Child Safety Seats/Booster Seats Help Protect Children

• In 2003, 471 children under the age of 5 died in crashes on our Nation’s highways in passenger vehicle crashes. About 158 (34%) of these children were totally unrestrained.²³ More than twice as many children ages 0-4 died on rural roadways than on urban roadways, and almost half of those killed in rural areas were unrestrained. More than twice as many child fatalities also occurred for children ages 4 to 7, and two and a half times more child fatalities occurred for children 8 to 15 years old on rural roadways, compared to urban roadways.²⁴

• Research shows that child safety seats reduce fatal injury for infants (less than 1 year old) by 71 percent and toddlers (1-4 years old) by 54 percent in passenger cars. For infants and toddlers in light trucks, the corresponding reductions are 58 and 59 percent, respectively.²⁵

• Adult safety belt use is an important predictor of restraint use among children. Observations conducted in 2002 showed that young children were restrained 92 percent of the time when the driver was belted and only 72 percent of the time when the driver was not buckled up.²⁶

• Children 12 and younger should be appropriately restrained in the back seat whenever possible, especially in vehicles equipped with passenger air bags. Because of their small stature, children are at high risk for fatal head and spinal cord injury from a deploying air bag in a crash. Owners of pickup trucks and cars with no rear seat or small rear seats that will not properly accommodate child safety seats should have an on/off switch installed for the passenger air bag. The switch should always be turned to the “OFF” position when a child 12 or younger is transported in the front seat. If the vehicle has a passenger air bag but is not equipped with an air bag on-off switch, owners should contact NHTSA at 888-327-4236 and ask for the brochure Air Bags and On/Off Switches and an application for getting a switch installed.²⁷

• Children (and adults) should not be permitted to ride in the cargo areas of pickup trucks under any circumstances.

Stronger Safety Belt Laws Can Make a Difference

• Safety belt use laws vary from State to State. A primary safety belt law allows a law enforcement officer to issue a citation solely when the officer simply observes an unbelted driver or passenger. A secondary 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. Other major variances in the laws include: amount of fines, seating positions covered, and vehicle exemptions. At the time of this publication 22 States, the District of Columbia, and Puerto Rico had primary laws, 27 States had secondary laws, and New Hampshire had no adult law.

• 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 2004, the average safety belt use rate in States with primary enforcement laws was 11 percentage points higher than in States without primary enforcement laws – 84 versus 73 respectively.²⁸  Among pickup trucks the rate was 71 percent versus 55 percent respectively (based on 2003 data).²⁹

• Laws making it illegal for children (up to 18 years old) to ride in the cargo area of pickup trucks vary from State to State as well. Some States have laws without exemptions; other States include exemptions such as when all seats are occupied, age specifications, vehicle speed, road type, special events or circumstances, etc.

Law Enforcement Can Make a Difference

	Occupant Protection Selective Traffic Enforcement Programs (STEPs) are periods of highly visible safety belt enforcement campaigns combined with extensive media support. These programs are a proven method to change motorists’ safety belt use behavior quickly. Successful Occupant Protection STEPs have been documented in Canada, Europe, and the United States.30 31 32 33
While STEPs are a successful method to increase safety belt use, rural America faces challenges in implementing this approach, especially rural States with secondary safety belt laws. Limited resources, inadequate man power, and lack of community support for strong enforcement leads to decreased participation by rural communities in coordinated national, State, and local safety belt enforcement campaigns. Enforcement alone has its limitations for increasing safety belt use. However, enforcement of safety belt laws, combined with intensive media support, is effective in increasing safety belt use because the perceived risk of receiving a safety belt citation is increased. Research shows that people will buckle up if they believe the police are enforcing the law.

Forming Partnerships to Reach Rural Areas

When implementing safety belt campaigns in rural areas, it is important to tie into existing infrastructures serving rural areas, especially those at the community level. Examples of organizations include 4-H, the National Children’s Center for Rural and Agricultural Health and Safety, Farm Safety 4 Just Kids, the National Rural Health Association, the Bureau of Indian Affairs, the Indian Health Service, and the Office of Rural Health Policy (Department of Health and Human Services). Local businesses, media, and civic organizations are also valuable sources for additional support.

Message emphasis should be based on community norms and acceptance, and on what the high-risk group (i.e., pickup truck occupants due to their low observed safety belt use) will likely respond to. Examples of such initiatives include:

• Buckle Up Santa Rosa by Think First of Northwest Florida and Pick Up the Buckle, by Avera Rural Health Institute in Sioux Falls, South Dakota – both NHTSA rural pickup truck safety belt demonstration projects;

• Kids Aren’t Cargo – a NHTSA national campaign initiated by a concerned mother after several crashes involving children in the back of pickups occurred in her community; and

• Buckle Up or Eat Glass – an education program developed by Farm Safety 4 Just Kids that targets rural teen pickup truck drivers.