Jonathan Wood, MD
SEAT BELT FACTS
Lap-shoulder belts reduce the risk of fatal injury to front-seat occupants by 45-73% and the risk of moderate-to-critical injuries by 44-78%, depending on the type of vehicle and seating position involved. (National Highway Traffic Safety Administration, or NHTSA, 2002)
Seat belts are credited with preventing 11,900 fatalities and 325,000 serious injuries annually. (NHTSA, 2003)
If all passengers were to wear their seat belts, an additional 9,200 fatalities and 143,000 serious injuries could be prevented each year. (NHTSA, 2003)
Six out of ten children who died in passenger vehicle crashes were unbelted. (National Safety Council, or NSC, 2002)
The needless deaths and injuries that result from non-use of seat belts cost society an estimated $26 billion annually in medical care, lost productivity and other injury related costs. (NHTSA, 2002)
Average inpatient costs for traffic crash victims who did not use seat belts were 50% higher than for victims who were belted. (NSC, 2001)
Safety Belts and Teens
Teens* have the highest fatality rate in motor vehicle crashes than any other age group.1 There are many reasons; for instance, while teens are learning the new skills needed for driving, many frequently engage in high-risk behaviors, such as speeding and/or driving after using alcohol or drugs. Studies also have shown that teens may be easily distracted while driving.2 One key reason for high traffic fatalities among this age group is that they have lower safety belt use rates than adults.3 Because teens have an increased exposure to potentially fatal traffic crashes, it is imperative that efforts to increase safety belt use among this age group be given the highest priority. In addition, the youth population has increased by more than 12 percent since 1993, and is expected to increase by another seven percent by 2005.4 As this age group increases as a percentage of the population, the personal and societal costs associated with deaths and injuries from motor vehicle crashes also will rise.
Teens Are At Risk
Motor vehicle crashes are the leading cause of death for 15 to 20 year olds in the United States.5
In 2001, 5,341 teens were killed in passenger vehicles involved in motor vehicle crashes. Two thirds of those killed were not buckled up.6
In 2001, 3,608 drivers 15 to 20 years old were killed in motor vehicle crashes, and an additional 337,000 were injured.7
When driver fatality rates are calculated on the basis of estimated annual travel, teen drivers (16 to 19 years old) have a fatality rate that is about four times higher than the fatality rate among drivers 25 through 69 years old.8
Many high school students fail to use their safety belts even when riding with adults who are buckled up. An observational survey conducted at 12 high schools found that 46 percent of high school students were not wearing their safety belts when riding with adult drivers. About half of the unbelted students were riding with adults who were belted.9
A recent medical study examined motor vehicle fatality exposure rates and found that, per mile traveled, African American and Hispanic male teenagers (13-19 years old) are nearly twice as likely to die in a motor vehicle crash as male teenagers who are white.10
Male high school students (18 percent) report that they are more likely to rarely or never use safety belts compared with female high school students (10 percent).11
Seat Belts Save Lives And Dollars
In 2001, the estimated economic cost of police-reported crashes involving drivers between 15 and 20 years old was $42.3 billion.7
Safety belts saved more than 12,000 American lives in 2001. Yet, during that same year, nearly two-thirds (60 percent) of passenger vehicle occupants killed in traffic crashes were unrestrained.12
Research has shown that lap/shoulder belts, when used properly, reduce the risk of fatal injury to front-seat passenger car occupants by 45 percent and the risk of moderate to critical injury by 50 percent. For light truck occupants, safety belts reduce the risk of fatal injury by 60 percent and moderate-to-critical injury by 65 percent.13
Safety belts should always be worn, even when riding in vehicles equipped with air bags. Air bags are designed to work with safety belts, not alone. Air bags, when not used with safety belts, have a fatality-reducing effectiveness rate of only 12 percent.14
Safety belt usage saves society an estimated $50 billion annually in medical care, lost productivity, and other injury-related costs.15
Conversely, safety belt nonuse results in significant economic costs to society. The needless deaths and injuries from safety belt nonuse account for an estimated $26 billion in economic costs to society annually.16 The cost goes beyond the lost lives of unbuckled drivers and passengers: We all pay - in higher taxes and higher health care and insurance costs.
Strong Safety Belt Laws Can Make a Difference
There are two types of safety belt laws: primary and secondary. A primary (standard) safety belt law allows law enforcement officers to stop a vehicle and issue a citation when the officer simply observes an unbelted driver or passenger. A secondary safety belt law means that a citation for not wearing a safety belt can only be written after the officer stops the vehicle or cites the offender for another infraction.
Primary safety belt laws are much more effective in increasing safety belt use, because people are more likely to buckle up when there is the perceived risk of receiving a citation for not doing so. In June 2002, the average safety belt use rate in States with primary enforcement laws was 11 percentage points higher than in States without primary enforcement laws.17 (Safety belt use was 80 percent in primary law States versus 69 percent in States without primary enforcement.)
Many teens support primary enforcement safety belt laws. In 2000, a nationwide survey was conducted to determine attitudes regarding primary enforcement safety belt laws. Of the more than 500 young people 16 to 20 years of age who were surveyed, 60 percent voiced their support for primary enforcement laws.18
Young drivers are more likely to use safety belts in States with a primary safety belt law versus States with a secondary law. The five states that currently have the highest teenage safety belt use are California, Maryland, Michigan, North Carolina, and Oregon. These States have primary safety belt laws that are among the strongest in the nation.19
Safety Belt Enforcement Programs
Occupant Protection Selective Traffic Enforcement Programs (sTEPs) are periods of highly visible safety belt law enforcement combined with extensive media support. These programs are a proven method to change motorists’ safety belt use behavior and do it quickly. Successful Occupant Protection sTEPs have been documented in Canada, Europe, and the United States.20, 21, 22, 23
Highly visible enforcement of safety belt laws is at the core of any plan to increase safety belt use; no State or community has ever achieved a high safety belt use rate without strong enforcement of such laws. Strong enforcement of safety belt laws sends the message that the State takes safety belt use laws seriously. Ultimately, this leads to greater compliance.
Enforcement of safety belt laws is significantly more effective when it is combined with media saturation because the perceived risk of receiving a citation is increased. Research shows that people will buckle up if they believe the police are enforcing the law.
The "Click It or Ticket" model has been enormously successful in increasing safety belt use at the community, State, and regional level. A "Click It or Ticket Campaign" was fully implemented and evaluated in 10 States in May 2002. This initiative, which involved a partnership between the National Highway Traffic Safety Administration (NHTSA), the Air Bag & Seat Belt Safety Campaign, and hundreds of law enforcement agencies, helped to raise safety belt use an average of nine percentage points among these 10 States. One State, Vermont, experienced a 19 percentage-point increase in safety belt use as a result of the campaign.
Many jurisdictions in the United States have adopted graduated licensing, a system designed to delay full licensure while allowing beginners to obtain their initial experience under lower risk conditions. There are three stages: a minimum supervised learner’s period, an intermediate license, and a full-privilege driver’s license after successful completion of the first two stages.24 A good graduated licensing system will have education and enforcement of safety belt laws. For example, in North Carolina, graduated licensing law includes provisions for fines for up to $100 for safety belt violations by new drivers.