About 3 million people are injured in motor vehicle crashes 

every year in the United States.

Understanding the risk and protective factors in a crash can help prevent injuries and deaths and reduce related costs. Linking existing 

data sources such as police, hospital, and emergency medical service (EMS) records is one way to better understand motor vehicle 

crashes.1, 2 These data sets are generally collected and stored separately. Linking these data creates a more complete picture of what 

happens before, during, and after a crash. This can help states and communities target prevention efforts.

WHY SHOULD MY STATE LINK DATA?

1. Define the problem.

Linked data can be used to help define and understand the problem 

by providing data from before, during, and after the crash. 

2. Identify risk and protective factors for motor vehicle crashes 

and their economic and health-related outcomes.

Data can do more than just help identify risk factors (e.g., speeding, 

alcohol and/or drug use) and protective factors (e.g., use of seat belts). 

Linked data can be used to measure the association of these factors 

with economic costs (e.g., medical costs) and health-related outcomes 

(e.g., traumatic brain injury).

3. Develop and test prevention strategies.

With the insights gained from using linked data to define the problem 

and identify risk and protective factors, strategies can be identified and 

tested to prevent motor vehicle crash injuries and deaths among those 

most at risk.

4. Measure the impact of prevention strategies.

The comprehensive picture provided by linked data allows for 

evaluating the impact of prevention strategies. For example, data can 

be used to determine if protective behaviors have increased 

(pre-crash) and measure the impact on health outcomes and 

associated costs (post-crash). 

Building a Data Linkage Program 

for Nonfatal Crash Surveillance

STATEWIDE TRAUMA

REGISTRY

DRIVER

CITATIONS

HOSPITAL RECORDS

(DISCHARGE, ED)

VEHICLE

REGISTRATION

TOXICOLOGY

RESULTS

EMS

REPORTS

VITAL

STATISTICS

DRIVER

TRAINING

POLICE

CRASH

REPORTS

AUTOPSY

RECORDS

Pre-Crash

Post-Crash

Crash

DRIVER

LICENSES

Data linkage is essential to inform injury prevention 

programs, policies, and decision making.
SUCCESS STORY

Linking Data Led to 25% Decrease in Children Injured in Crashes

Age- and size-appropriate restraint use decreases 

injuries and deaths among child passengers. While 

child passenger restraint laws vary by state, most do 

not meet current safety recommendations.3 Prior to 2008, 

Utah’s law only required children ages 4 and under to 

be buckled in child restraints.

Utah’s police-reported data showed that older children involved in crashes were 

less likely to be restrained than younger children. Researchers were able to 

provide a more complete picture with the addition of linked police and hospital 

data. In 2006–2007, unrestrained children ages 1 to 8 in Utah were almost five 

times more likely to be hospitalized and two times more likely to be treated in 

emergency departments, compared to those who were restrained. In addition, 

children ages 5 to 8 were less likely to use car seats or booster seats and more 

likely to be hospitalized than children ages 1 to 4. 

These findings along with other efforts were key to expanding Utah’s child 

passenger restraint law to cover children up to age 8. The number of children 

injured in crashes went down by 18% one year later and by 25% five years later. 

This change has provided better protection for child passengers in Utah.

HOW CAN STATES START OR EXPAND A 

DATA LINKAGE PROGRAM?

1. Build partnerships to:

• expand the scope of injury prevention opportunities,

• build credibility,

• share resources, 

• share findings and recommendations, and

• help sustain the data linkage program.

2. Develop a business model and policies.

Essential steps include establishing funding, identifying resources, exploring 

business models, and defining privacy and security policies.

3. Establish the data linkage process.

Establishing the data linkage process is the final component of a successful 

and sustainable program. Activities include establishing data use agreements, 

preparing and linking data, and conducting analyses.

Linking state-level 

data provides valuable 

insight into statespecific trends and 

patterns. 

Decision makers can 

use the most effective 

strategies to reduce 

motor vehicle crashes, 

injuries, and deaths, 

and their related costs.

REFERENCES

1. Milani, J., Kindelberger, J., Bergen, G., Novicki, E. J., Burch, C., Ho, S. M., & West, B. A. (2015, August). Assessment of characteristics of state data linkage systems. (Report No. DOT HS 812 180). Washington, DC: National Highway 

Traffic Safety Administration, and Atlanta: Centers for Disease Control and Prevention.

2. Centers for Disease Control and Prevention. (2019, September). Linking Information for Nonfatal Crash Surveillance (LINCS): A guide for integrating motor vehicle crash data to help keep Americans safe on the road. Centers 

for Disease Control and Prevention (CDC) National Center for Injury Prevention and Control (NCIPC). Retrieved from https://www.cdc.gov/motorvehiclesafety/pdf/linkage/CDC_LINCS_Guide_508c.pdf. 

3. Durbin DR, Hoffman BD, and AAP Council on Injury, Violence, and Poison Prevention. 2018. Technical Report—Child Passenger Safety. Pediatrics. 142(5):e20182461. 

 Retrieved from https://pediatrics.aappublications.org/content/142/5/e20182461.

Learn more about how to create or expand your data linkage program 

at www.cdc.gov/transportationsafety/datalinkage.html.

December 2020