Objective To examine the independent and combined associations of reported alcohol, drug, and fatigue involvement with crash fatality among young drivers in California. Methods Using 2016-2024 injury crash data from the University of California, Berkeley Transportation Injury Mapping System, we performed logistic regression to examine the association between reported driver impairment and crash fatality among drivers aged 15-24. Additive interaction was assessed using binary impairment indicators and interaction terms. Relative excess risk due to interaction (RERI) and 95% confidence...