Advocates for Evidence-Based Health Policy Speakers
Upgraded Child Restraint Laws
Motor vehicle crashes are the leading cause of death for children 3 to 14 years old. Upgraded laws in New York State how shown that child restraint laws aimed at pre-school children can improve behaviors and reduce injuries.
The National Highway Traffic Safety Administration (NHTSA) has been a strong proponent of establishing federal, state and local guidelines for the use of child seat restraints. Motor vehicle crashes are the leading cause of death for children 3 to 14 years old based on figures from the National Center for Health Sciences (2006). NHTSA currently recommends the use of belt-positioning booster seats (child restraints) for children 4 to 8 years of age, greater than 40 pounds, and shorter that 4 feet 9 inches long who are too big for small infant/toddler car restraints but too small for standard adult lap and shoulder seat restraints in most vehicles.
As of September 2010, 29 states including the District of Columbia have adopted this law. (refered to as the upgraded child restraint law). However, 21 states and two U.S. Territories have not adopted the recommendation or only accepted parts of the NHTSA recommendation as a state law. Florida is the only state that only requires children 3 years or younger to have child seats restraints by law. Arizona , South Dakota, American Samoa and Puerto Rico all have laws that only require children 4 years or younger to have seat restraints. Twelve states have child seat restraint laws for children 5 years or younger, and six states have laws for children 6 years or younger. Since adoption of these laws, there have been several studies conducted to show the effectiveness of child seat restraints.
A recent study examined traffic injury rates of children 4-6 years old in the state of New York since its March 2005 implementation of upgraded child restraint law (UCRL) that mandated child seat restraints for this age group. Researchers compared the number of traffic injury rates for children 4-6 years old to children 0-3 years old who were previously required to be in infant/toddler child seat restraints. Data derived from the Accident Information System for New York, covering 27 months before and 33 months after UCRL implementation. The population-based, injury rates for children, the child restraint use rate, and the front seat rate were examined for children aged 0-6 years of age.
When compared to the 0-3 year old infants and toddlers, 4-6 year old children experienced a twenty percent increase in their restraint use rate and four percent decrease in their front seat use rate after UCRL implementation. The population-based injury rate decreased significantly for the 4 to 6 year old group (p<0.0001) most likely as a result of the upgraded child restraint law.
Commentary
Despite evidence from numerous studies and the NHTSA recommendations on establishing state laws for child car restraints in children 4-8 years of age, 21 states still do not currently have laws that follow their recommendations. There are several road blocks that may inhibit a state from creating a new law. These road blocks include: deciding whether to implement this potential law as a primary or secondary offense, budgeting for increased manpower to enforce the potential law, and providing educational services on proper placement and installation of the child car restraints.
Although the benefit appears to outweigh the risks, there may be resistance from parents and political constituents for a new law. This resistance may be due to lack of financial means to afford child car restraints for a large family or limited space in a smaller vehicle to transport multiple children with child car restraints. Despite these limitations, state lawmakers should continue to review and seriously consider implementing child car restraint laws for better child safety.
by
Tyree M. S. Winters, DO
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