Introduction
Drunk driving in the United States takes many descriptions depending on the jurisdiction, whether federal, state, or local. In all jurisdictions in the country, the practice is illegal and attracts varying penalties depending on the severity. Drunk driving is also synonymous with terms such as driving under the influence (DUI), driving while intoxicated (DWI), operating while impaired (OWI), and operating a vehicle under the influence (OVI), depending on the state where the law applies. In this research, the terms will apply interchangeably but mainly DWI and DUI will mostly apply. It is important to note that in most jurisdictions, the laws apply beyond motor vehicle drivers and include boating and aircraft as well. Additionally, it may include farm machinery as well as horse-drawn carriages whose operation while under the influence may qualify as risky to the public or self.
Drunk driving refers to the activities involving the operation of a machine or a motor vehicle while under the effects of alcohol and/ or drugs to an extent that mental capabilities don’t function normally. The rationale behind criminalization stems from the belief that in the above state, someone poses danger to him/herself and the public (Jacobs, 1989, p. 17).
DWI is a widespread problem in the US which according to the National Highway Traffic Safety Administration was responsible for over 17000 deaths in 2006. The above deaths were alcohol-related and represented slightly over 40% of all traffic deaths in the country. Hundreds of thousands more sustain injuries every year according to the NHTSA (King, 2011, p. 47).
In a bid to determine if an accident is alcohol-related and to control the DWI related accidents, all states in the US have established blood alcohol content parameters that define the limits within which one can drive or operate a machine without the possibility of causing harm to himself or others (Valle, 1986, p. 97). States have designated per se alcohol levels that act as the benchmark for the commission of a criminal offense. Most states have 0.08% BAC as the maximum level that one can legally operate a machine or motor vehicle. As mentioned earlier, the problem is prevalent in all states of the US including New Mexico. This research will carry out an in-depth analysis of the DWI problem in the City of Albuquerque, New Mexico State. Ultimately, a nursing diagnosis and intervention will form the main focus. Besides, there will also be a close examination of the city’s community, health status indicators, and a review of the public health literature of the city.
Definition of the community
Albuquerque is New Mexico’s largest city and US’s 32 largest city with population totaling 545, 852 people according to the 2010 national Census. However, after including the metropolitan area of city of Rancho, population increases to over 900,000. It is one of the fastest growing cities in the US coming in 6th position as of 2007 (Carr, 2009, p. 105).
The city is lies in central New Mexico and spans a total area of 181.3 square miles (470 km2) with a considerable portion of that being water. The city’s location falls within the Upper edge of the Chihuahua desert. The city spots one of the highest elevations of an urban center in the US with a major effect coming from its location in the continental south-westerly position. Besides, the city’ geography has heavy influences from the surrounding major geographical features including the Arizona-New Mexico Mountain and the Colorado Plateau Desert (Carr, 2009, p. 107).
Like the US, the city is a melting pot of various cultures and people reminiscent of its history and position. Various Western folklores attribute the origin of the city’s name to different sources. It is generally agreed that the city rose from a village that acquired its name from the provincial governor Don Francisco Cuervo y Valdes who named it after a viceroy of New Spain in the 17th century. However, other folklore does quote Arabic, Portuguese, Latin and Arabic influences in the name of the city. Albuquerque owes much of its history to the Spanish settlers who established it in 1706 as a colonial and military outpost. Some of the Spanish colonial relics of the city such as the “Old town” still exist though as museums to the public. American influence on the city began after occupation of New Mexico by the US and a subsequent establishment of a federal garrison and a quartermaster in the 19th century. The city was also battlefield that featured a confrontation between Confederate and Union troops. Under American administration, New Mexico experienced rapid growth including establishment of key institutions such The University of New Mexico, Kirtland Air Force Base in 1939, Sandia Base in the early 1940s, and Sandia National Laboratories in 1949. The current city status of Albuquerque is a result of decades of growth with major influence Spanish but also largely American culture. Currently the city experiences many problems that have come up as a result of urbanization and changes associated with 21st century cultural dynamics.
By virtue of being a metropolitan area, population of Albuquerque is uniquely more prone to the social ills that are characteristic of urban populations. As earlier mentioned, drunk driving is a common problem in the US. However, the effect on urban areas is higher than it is in rural areas. Sociologically, it is safe to conclude that the uniqueness associated with the urban population including Albuquerque stems from the increased liberal tendencies among the population, especially among the youth. In addition to that, the economic status of most city residents is slightly better and they are in a better position to access machines and substances that lead to DWI.
Description of the community and its people
Albuquerque is a cosmopolitan urban center with nearly all major ethnic and racial communities in the US represented in the city (Taylor & Oberman, 2006, p. 723). According to the US census of 2010, whites, other races, Native Americans and African-Americans form the majority of Albuquerque population as the table below illustrates.
Table 1: Albuquerque residents by race
It is important to note that 46% of all the people represented in the table above are Hispanics irrespective of their race. According to the census, the population density of the city stood at 3010.7 with 239,166 households, and 224,330 families. Slightly over 30% of the households had children under the age of 18 while slightly over 12% of the households had females as the heads (Carr, 2009, p. 8). The age distribution according to the 2010 census was as the table below illustrates.
Table 2: Population Distribution in Albuquerque
The gender distribution of the city is fairly even with the ratio of 100 females to 94.4 females. Males according to the census have a superior income median compared to females at approximately $34200 and $26400 respectively.
The economy of Albuquerque draws its support from a number of both government and private institutions that operate from the city. It is important to note that the city lies right in the middle of the Technology Corridor of New Mexico that includes a host of private companies and government institutions with vast investments in technology. The corridor lies along the Rio Grande with institutions such as Kirtland Air Force Base, Intel Corp., PNM resources, Sandia National Laboratories and Bank of Albuquerque gracing it. Additionally, there is the solar energy and architectural design company Zomeworks that has been in the city region since 1960, Los Alamos National Laboratory plus a host of many other technology related companies that are crucial to the survival of Albuquerque’s economy (King, 2011, p. 67).
The city is home to one of the nation’s largest school districts, the Albuquerque Public schools that cater for education needs of over 80,000 students. The city’s flagship education institution is the University of New Mexico which is the oldest in the state. Besides, the city also has the National American University, Trinity Southwest University and the University of St. Francis, a college of nursing and allied health department of physician assistant studies. There are also numerous technical schools that serve the city’s educational purposes including ITT technical institute and the University of Phoenix. Transport and communication is perhaps directly linked with the main subject of this research. Albuquerque boasts of developed state of the art transport and communication facilities that include highways, rails, bridges and airports.
Given that Albuquerque is the largest city in New Mexico, the statistics about DWI in the state will, therefore, mostly apply on the city as well. There is little variation on the margins of error between the state and city figures especially on drunk driving. It is, therefore, important to note that reference to statistics on DWI in New Mexico will be part of the analysis on city of Albuquerque from time to time. The health status of city of Albuquerque is full of social trends that point to a persistent problem of DWI. A while back, the Centers for Disease Control pointed out that New Mexico ranked highest in the entire US in the use of alcohol by minors below age 13. Additionally, there was a documentary a while back on drug usage among New Mexico students that pointed out that over 13% of students in the state had more than once received experimental drug offers at school (Dempsey & Forst, 2011, p. 275).
Concerning use of alcohol among the population of New Mexico and especially Albuquerque, the Native American factor comes to the fore. In the 1970’s and 80’s, Gallup, a city in the North Western part of the state inhabited mainly by Native Americans became the synonymous with drinking. The trend traces its origin to the repealing by Congress of the law prohibiting sale of alcohol to Native Indians and the unavailability of the commodity in some of the Native Indian reserves. The problem reached its peak in the 1970’s and 80’s. By 1988, when police would regularly round-up an estimated 35000 people from the roadsides by authorities for public intoxication and retained under protective custody according to New Mexico laws. It is, therefore, possible that the considerable presence of that ethnic group in Albuquerque city influences to a certain extent the trends experienced in drunk driving.
Health Status Indicators
Drunk driving or DWI is generally a concern not only in Albuquerque but also in the entire world. DWI is a public health concern given that it causes deaths and other health problems such as permanent disability. The problem is severe in the US compared to its developed peers especially the UK and Australia where deaths caused by drunk driving are less than in the US. For instance, the UK with population of 61 million recorded 380 alcohol related deaths in 2010 while California, a state with slightly more than 36 million people recorded 1500 deaths resulting from accidents that are alcohol related (Oyerbey, 2006, p. 20). It is important to note that in the backdrop of the above scenario, statistics indicate that UK and Australia have higher alcohol consumption per capita than the US while the legal drinking ages for the former two are also lower than the latter. The consensus among stakeholders that driving while intoxicated be it in Albuquerque causes injuries and death gives impetus to classification of DWI as an important problem that needs tackling.
Severity of DWI in Albuquerque is reflection of the larger New Mexico and US societies. However, like the above bigger jurisdiction areas, DWI in Albuquerque is unique as dictated by the circumstances unique only to the city (Gaines & Kappeler, 2011, p.208). The table below illustrates the total number of fatalities (in percentage) resulting from alcohol related traffic accidents in the State of New Mexico from the year 2000 to 2009.
Table 3: Alcohol-Related Traffic Fatalities in the State of New Mexico
The figures presented above involve people involved in alcohol related crashes but who were necessarily not driving especially non occupants such as bicyclist or pedestrians. In the above statistics at least one of the people involved driver or not had positive blood alcohol content.
The figures above represent a considerable decline in the number of fatalities since the year 2000 from highs of 41% to 32% in 2009. The lowest in has got in the ten years is 28%. Despite the drop however, 32% is still a high figure. It is, therefore, safe to conclude that the DWI is still rampant and widespread in the state of New Mexico despite the legal measures put in place to deter it (Gaines & Kappeler, 2011, p.208).
Closer to Albuquerque, the DWI Information Network published a report on Bernalillo in 2004, the county where Albuquerque belongs as having a fatal crush in every thirteen minutes, an injury in every 15 seconds, property damage in every eight seconds and a crash in every 5 seconds, all traffic related. In Bernalillo and Albuquerque, therefore, the report concluded that the toll created by traffic crashes is greater compared to that caused by violent crimes. The number of alcohol impaired fatalities in the county seesawed peaking in 2005 and registering a decline in 2006 and 2007 from.25 fatalities per 100,000 people to 2.83 fatalities per 100,000 people (Wanberg et al., 2004, p. 367). The table below shows the number in percentages of DWI citations issued by agencies from the year 1999-2003.
Table 4: DWI Citations by agencies in NM State
According to the above table, the number of DWI citations in Albuquerque was constant throughout though a worrisome trend points out the situation in Albuquerque concerning DWI. Despite the trend shown above, recent media reports quoted the police as saying that DWI cases are on the decline in Albuquerque city. In 2010 for instance the Albuquerque Police Department reported 3500 drunken driving arrests (Gerdes, 2004, p. 28).
The table below shows the number of the numbers in percentage of alcohol related deaths in the US since the year 2000. Compared to that of the State of New Mexico as shown in table 3, the fatality rates are lower nevertheless within unacceptable proportions.
Table 5: Number of Alcohol related fatalities in the US
Many works of research have shown despite DWI offenders being of both genders males mostly make up majority. According to the DWI Information Network report, men make up majority of arrests and convictions in Bernalillo County where city of Albuquerque falls. However, as the following graph shows, female arrests and convictions have steadily grown, especially in the three years analyzed, and make up a considerable part of the county’s DWI statistics (Adam & Maurice, 2011, p. 53).
It is, therefore, safe to conclude that the problem is prevalent in the community in the city and emphasis should no longer target males only. It is important that measures be put in place so as to contain the number of females involved in DWI.
In addition to the gender perspective to DWI problem, age is another factor. According to the not for profit organization Teens Against Drunk Driving (TADD), more than half of the approximately 30,000 people who lose their lives in the US every year to traffic accidents are less than 21 years. The organization adds that more than half of deaths of teenager aged 16-19 are as a result of car crashes. Given the above statistics, therefore, teenager deaths from car crashes account for nearly 17% of all car related deaths in the US. While a big part of these deaths result from other factors like negligence, a big proportion are as a result of drunk driving. It is, therefore, correct to generalize these statistics on New Mexico and specifically Albuquerque to get the true picture of the situation concerning DWI (Gifford, 2009, p. 89).
Community/ Nursing Diagnosis
- Achieving the targets on DWI as envisaged in the Healthy People 2020 initiative is likely to take longer than expected. While there is progress made in reducing DWI cases in New Mexico and Albuquerque, it is increasingly difficult for law enforcement to identify children driven by drunk drivers thus making it difficult to achieve the 25.5% target set by the initiative. It is necessary to enact new laws that will make it easier for law enforcement to identify people violating DWI laws in order to reduce the rate of DWI as outlined in Healthy People 2020.
- There is a feeling among many people in Albuquerque that DWI is rampant and poses a grave danger to both young and old. Backed by organizations such as Mothers Against Drunk Driving, the residents of the metropolitan and the State in general, support drastic measures such as vehicle forfeiture in order to control runaway DWI crimes. People are willing to take the necessary steps to stop the problem from recurring. Public awareness by authorities is, therefore, necessary to solidify this support and goodwill for the good of the Albuquerque community. Authorities acknowledge existence of the problem in the city hence initiatives such as vehicle forfeiture program that are yielding positive results.
- The number of females committing DWI offenses is likely to rise as evidenced by the statistics. While the rise is attributable to social trends in a dynamic society, it does not augur well with efforts to combat DWI in Albuquerque. If left unchecked, the problem of rising females committing DWI offenses will most likely spiral out of hand.
- Existence of DWI in the Albuquerque community is real and widespread. The effect transcends almost all demographic sections of the population that are vulnerable to DWI. Males are the most affected while females and teenagers follow closely follow. Despite the initiatives put in place, there are indications of continuous engagement in drunk driving by a considerable number of members of the public effectively putting the lives of other city residents in danger. The continued existence of this problem in Albuquerque city continues to expose the place to a ripple effect of the adverse effects of DWI. There is a considerable amount of loses that community of Albuquerque is incurring to drunk driving chief among them being loss of lives. Additionally, DWI wrecks havoc on the social setting of the community because legal proceedings, vehicle forfeitures or injuries contribute to social trauma the immediate family of anyone involved.
- Combating DWI costs the Albuquerque community of millions of dollars every year, money that is diverted from important development initiatives. For instance, the vehicle forfeiture programs that includes impounding, towing and auctioning costs the county approximately one million dollars every year. When quantification of non-monetary costs takes place, the long-term effects of DWI in the Albuquerque communities are likely to have a lasting impact on the social wellbeing of the residents. Monetary loses, health loses through injury and social loses through humiliation are likely to have a negative impact on the community.
- As said above, the Albuquerque community has shown willingness in combating the problem. Already, the mechanism on which such programs can take place exists. It is, therefore, easy for authorities and residents to collaborate in any way necessary to address DWI. However, it is imperative to refine the already existing programs before implementing completely new ones. Success of such programs depends on the willingness of the residents and authorities which so far has been evident in the already running programs.
Highest priority Diagnosis
Given the nature of the problem tackled in this research, the highest priority diagnosis is:
“The existence of DWI in the Albuquerque community is real and widespread. The effect transcends almost all demographic sections of the population that are vulnerable to DWI. Males are the most affected while females and teenagers follow closely follow. Despite the initiatives put in place, there are indications of continuous engagement in drunk driving by a considerable number of members of the public effectively putting the lives of other city residents in danger. The continued existence of this problem in Albuquerque city continues to expose the place to a ripple effect of the adverse effects of DWI. There is a considerable amount of loses that community of Albuquerque is incurring to drunk driving chief among them being loss of lives. Additionally, DWI wrecks havoc on the social setting of the community because legal proceedings, vehicle forfeitures or injuries traumatize the immediate family of anyone involved.”
This diagnosis captures the status of DWI problem in Albuquerque and tries to give the true picture from a community nursing point of view. Through this diagnosis, authorities will find it easy to identify the priority areas that need attention concerning DWI.
Review of Public Health Literature
Drunk driving is as old as the auto industry itself. Before World War II, laws governing DWI were not given much thought by authorities. However, after the war ended the economies of warring nations began to grow and the US which had not lost much to the war was the venue for a fast growing auto industry (Robin, 1991, p. 77). Indiana had in place a law setting the limit for a BAC of 0.15 in 1938 before the war began. New York was however the first jurisdiction in the US to have in place, a law against drunk driving in 1910. The growing vice and that of auto industry in Detroit city necessitated establishment of the Traffic Safety Association of Detroit. Through TSA’s initiatives, alcohol related accidents in Detroit reduced by over 90% in a few years. California in 1957 also passed a law on drunk driving whose effectiveness stemmed from the punitive measures it proposed for drunken drivers. The US saw an upsurge of laws and enhancements stemming from pressure from non-governmental organizations such as Mothers Against Drunk Driving. It is during this time that enactment of most of the laws today that criminalized drunk stressing zero tolerance to drunk driving took place.
Tackling drunk driving is one of the most prioritized of authorities including various governments that fall under US jurisdiction. While complete elimination of the vice is tough for many authorities, controlling it to within acceptable levels is possible. One of the frameworks within which tackling DWI falls under is the Healthy People 2020. This framework sets goals and objectives that various departments concerned with health issues in the US must achieve by the year 2020. Some are directly related to DWI while others only relate indirectly. ‘
The Healthy People 2020 goals and objectives list substance abuse as one of the areas that must receive special emphasis in order to achieve set targets. Of particular importance is the issue both children and adults being exposed to DWI situations knowingly and unknowingly. The Health People 2020 initiative aims to achieve a 25.5% reduction in the number of teenagers who report to having ridden with a DWI driver in the last 30 days. This motivated by statistics showing that 28.3% of students in grades 9 through 12 have ridden in the same vehicle with a DWI driver in the year 2009 (Healthy People 2020, 2011, p. 9).
In the intuitive blue print, substance abuse objective five aims at increasing the number of courts in the US that deal with drugs, DWI cases as well as other specialties that relate to the above. Additionally, the initiative aims at increasing the States with mandatory ignition interlock laws for first and repeat DWI offenders in the US. The target is all states plus the District of Columbia compared to only 13 that had the mandatory ignition interlock laws in 2009.
Objective 15 aims at reducing the number of adults who drank excessively in the last 30 days with a target improvement of 10%. Additionally, it targets reduction of the average annual alcohol consumption to 2.1 gallons. Closely related to the above objectives and more relevant to information in this research is objective 17 that aims at decreasing the rate of DWI driving fatalities by drivers with more than.0.08% blood to alcohol content. The above objective targets a 5% improvement. Data from the Fatality Analysis Reporting System in 2008 showing that 0.40 deaths occurring per 100 million miles travelled involve a driver or rider with a blood to alcohol content of more than 0.08 (Healthy People 2020, 2011, p. 17).
It is important to note that the above initiatives target the entire United States including New Mexico and Albuquerque. It is, therefore, safe to conclude that whatever mechanisms concerned authorities are going to put in place will help alleviate to an extent the DWI problem in New Mexico and specifically Albuquerque.
Initiatives such as the above have come up because the authorities acknowledge existence of problems such as DWI in Albuquerque and the larger New Mexico. According to the New Mexico Department of health and New Mexico Prevention Research Center Policy Brief Series, deaths from motor vehicle crashes resulting from DWI have sharply declined by almost 80%. According to the two departments, deaths caused by DWI related circumstances have declined from a high of 3.2 per 100 million vehicle miles travelled to 0.8 per 100 vehicle miles travelled. The former figure was the highest in the nation in 1982 while the decline saw the state’s rank fall to 14th highest in 2006.
The State Traffic Safety Information and the National Highway Traffic Safety Administration attributes the following policies to the fall in the DWI deaths. They include:
- Introduction of laws that have slashed the allowable BAC levels in drivers who are both underage and also those that have raised the minimum legal drinking age to 21
- There have also been laws mandating installation of ignition interlock for first time offenders in order to check recidivism.
- Also credited by the two organizations is introduction of sobriety checkpoints backed by public campaigns creating awareness as well as raising the perception of risk of arrest among the public
- In addition, advanced technology especially in the design and installation of safety belts and laws that make their use mandatory have also contributed to reduction of DWI related deaths.
Albuquerque has also implemented initiatives aimed at reducing DWI deaths and vehicle crashes in the city. They include programs such as DWI-DUI Assistance programs that include an outpatient, partial hospitalization for substance abuse and day treatment for persons that need help with DWI related conditions. There is also DWI-DUI programs that include assistance programs like outpatient substance abuse treatment and drug rehab program for people who are in need of DWI related conditions.
Perhaps, one of the best DWI deterrence programs the city has is the Albuquerque DWI Vehicle Forfeiture Program. Under this program, repeat impaired drivers have their vehicles seized, impounded and in numerous cases auctioned off. These punitive measures are mostly applied on repeat impaired drivers as well as those that drive on a revoked license as a result of a DWI offense.
Besides, there is a requirement for all first time licensees in the state of New Mexico to take a DWI awareness class for drivers aged between 18-24 years. The New Mexico legislature passed the law in 1993 with the sole intention of combating drunk driving. The law lowered the intoxication level and imposed stiffer penalties and fines on offenders besides setting up an informal class for first time licensees. The program educates would be drivers of the laws that exist on drunk driving and the penalties associated with failure to obey.
Success of the programs above is varies. As earlier noted, the number of fatalities resulting from DWI in New Mexico has fallen from being the highest in the country to 14th highest. Additionally, the there is evidence of increased awareness among the Albuquerque residents especially on the backdrop of programs like vehicle forfeiture.
Nursing Intervention
Based on the discussion above, it is prudent to propose a solution that will tackle the DWI problem in the Albuquerque community. Before putting a proposal forward, it is important to highlight on the following areas:
- Males make up the most culprits in DWI cases
- Teenagers are the most vulnerable group that can easily succumb to the effects of DWI
- The number of women involved in DWI is likely to rise in the foreseeable future
- Data suggests that 60% of people involved in alcohol related crashes in Bernalillo County where Albuquerque belongs, have previously received DWI citations
- There are more people in the UK and Australia taking alcohol compared to the US, yet the US has a higher number of alcohol related fatalities than the two countries above
- There are still a considerable number of DWI cases in Bernalillo County where Albuquerque belongs despite extreme punitive measures such as vehicle forfeiture programs.
The above facts give a sneak peek into the problem and the issues surrounding it. The picture that comes out clearly is that DWI is a social problem and no amount punitive measures can completely erase. Also, DWI has everything to do with the social setting of the community where it occurs. Additionally, it is clear that availability of alcohol does not necessarily mean high DWI cases. In a nutshell, DWI problems are purely social and only social approaches will contain them. The solution to the DWI problem in Albuquerque is, therefore, a “Stepped up community awareness campaign program”.
The rationale behind this social-oriented intervention is to entrench DWI information in the community to a level that it will influence people decision making concerning drunk driving. Primarily, the intervention will aim at expanding the already existing state program where first time licensees attend mandatory drunk driving classes. Besides, there will be new programs that will entice people to attend DWI prevention classes voluntarily. The plan will entail a more detailed approach than what is currently offered. In addition to that, the program will include medical details on the effects of driving while drunk and a community nursing point of view as well.
The main purpose of this plan will be to help people willingly appreciate the dangers of DWI and make sound decisions regarding the same. In the long-term, this plan will be aiming at reducing the overall DWI cases and effectively alcohol-related accidents.
The plan will target all people equally with the aim of checking a rise in the number of females involved in DWI, reduction of male DWI cases and prevention of teenagers from falling to the DWI trap. In order for this plan to succeed, all stakeholders including state government, county leadership and community leadership will need to participate. Seminars and the media-both electronic and print will be the primary communication channels. Besides, the program will solicit for funds that will enable it run beneficial promotional activities so as to attract a wider audience.
References
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Wanberg, W. K et al. (2004). Driving with care: education and treatment of the impaired driving. New Jersey: Infobase Publishers.