Driver licensing and health: A social ecological exploration of the impact of licence participation in Australian Aboriginal communities

Abstract

Introduction: Reduced licence participation in Aboriginal and Torres Strait Islander communities contributes to transport disadvantage, higher rates of transport-related morbidity and mortality. This study will incorporate a social ecology framework to better understand the economic, social inclusion and cultural impacts of licensing at all levels of the system from individuals, families, communities and the socio-political environment. Methods: Qualitative methods underpinned by a social ecology approach triangulates in-depth interviews (n = 17) and community discussion groups (n = 21). Analysis was inductive and deductive. Results: The impacts of licence participation were evident at multiple levels of the social ecology and it emerged that licensing greatly impacts the mobility of individuals, families and communities. Beyond mobility, the data amalgamated into four main themes: 1) Social and economic opportunity; 2) Access to services; 3) Cultural identity; and 4) Autonomy and the justice system. Discussion: Reduced driver licensing is impacting individuals, families and communities with an immense cost to multiple levels of the social ecology. This study has highlighted the value of licence participation for cultural identity and community wellbeing. Further, licence participation interacts with persistent inequity in the licensing and justice system and impacts on the capacity of individuals, families and communities to function autonomously within the parameters of the law. Accordingly, policy should be directed at facilitating equitable access to driver licensing to promote social inclusion. Licensing is not simply a "Transport" problem; addressing this complex issue of health and social justice is a prime example of the need for an intersectoral approach that targets change at the socio-political level to improve the equity, health and wellbeing of Aboriginal and Torres Strait Islander people.

Drink and drug driving education in the Northern Territory: a qualitative study illustrating issues of access and inequity

“…The cost of delivering the program in remote areas is high, and from course providers’ perspectives, must be recouped to sustain profitability. People in remote areas and who are financially disadvantaged therefore face greater barriers in obtaining their licence due to the high and inconsistent cost of the course, which compounds existing disadvantage as individuals without a driver's licence have reduced access to education, employment and healthcare 15 . It has been shown that when services are left to be delivered in a free market, those who already experience difficulties are those most severely impacted, leading to inequities and a widening of existing socioeconomic disadvantage 16,17 .…”

“…People in remote areas and who are financially disadvantaged therefore face greater barriers in obtaining their licence due to the high and inconsistent cost of the course, which compounds existing disadvantage as individuals without a driver's licence have reduced access to education, employment and healthcare. 15 It has been shown that when services are left to be delivered in a free market, those who already experience difficulties are those most severely impacted, leading to inequities and a widening of existing socioeconomic disadvantage. 16,17 A move away from the user-pays model, to one whereby the Northern Territory government is responsible for the funding and provision of drink and drug driving education services, may assist in overcoming disadvantages resulting from the current system.…”

Road user behaviour, attitudes and crashes: a survey of Aboriginal and Torres Strait Islander people in Australia

“…Alternatively, lack of access to public or private transport can increase the likelihood that people will drive unlicensed, which can be a risk factor for injury as unlicensed driving is associated with more severe crashes and other risky behaviours including speeding and drink driving 27–30. Furthermore, Aboriginal and Torres Strait Islander peoples require transport to meet specific cultural needs, including transporting family members to events and locations of cultural or kinship significance; however, in transport disadvantaged communities this can also contribute to unsafe driving practices including vehicle overcrowding, insufficient restraint use and drink driving 19 31…”

The road beyond licensing: The impact of a driver licensing support program on employment outcomes for Aboriginal and Torres Strait Islander Australians

“…Though employment rates have been on the rise over the last decade from 48.2-49.1% between 2008 and 2018-2019, there is still much needed improvements to reach parity with the 75% employment rates achieved by the labour force (age 15-64 years) of non-Indigenous Australians [17]. It is known that higher levels of education and training are important determinants for reaching parity in employment outcomes [18], but studies have also shown from the perspectives of Aboriginal and Torres Strait Islander young peoples the importance placed on driving as being an enabler to gaining employment and accessing job opportunities [19]. Our past research also showed that having a licence is associated with increased likelihood of having a job [20].…”