Seat belt laws: Do they really work? (Q&A)

Neil Bartlett

A seat belt can be the difference between life and death in a car crash. All states (except New Hampshire) have laws requiring adults to buckle up -- but are these laws effective?

Ruth Shults is a senior epidemiologist in the Division of Unintentional Injury Prevention at the National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (CDC). Her area of study is preventing motor vehicle crashes and seat belt use. seat belt laws asked her to talk about how effective current seat belt laws are, what can be done to improve them, and what advice she has for parents with small children, teens and older adults.

How effective are seat belt laws?

Are seat belt laws proving to be effective in guarding against crash injury and death?

Yes. In a crash, seat belts are highly effective in preventing serious injuries and death. Of individuals who die in a vehicle crash, (about 50 percent) are not belted. In a serious crash, you're about half as likely to die if you're belted.

Each year, the National Highway Traffic Safety Administration (NHTSA) estimates how many lives are saved by drivers and passengers using seat belts. Their estimate for 2012 was that over 12,000 lives were spared and another 3,000 could have been saved if everyone over age 4 were belted.

When unbelted people are in a crash, they become very dangerous. They can become flying objects. And they can either fly out of the car -- which is most likely to be fatal -- or you're smashing into other people in the car. The driver and others in the front seat are (at a higher) risk of death if the people behind them aren't belted.

How prevalent is seat belt usage?

It's high but it could be higher. Since 2009, the percent of Americans buckling up is about 85 percent -- and more than one study has confirmed that number to be accurate. Among those sitting in the front seats, (seat belt use) is about six times what it was 30 years ago.

Passengers in a vehicle's back seat are belted less than in the front seat -- in 2012 it was 74 percent of rear seat occupants. Young people use seat belts less than those over age 25, and men use belts less than women. The lowest-use states were South Dakota and Massachusetts.

If you look at (road death) data, there's a huge number of young men. There's a high-risk group of young males who don't wear belts.

So our challenge is to encourage seat belt use, while at the same time create targeted efforts to encourage increased use in these high-risk groups.

There are 16 states with secondary seat belt laws and 33, plus Washington, D.C., with primary laws. Is there any research that ties the type of law with a reduction in crashes and/or deaths in that state?

Primary laws allow police officers to pull drivers over and issue tickets solely because someone in the car isn't wearing a seat belt. In states with secondary laws, a seat belt ticket can be issued only when a driver is pulled over for another reason. States with primary laws have a higher rate of passengers using seat belts -- about 9 percentage points higher, according to the CDC's Behavioral Risk Factor Surveillance System survey released in 2010. It's 89 percent in states with primary laws and 80 percent in states with secondary laws.

How could current seat belt laws be improved?

Primary laws get more people belted and they save more lives.

Every state except New Hampshire has a seat belt law for adults -- but not every state covers every seating position. The CDC recommends that everyone in a vehicle be belted, regardless of their position in the car, every time they ride in a car. It's safest when everyone in the car is wearing a seat belt.

What advice do you have for parents with small children, teens and older adults?

It's up to the driver to see that everyone in the vehicle is properly restrained. They should also be familiar with restraint laws in their state -- they vary by state.

Often people won't belt if they're driving a short trip or they're driving on a familiar route. That's a mistake. There's no reason not to be belted on every trip.

The CDC recommends that children 12 and under always sit in the back seat. The middle of the back seat is the safest spot, and if there's only one child, he or she should sit in the middle.

When teens begin driving or riding with friends, parents should insist that they always buckle up. If they're behind the steering wheel, they need to make sure all passengers are wearing seat belts. Mile for mile, teen drivers have the highest likelihood of being in a crash. It takes years to become an experienced driver, and wearing seat belts is a critical part of that process. It's the job of parents to help keep their teens safe as they get experience behind the wheel.

The chance that an older person will die from a severe crash is higher than it is for those younger than them. It's important that older people wear seat belts

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