Racial/Ethnic Differences in Limited English Proficiency (LEP) and Associations with Regular Seat Belt Use

Abstract

Background Young drivers who are racial/ethnic minorities are at higher risk for being unrestrained and dying in a motor vehicle crash. Racial/ethnic disparities are also present in outcomes and efficacy of health communication, particularly for those with limited English proficiency (LEP). Little is known about the role of LEP in traffic safety behavior. This study explores the association between LEP and regular seat belt use among a nationally representative sample of US high school students. Methods Data came from the Centers for Disease Control and Prevention's 2015 national Youth Risk Behavior Survey (YRBS). The YRBS assessed seat belt use as a passenger during the 30 days before the survey, which included 9,895 students ages 16 or older. Seat belt use (regular/always v. irregular) and English proficiency were dichotomized. Chi-square tests examined associations between English proficiency and seat belt use. Logistic regressions assessed the association between English proficiency and seat belt use, controlling for demographic variables and examining race as a possible moderator. Results The prevalence of LEP among students 16 or older was 1.9%. Those with LEP were more likely to have irregular seat belt use compared with their peers with English proficiency (adjusted odds ratio: 3.31; 95% confidence interval: 2.28–4.80; p Conclusions English proficiency is a significant predictor of seat belt use. Although the moderating effect of race on this association needs further study, it is clear that LEP has a disproportionately adverse effect on APIs, who are not traditionally targeted in traffic safety messaging. This study suggests a need for linguistically- and culturally-sensitive traffic safety programming for young drivers at risk for LEP and irregular seat belt use.