environment." (Author/publisher)
Samenvatting