An assessment of court fees, surcharges, and penalties for alcohol-impaired driving in five midwestern U.S. states: implications for exacerbating poverty and health inequalities.

Driving under the influence (DUI) remains an important threat to public health in the United States, and a substantial literature has evaluated the effectiveness of state-mandated penalties. Researchers have overlooked accelerated use of obscured fees and surcharges levied by local and state court systems added to penalties in the past 15 years. We present data regarding DUI penalties for offenders with a blood alcohol content (BAC of 0.