Emergency Message System

Motor Vehicle Crashes: A Leading Cause of Death for Children. Of the children who were killed in a crash, 36% were not buckled up. Parents and caregivers can make a lifesaving difference by ensuring that their children are properly buckled on every trip. Risk Factors for Child Passengers   Age Restraint use (like car seat, booster seat, or seat belt use) varies by age. Restraint use typically decreases as children get older. In a study from 2021 where researchers observed children riding in cars, they found: <1% of children under age 1 were not buckled up, 6% of children 1–3 years old were not buckled up, 11% of children 4–7 years old were not buckled up, and 13% of children 8–12 years old were not buckled up.3   Being unrestrained in a vehicle increases the risk of being killed in a crash. In a study from 2023 using fatal crash data, researchers found: 30% of 0–3-year-olds killed in crashes were not buckled up and 36%§ of 8–12-year-olds killed in crashes were not buckled up.   Also, among children who are buckled up in child restraints, many graduate too soon to the next stage of child passenger safety. An example is when children stop using a booster seat before the seat belt fits them correctly. Age-appropriate restraint use typically decreases as children get older. Race and ethnicity American Indian and Alaska Native children and Black children are more likely to be killed in a crash than White children. Child passenger death rates were highest among American Indian and Alaska Native children (2.67 per 100,000 population), followed by Black children (1.96), according to combined data from 2015–2019. Several studies also indicate that it is more common for Black children, Hispanic children and American Indian and Alaska Native children to travel unrestrained or improperly restrained when compared with White children. 21% of Black children, 15% of Hispanic children, and 7% of White children ages 4–7 years were not buckled up, according to a study in 2021 where researchers observed children riding in cars. There are likely many reasons for these differences, including access to affordable car seats and booster seats and differences in culture and perceptions related to car seat and booster seat use. Rural versus urban location Children in rural areas are typically at higher risk of being killed in a crash. According to combined data from 2015–2019: Child passenger death rates were highest in the most rural counties (4.5 per 100,000 population) and lowest in the most urban counties (0.9). Death rates among children who were not using age-appropriate restraints were highest in the most rural counties (2.9 per 100,000 population) and lowest in the most urban counties (0.5). Studies also indicate that children in rural areas are more likely to be incorrectly restrained than children in urban areas. A multistate study using data from car seat check events found that child restraint misuse was more common in rural locations (91%) than in urban locations (83%).Similar to racial and ethnic disparities, there are likely several factors for these differences. Alcohol-impaired driving Alcohol-impaired driving is a major threat to all road users, including child passengers. In 2021, 25% of deaths among child passengers (ages 14 and younger) involved an alcohol-impaired driver. Among all child passengers (ages 14 and younger) who were killed in crashes, a higher proportion of those riding with alcohol-impaired drivers were unrestrained (43%) compared with children riding with drivers who had no alcohol in their system (38%).   Driver seat belt use Restraint use among children is associated with their driver’s seat belt use. In 2021, 69% of child passengers ages 14 and younger killed in crashes who rode with unbuckled drivers were also not buckled up, compared with 26% of children riding with buckled drivers. Researchers who observed adults and children riding in cars in 2021 found that 95% of children ages 7 and younger who were driven by a buckled driver were restrained, compared with 77% of children driven by an unbuckled driver. Many other studies assessing different child age groups or specific geographic locations have also found strong associations between unrestrained drivers and unrestrained child passengers. Car seat and booster seat misuse Car seats and booster seats are often used incorrectly, which can make them less effective. Researchers who observed children riding in cars in a 2011 study estimated that 46% of car seats and booster seats are used incorrectly in a way that could reduce their effectiveness.22–24 Car seat misuse estimates are even higher at 59% when booster seats are excluded. More