|INCREASING TEEN SAFETY BELT USE|
The leading cause of death for young people 16 to 20 years old is motor vehicle crashes.162 The teen traffic crash death rate—more than 5,000 teen deaths per year—is high no matter how it is calculated (per 100,000,000 vehicle miles traveled by teens; per 100,000 licensed teen drivers; or per 100,000 teens in the population). 259 The teen population in the United States has increased 12 percent since 1993 and is expected to increase another 7 percent by 2005. 167 Unless effective measures are implemented, it can be expected that teen deaths will increase commensurately.
One of the major reasons teens are killed or seriously injured when involved in traffic crashes is lack of safety belt use. A recent safety belt use survey (for 2002) indicates that only 69 percent of 16- to 24-year-olds use safety belts, compared to 82 percent of children and 76 percent of adults 25 to 69. 62 The Fatality Analysis Reporting System (FARS) 259 shows that more than two-thirds of teen occupants killed in crashes are not wearing safety belts. An observational survey conducted at high school parking lot entrances found that almost half (46%) of high school students were not belted when riding with an adult, even when half of the adults they were driving with were belted. 90
The wearing of safety belts saved an estimated 14,164 lives in 2002. If 85 percent of passenger vehicle occupants older than age 4 wore safety belts, an additional 2,701 lives could have been saved in 2002, 268 totaling 16,865 lives. Unbelted drivers account for 75 percent of impaired-driving fatalities. Safety belts reduce the chances of being killed or seriously injured in a motor vehicle crash by almost 50 percent, 268 because they prevent ejection from the vehicle, spread forces from the crash over a wide area of the body, allow the body to slow down gradually, and protect the head and spinal cord from serious injury. Most teens are taught this in driver’s education classes and are well aware of the benefits of wearing safety belts.
Almost 85 percent of all medical costs for crash victims fall on society, and not on the individuals involved. Medical costs for unbelted crash victims are 50 percent higher than for those who are belted. Employer health care spending on crash injuries is nine billion dollars annually. Another nine billion dollars is spent on sick leave and life and disability insurance for crash victims.255
According to the 2003 Motor Vehicle Occupant Safety Survey (MVOSS) sponsored by NHTSA, teen drivers are less likely to wear a safety belt “all the time” (79%) than older drivers (84%).15 About one-half (47%) of 16-20-year-olds reported they agreed that safety belts “were as likely to harm as to help,” compared to 34 percent of those 21-64. Teens were also more likely to agree that a crash close to home was usually “not as serious” (30%), that wearing a safety belt makes them “worry more about being in an accident” (27%), and that they would feel “self-conscious if they were going against the group norm in wearing safety belts” (30%) than older drivers, according to the MVOSS.
Research also shows that when a driver of a motor vehicle wears a safety belt, a toddler in that vehicle also is restrained 86 percent of the time. However, when the driver is not restrained, toddlers in that vehicle are only restrained 24 percent of the time. 64 Thus, parents play an important role in conditioning youth to wear safety belts. The percentage of teens who say in surveys that they “rarely or never wore safety belts” ranges from 8 to 27 percent, depending upon the State. 27 This generation of teenagers mostly have been brought up in child safety and booster seats, and have been exposed to safety belt use laws and education. More teens are subject to GDL laws and policies concerning safety belt use than ever before. Yet teens do not wear safety belts at adult rates.
While it is important that people of all ages wear safety belts, it is especially important for teenagers because their crash rate is extremely high. Every 9 seconds, someone is injured in a traffic crash and every 13 minutes, someone is killed in a traffic crash. Safety belts presently save about 11,000 lives a year in America. Wearing a safety belt is the best protection against drunk, tired, or aggressive drivers. As safety belt use increases from 70 to 85 percent, 5,300 lives will be saved and 100,000 injuries prevented each year. This would save society almost $7 billion dollars each year in direct costs.268
Teenage safety belt wearing rates from observational and crash-involvement studies consistently show lower wearing rates compared to older adults. Surveys indicate from observations that teens wear safety belts at rates 5-15 percent less often than most older adult age groups. The FARS259 indicates that 63 percent of fatally injured teens in crashes were not wearing safety belts, compared to 55 percent for older adult (21 and older) occupant fatalities.
There are many theories presented in the scientific literature5 181 133 on why teens have low safety belt use rates and high traffic-crash rates. Briefly, among the most frequently cited theories are the following:
NHTSA’s Integrated Project Teams Report (IPT) on Initiatives to Address Safety Belt Use261 discusses various approaches to increasing safety belt use in general. The following strategies described in that report and other reports all have potential for increasing teen safety belt use.
Safety belt use laws. Primary and secondary enforcement laws and the strengthening of other components of the laws (e.g., types of vehicles, locations and ages of occupants covered by laws, the use of fines, and points on the license, etc.) can all have an effect on teen safety belt usee.g. 32. Note the effect of teen wearing rates as a function of their States’ safety belt laws (figure 2).
High-visibility enforcement. Special Traffic Enforcement Programs (STEPs), Click It or Ticket mobilizations, and other enforcement programs have been shown to increase safety belt use by teens.
Increased sanctions. Increased sanctions for safety belt violations including increased fines and points on the driver’s license have significant potential to increase teen safety belt use.
Incentive programs. Rewarding teens for buckling up via high school reward programs and insurance incentives have been shown to increase teen safety belt use.
Parental management. Programs for parents to monitor teens more closely and establish restrictions on teen driving, including safety belt use, number of passengers, and curfews also have potential for increasing teen belt usee.g. 146.
School and employer policies. The effects of school and employer policies on safety belt use by teens have not been evaluated, but could have some limited effect.
Vehicle strategies. The effects of reminders, safety belt use monitoring devices, ignition interlock devices and improvements in comfort and convenience on teen belt use need to be explored.
Other public health interventions. Information on the effects of other public health interventions that have worked to change the risky behavior of teens, such as antismoking campaigns, safe sex, and zero tolerance for drinking and driving, may be important to increasing teen safety belt use.
With this as background, there is an urgent need for an accurate definition of the teen safety belt use problem, a summary of the various programs and approaches that have been conducted to increase safety belt use by teens, and recommendations for future research and programs that have the potential to increase safety belt use by teens.