Background and Objective: Despite billions of dollars being spent on road safety each year, road transport crashes remain a leading cause of injury and death worldwide. New approaches to road safety are needed. Methods: We used data from a 2003/2004 Australian survey of young drivers (n=20 806), linked to police-reported crash, hospital and death data up to 2016. We used generalised linear models to estimate the association between protective and risk factors with car crash. Results: After adjusting for confounding, drivers of lowest socioeconomic status had 1.90 (95% CI 1.25 to 2.88) times higher rate of crash related hospitalisation compared with drivers of highest socioeconomic status. Drivers with the highest risky-driving scores had 1.92 times (95% CI 1.13- 3.27) higher rates of hospitalised crashes compared with drivers with the lowest scores. Drivers with three or more driving offences had 3.28 (95% CI 2.28-4.72) times higher rates of single vehicle crashes compared with drivers with no driving offences. Drivers who participated in a youth resilience education program during school had 0.76 (95% CI 0.60-0.96) lower rate of any crash, compared with those who did not participate in such program. Conclusions: We showed the sustained effect of risk and protective factors during youth and crash later in life. This implies that, in addition to creating safe-systems, injury prevention also needs to consider the intersection of the wider social determinants of health to address the underlying causes. This broader, temporal concept is embodied in a life course approach to injury prevention.