Are risky driving, health behaviors, and cardiometabolic risk interrelated? Findings from the cooper center...

While risky driving behaviors and unhealthy lifestyle behaviors both have deleterious consequences, they are rarely targeted jointly. The present study examines the associations between risky driving behaviors, health-related behaviors, and cardiometabolic risk factors among adults over time.

Longitudinal examination of 17,846 adults who attended a preventive medicine clinic (Dallas, TX) at least twice (1988-2024). The primary independent variables were risky driving behaviors: not wearing a seat belt, driving after drinking alcohol, angry driving, and speeding, as well as an overall score (0-4). The dependent variables were current smoking, alcohol intake, cardiorespiratory fitness levels, and cardiometabolic risk factors. The relationships were examined using a hybrid model, which accounted for both between- and within-person variations.

The average age of participants at baseline was 46.4 years (SD = 8.7), three-quarters (75.2%) were men, and 84.6% were college-educated. Examining variation between participants, a 1-point higher risky driving behavior total score was associated with 2.89 (95%CI 2.52, 3.33) times higher odds for current smoking, 1.61 (95%CI 1.53, 1.70) times higher odds for greater alcohol intake, and 10.0% lower odds for higher fitness (OR = 0.90; 95%CI 0.85, 0.94). Additionally, a higher total risky driving behaviors score was related to elevated cardiometabolic risk factors, such as elevated waist circumference (OR = 1.73; 95%CI 1.51, 1.97) and glucose (OR = 1.20; 95%CI 1.11, 1.30). In a within-person examination, a 1-point increase in the total risky driving behaviors score was associated with increased alcohol intake (OR = 1.09; 95%CI 1.07, 1.11), and elevated glucose (OR = 1.07; 95%CI 1.02, 1.12). When examining risky driving behaviors, not wearing a seatbelt and driving after drinking were related to three dependent variables in the within-person analyses. For example, an increase in driving after drinking was associated with increased smoking (OR = 1.26; 95%CI 1.05, 1.52), increased alcohol intake (OR = 1.51; 95%CI 1.43, 1.59), and increased glucose (OR = 1.28; 95%CI 1.15, 1.42).

Findings indicate that risky driving behaviors may accompany broader risk-taking tendencies across domains. Future research is warranted to determine whether targeting underlying psychological constructs can lead to improvements in both domains.