Did You Know? | An unbuckled rear-seat passenger is dangerous for all passengers

Seat Belts: Get the Facts | Motor Vehicle Safety | CDC Injury Center

August 21, 2015

Rear-seat motor vehicle passengers are less likely than front-seat passengers to wear a seat belt, making them more likely to injure themselves and other passengers in a crash. Rear seat belt use is higher in states [PDF-172KB] with primary or secondary enforcement laws that cover rear seats than in states without laws that cover rear seats. To increase seat belt use in rear passengers, states can review proven strategies and find ones that work best for their state.

Injury Prevention & Control: Motor Vehicle Safety

Seat Belts: Get the Facts

On this Page

• How big is the problem of crash-related injuries and death?
• What is the impact of seat belt use?
• Who is least likely to wear a seat belt?
• Primary enforcement laws make a difference
• What can be done to increase seat belt use among adults?
• Footnotes
• References

Motor vehicle crashes are a leading cause of death among those aged 1-54 in the U.S.1 More than 2.2 million adult drivers and passengers were treated in emergency departments as the result of being injured in motor vehicle crashes in 2012.1 Adult seat belt use is the most effective way to save lives and reduce injuries in crashes.2 Yet millions of adults do not wear their seat belts on every trip.3

How big is the problem of crash-related injuries and death?

Motor vehicle crashes are a major public health problem.

• Non-fatal crash injuries resulted in more than $50 billion in lifetime medical and work loss costs in 2012.4 
• Motor vehicle crashes are the leading cause of death among teens.1
• Young adults (18-24) have the highest crash-related injury rates of all adults.5

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What is the impact of seat belt use?

• Seat belts reduce serious crash-related injuries and deaths by about half.6
• Air bags provide added protection but are not a substitute for seat belts. Air bags plus seat belts provide the greatest protection for adults.7

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Who is least likely to wear a seat belt?

• Of the teens (aged 13-20 years) that died in crashes in 2012, approximately 55% of them were not wearing a seat belt at the time of the crash.8
• Adults age 18-34 are less likely to wear seat belts than adults age 35 or older. (CDC, 2010, unpublished data)
• Men are 10% less likely to wear seat belts than women. (CDC, 2010, unpublished data)
• Adults who live in rural areas are 10% less likely to wear seat belts (78% use) than adults who live in urban and suburban areas (87% use). (CDC, 2010, unpublished data)
• Seat belt use is lower in states with secondary enforcement seat belt laws or no seat belt laws (80%) compared to states with primary enforcement laws (89%).3
• Rear-seat motor vehicle passengers are less likely than front-seat passengers to wear a seat belt, making them more likely to injure themselves and other passengers in a crash.9

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Primary enforcement laws make a difference

Research shows, primary enforcement seat belt laws make a big difference in getting more people to buckle up.10 A primary enforcement seat belt law means a police officer can pull a vehicle over and issue a ticket just because a driver or passenger covered by the lawa is not wearing a seat belt. A secondary enforcement law only allows a police officer to issue a ticket for someone not wearing a seat belt if the driver has been pulled over for some other offense. In 2013, 33 states did not have a primary enforcement law covering all seating positions.11

Seat  belt use in 2010 was 89% in states with primary enforcement laws but only 80% in states with secondary enforcement laws or no seat belt laws.3

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What can be done to increase seat belt use among adults?

When it comes to increasing seat belt use, individuals, government, and health professionals can help promote safety. 

States can:

• Consider proven strategies for increasing seat belt use and reducing child motor vehicle injuries and deaths, which include:10
  • Primary enforcement seat belt laws, which have been shown to increase use and reduce deaths compared with secondary enforcement laws.
  • Seat belt laws that apply to everyone in the car, not just those in the front seat.
  • Fines for not wearing a seat belt that are high enough to be effective.
• Make sure that police and state troopers enforce all seat belt laws.
• Support seat belt laws with visible police presence and awareness campaigns for the public.
• Educate the public to make seat belt use a social norm.

Health professionals can:

• Remind patients about the importance of seat belt use.
• Encourage patients to make wearing a seat belt a habit.
• Wear seat belts themselves and encourage their colleagues to do the same.

Parents and caregivers can:

• Use a seat belt on every trip, no matter how short. This sets a good example.
• Make sure children are properly buckled up in a car seat, booster seat, or seat belt, whichever is appropriate for their age, height, and weight.
• Have all children age 12 and under sit properly buckled in the back seat.
• Remember to never place a rear-facing child safety seat in front of an air bag.
• Properly buckle children in the middle back seat when possible because it is the safest spot in the vehicle.

Everyone can:

• Use a seat belt on every trip, no matter how short.
• Require everyone in the car to buckle up, including those in the back seat.

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Footnotes

a State primary and secondary seat belt laws vary by whether driver and front seat passengers are required to be buckled or whether drivers and all passengers (i.e., front and rear seats) are required to be buckled. These requirements may also vary depending on the age of the passenger. For information on laws in each state, check with the Insurance Institute for Highway Safety at http://www.iihs.org.

References

1. Centers for Disease Control and Prevention. WISQARS (Web-based Injury Statistics Query and Reporting System). Atlanta, GA: US Department of Health and Human Services, CDC; 2010. Available at http://www.cdc.gov/injury/wisqars. Accessed September 8, 2014.
2. National Highway Traffic Safety Administration. Lives saved in 2012 by restraint use and minimum-drinking-age laws. Washington, D.C.: US Department of Transportation, National Highway Traffic Safety Administration: 2013. Publication no. DOT-HS-811-851. Available at http://www-nrd.nhtsa.dot.gov/Pubs/811851.pdf. Accessed September 8, 2014
3. Shults RA, Beck LF. Self-reported seat belt use, United States, 2002-2010: Does prevalence vary by state and type of seat belt law? Journal of Safety Research 2012;43:417-20.
4. Bergen G, Peterson C, Ederer D, Florence C, Haileyesus T, Kresnow MJ, Likang X.  Vital Signs: Health Burden and Medical Costs of Nonfatal Injuries to Motor Vehicle Occupants-United Sates, 2012. MMWR 2014;63:1-7. Available at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm63e1007a1.htm?s_cid=mm63e1007a1_w
5. Beck LF, West BA. Vital Signs: nonfatal motor vehicle-occupant injuries (2009) and seat belt use (2008) among adults—United States. MMWR 2011;59(51):1681-6.
6. National Highway Traffic Safety Administration. Final regulatory impact analysis amendment to Federal Motor Vehicle Safety Standard 208. Passenger car front seat occupant protection. Washington, DC: US Department of Transportation, National Highway Traffic Safety Administration; 1984. Publication no. DOT-HS-806-572. Available athttp://www-nrd.nhtsa.dot.gov/pubs/806572.pdf. Accessed September 8, 2014.
7. National Highway Traffic Safety Administration. Third report to Congress: effectiveness of occupant protection systems and their use. Washington, DC: US Department of Transportation, National Highway Traffic Safety Administration; 1996. Available at http://www.nhtsa.gov/people/injury/airbags/208con2e.html. Accessed September 8, 2014.
8. National Highway Traffic Safety Administration. Traffic Safety Facts: 2012 Occupant Protection. Washington, D.C.: US Department of Transportation, National Highway Traffic Safety Administration: 2014. Publication no. DOT-HS-811-892. Available at http://www-nrd.nhtsa.dot.gov/Pubs/811892.pdf. Accessed September 8, 2014.
9. Bose, D., Arregui-Dalmases, C., Sanchez-Molina, D., Velazquez-Ameijide, J., & Crandall, J. (2013). Increased risk of driver fatality due to unrestrained rear-seat passengers in severe frontal crashes. Accident Analysis and Prevention, 53, 100–104.
10. Dinh-Zarr TB, Sleet DA, Shults RA, et al. Reviews of evidence regarding interventions to increase the use of safety belts. Am J Prev Med 2001;21(4S): 48-65.
11. Centers for Disease Control and Prevention. Prevention Status Reports 2013: Motor Vehicle Injuries. Atlanta, GA: US Department of Health and Human Services; 2014. Available at: http://www.cdc.gov/psr/motorvehicle.

Related Pages

• Buckle Up: Restraint Use State Fact Sheets
• Restraint Use and Motor Vehicle Occupant State Data
• Seat Belt Use US Map
• What Works: Strategies to Increase Restraint Use
• Child Passenger Safety
• CDC Vital Signs: Adult Seat Belt Use
• State-Based Motor Vehicle Data & Information
• data.cdc.gov
  View and download dozens of motor vehicle datasets and visualizations, including charts and maps, on data.cdc.gov.
• Motor Vehicle Prioritizing Interventions and Cost Calculator for States (MV PICCS)
  CDC offers a new interactive calculator to help state decision makers prioritize and select from a suite of 12 effective motor vehicle injury prevention interventions. MV PICCS is designed to calculate the expected number of injuries prevented and lives saved at the state level and the costs of implementation, while taking into account available resources.
• CDC's Safe Driving Board on Pinterest
  Help spread the word about the dangers of drunk driving. Visit the CDC Safe Driving Pinterest board for ready-to-share graphics and social media content.
• 2013 Prevention Status Report: Motor Vehicle Injuries
• Community Guide: Use of Safety Belts: Primary (vs. Secondary) Enforcement Laws