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

OBJECTIVE: 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. METHODS: 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. RESULTS: 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). CONCLUSIONS: 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.