Adult Seat Belt Use: Does the Presence of Children in the Household Make a Difference?

Abstract

Objective. To obtain prevalence estimates of seat belt use among adults with and without at least one child in the household and to examine whether having at least one child in the household is associated with adult seat belt use.

Methods. The Second Injury Control and Risk Survey (ICARIS-2) was a nationwide cross-sectional, list-assisted random-digit-dialing telephone survey of individuals who were at least 18 years old and who spoke either English or Spanish. ICARIS-2 was carried out from 2001 to 2003; a similar study, ICARIS-1, had been conducted in 1994. National estimates were calculated for the prevalence of adult seat belt use and stratified according to the presence or absence of children in the household. Prevalence estimates for the two ICARIS surveys were compared using t-tests. Multivariable logistic regression was used to explore the association between having at least one child in the household and self-reported adult seat belt use.

Results. Based on the 9,684 completed household interviews in ICARIS-2, an estimated 15.9% (13 million) of drivers with children in their households did not always wear their seat belt when driving, and 17.5% (15 million) of adult passengers with children in their households did not always wear their seat belt while riding. The prevalence of drivers and passengers who did not always wear their seat belt decreased between ICARIS-1 and ICARIS-2. Both driver and passenger seat belt use were associated with the respondent's age, sex, ethnicity, level of education, current marital status, and self-reported alcohol-impaired driving or riding with an alcohol-impaired driver. Drivers with children in the household, living in the Northeast, North Central, and Southern census regions of the country were significantly more likely than those in the West to report wearing their seat belt less than always.

Conclusions. While seat belt use rates are increasing, many more lives could be saved by more complete restraint use. Effective strategies for increasing seat belt use rates and decreasing the number of both fatal and nonfatal motor vehicle injuries include primary enforcement laws, enhanced enforcement of seat belt use laws, and child safety-seat distribution combined with education programs.

Keywords:

• Motor Vehicle
• Seat Belt
• Restraint
• Child

ACKNOWLEDGMENTS

We would like to acknowledge the contributions of the members of the ICARIS projects, who designed and conducted the surveys from which these data were obtained:

ICARIS-2: Project Core Group: Jieru Chen; Ann Dellinger; Marcie-jo Kresnow; Chester Pogostin; and Thomas R. Simon, NCIPC, CDC; Robert Black, Diane Burkom, Battelle Centers for Public Health Research and Evaluation. Project Associates: Ileana Arias, Kim Blindauer; Christine Branche; Alex Crosby; Linda Dahlberg; Megan Davies; Julie Gilchrist; John Horan; Dafna Kanny; Robin Ikeda; Bruce Jones; Scott Kegler; Joanne Klevens; James Mercy; Sarah Olsen; Linda Saltzman; Rich Schieber; Gene Shelley; David Sleet; Judy Stevens; Martie Thompson; and Dionne White, NCIPC, CDC; Jeffrey Sacks, National Center for Chronic Disease Prevention and Health Promotion, CDC; Charles Wolters, and Carol Oppenheim Battelle Centers for Public Health Research and Evaluation.

ICARIS-1: Principal Investigator: Jeffrey Sacks. Project Core Group: Barbara Houston; Marcie-jo Kresnow; Joann M. O'Neil; and Suzanne M. Smith of NCIPC, CDC. James Hersey; Rick Williams; and Aiman Zeid of Battelle Centers for Public Health Research and Evaluation. Sherry Marcy and Deborah J. Zivan of DataStat. Project Associates: Julie Bolen; Christine M. Branche; Peter Briss; Terence Chorba; Alex Crosby; Yvette Davis; Jennifer Friday; Arlene Greenspan; James Mercy; Phil McClain; Lloyd Potter; and Kenneth E. Powell of NCIPC, CDC; Thomas Matte of the National Center for Environmental Health, CDC.

Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention/Agency for Toxic Substances and Disease Registry.

Notes

∗p Value for the Wald chi-square test

∗p Value, student's t-test

∗Each odds ratio is adjusted for all other variables listed

^a p value, Wald chi-square test

^b p value for the census region by children in the household interaction term. Because there was a significant interaction, results showing the association between census region and driver seat belt use are presented separately for respondents living in households with and without children