Traffic Crashes Take Their Toll on America's Rural Roads

The critical need for active, ongoing seat belt use programs in rural Areas

A number of factors contribute to disproportionately high numbers of deaths and injuries in rural areas, all of which are reasons why programs addressing the importance of seat belt use are so important. The first group of factors that speak to the need for seat belt use programs are environmental, reflecting conditions that are more likely to occur in rural areas. The second group relates to the types of crashes that are most likely to occur in rural areas. The lifesaving benefits of seat belts are real. Increasing use in rural areas, particularly among those less likely to buckle up, can make a difference.

Environmental Factors and Conditions

Although traffic and road congestion are minimal in rural communities, data from the National Highway Traffic Safety Administration show that the fatality rate per million vehicle miles traveled for rural crashes is
more than twice the fatality rate of urban crashes. One factor contributing to this risk is the significantly higher number of vehicle miles traveled by people who live in rural communities. The relative scarcity of public transportation and the greater distances between destinations both contribute to this risk factor. Two other factors affecting crash risk are: (1) the greater likelihood that rural residents will be traveling on a roadway that has a speed limit of 55 mph or higher, and (2) that they will be traveling on a roadway that is not straight (rural communities have more curved roads than urban communities).

In addition, straight roads usually provide less of a challenge to a driver than ones that bend and curve. This is particularly true when a driver is going fast, is distracted, is drowsy, or is impaired by alcohol or drugs. When combined with speed limits 55 mph and higher, it is not surprising to find that 28 percent of rural fatal crashes occurred on curved roads in 2004, as compared to 18 percent of urban fatal crashes.

Timely emergency response and treatment are crucial environmental challenges in rural areas contributing to the high fatality rate. The longer it takes for EMS personnel to arrive at a crash scene, the more likely it is that crash victims will die before they can reach a hospital.

  • It takes more than twice as long for EMS personnel to arrive at a crash scene in a rural community, as compared to an urban community—19 minutes versus 7 minutes.
  • Overall, the total time from the occurrence of a crash to delivery of the victim to a hospital averages almost an hour in rural areas (53 minutes) in contrast to about one-half hour in urban areas (36 minutes).
  • In 2004, only 35 percent of rural passenger vehicle occupant fatalities were taken to a hospital. In comparison, 50 percent of urban victims reached a hospital and its potentially life-saving facilities.

Crash Factors and Unrestrained Occupants

Ejection from the vehicle is one of the most injurious events that can ­happen to a person in a crash. In fatal crashes in 2004, 74 percent of passenger vehicle occupants who were totally ejected from the vehicle were killed. In the same year, 72 percent of the people killed (5,959) who were partially or totally ejected from a passenger vehicle, were riding in a rural area. Of this number, 92 percent were not wearing seat belts or not properly restrained in a child safety seat. Seat belts are effective in preventing ejections: overall, 44 percent of unrestrained passenger vehicle occupants killed are ejected, partially or totally, from the vehicle, as compared to only 5 percent of restrained occupants.

In addition to the high incidence of ejections in rural crashes, people killed in pickup truck, rollover, alcohol-related, and high-speed crashes are also overrepresented in rural areas, both in number killed and percent unrestrained. For example, of the 20,302 passenger vehicle occupants killed in rural area crashes in 2004:

  • 11,043 (54 percent) were unrestrained.
  • 4,428 were pickup truck occupants, accounting for 77 percent of all pickup truck occupant fatalities. Sixty-seven percent of the rural pickup truck occupants killed were unrestrained (based on known restraint use).
  • 7,757 were in crashes where the vehicle rolled over, accounting for 74 percent of all fatalities resulting from such crashes. Seventy-two percent of the people killed in rural crashes where the vehicle rolled over were unrestrained (based on known restraint use).
  • 7,666 died in alcohol-related crashes, accounting for 62 percent of the total passenger vehicle alcohol-related fatalities. Sixty-eight percent of those killed in rural alcohol-related crashes were unrestrained.
  • 14,856 died in crashes on roads with speed limits of 55 mph and above, accounting for 79 percent of all passenger vehicle fatalities on high-speed roads. Fifty-two percent of those killed on rural high-speed roads were unrestrained.

This data demonstrates, once again, that failure to wear a seat belt significantly increases the risk of death and serious injury.

The Benefits of Seat Belt Use

In the event of a crash, there are three basic ways to limit injuries and death to vehicle occupants.

  1. Vehicles can be modified to provide better protection for drivers and passengers.
  2. Emergency medical services (EMS) can be improved to reach victims more quickly and to provide more extensive medical care.
  3. People can buckle the seat belts already in their vehicles.

NHTSA data shows that when lap/shoulder seat belts are used properly, they 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 front-seat occupants, seat belts reduce the risk of fatal injury by 60 percent and the risk of moderate-to-critical injury by 65 percent. (Light trucks, weighing less than 10,000 lbs., also include truck-based station wagons.)

Increasing seat belt use is the simplest and least expensive way to reduce deaths and serious injuries on our roads. During 2005, the Nation’s seat belt usage increased to a record 82 percent. This means that over 15,000 lives are now being saved through the use of seat belts. Every percentage point increase in seat belt usage yields an additional 270 lives saved each year, and $800 million in costs saved. Seat belt use saves society an estimated $50 billion annually in medical care, lost productivity, and other injury-related costs.2 Furthermore, the average inpatient costs for crash victims who don’t use seat belts are 55 percent higher than for those who use them.3

Low Ranking Belt Users

Rural areas tend to have varying degrees of lower seat belt use compared to national, State, and urban/suburban rates. Generally, pickup truck occupants, teens and young adults, and males in all age groups have low use rates; and use rates among these groups are even lower in rural areas. In looking at the 18 percent of the Nation’s population who still are not buckling up, among the most evident are: teens/young males age 16 to 24; rural populations/pickup truck occupants; children 8 to 15 years old; and booster-age children 4 to 8 years old.

Use rates can also range dramatically from one location and State to the next. Use rates vary depending on a number of factors including whether a State has a primary or secondary seat belt law, how aggressively the law is enforced locally, and social norms of the demographic group or area.

2 FY2006 Budget Request Statement, Dr. Jeff W. Runge, NHTSA Administrator,

3 Crash Outcome Data Evaluation System (CODES) Project Seat Belt and Helmet Analysis, Research Note (Revised), National Center for Statistics and Analysis, NHTSA, February 15, 1996.