Self-reported Belt Use Research Articles

State-level seat belt use in the United States, 2011–2016: Comparison of self-reported with observed use and use by fatally injured occupants

Introduction: Despite 49 states and the District of Columbia having seat belt laws that permit either primary or secondary enforcement, nearly half of persons who die in passenger vehicle crashes in the United States are unbelted. Monitoring seat belt use is important for measuring the effectiveness of strategies to increase belt use. Objective: Document self-reported seat belt use by state seat belt enforcement type and compare 2016 self-reported belt use with observed use and use among passenger vehicle occupant (PVO) fatalities. Methods: We analyzed the Behavioral Risk Factor Surveillance System (BRFSS) self-reported seat belt use data during 2011–2016. The Pearson correlation coefficient (r) was used to compare the 2016 BRFSS state estimates with observed seat belt use from state-based surveys and with unrestrained PVO fatalities from the Fatality Analysis Reporting System. Results: During 2011–2016, national self-reported seat belt use ranged from 86–88%. In 2016, national self-reported use (87%) lagged observed use (90%) by 3 percentage points. By state, the 2016 self-reported use ranged from 64% in South Dakota to 93% in California, Hawaii, and Oregon. Seat belt use averaged 7 percentage points higher in primary enforcement states (89%) than in secondary states (82%). Self-reported state estimates were strongly positively correlated with state observational estimates (r = 0.80) and strongly negatively correlated with the proportion of unrestrained PVO fatalities (r = −0.77). Conclusion: National self-reported seat belt use remained essentially stable during 2011–2016 at around 87%, but large variations existed across states. Practical Applications: If seat belt use in secondary enforcement states matched use in primary enforcement states for 2016, an additional 3.98 million adults would have been belted. Renewed attention to increasing seat belt use will be needed to reduce motor-vehicle fatalities. Self-reported and observational seat belt data complement one another and can aid in designing targeted and multifaceted interventions.

Belt Use: Comparison of NASS-CDS and Police Crash Reports

Objective: This study compares belt use in police reports with NASS-CDS investigator-determined belt use. The NASS-CDS cases were analyzed by severity of occupant injury and the crash type. Methods: 1993–2007 NASS-CDS was analyzed for occupant injury severity and crash type. Light vehicles were included with model year 1994+. Injury severity was subdivided by MAIS 0, 1–2, 3, 4+F, and fatal. Crash types were frontal, side, rear, and rollover. The NASS-CDS determination of belt use was assumed the gold standard used to determine miscoding by the police. Results: The fraction of unbelted occupants increased with the severity of injury from 3.8 percent with no injury to 53.9 percent with fatalities in the police reports. NASS-CDS reported no belt use of 7.9 percent (2.18 times greater than the police) with no injury to 58.2 percent (1.08 times) with fatalities. In side impacts, severely injured occupants were unbelted in 46.9 percent of NASS-CDS cases. This was 1.35 times greater than the 34.7 percent unbelted reported by the police. For severely injured occupants (MAIS 4+F), 18.4 percent of the police reported cases with belt use were actually unbelted occupants by NASS-CDS. The reporting error decreased to 5.0 percent for uninjured occupants (MAIS 0). For uninjured occupants, 35.7 percent of the police-reported cases of no belt use were coded as belted by NASS after inspecting the belt system. This difference decreased to 2.6 percent for fatally injured occupants. Conclusions: For occupants with serious-to-fatal injury, the error in police reporting belt use was 13–18 percent. The police often rely on self-reported belt use, which overestimates actual belt wearing and they do not always conduct in-depth investigation of vehicle, seat belt, and occupant injury to reach a conclusion of belt use. The police generally overreport belt use in motor vehicle crashes.

The relationship between perceived risk of being ticketed and self-reported seat belt use

Problem: Twenty-nine percent of Americans failed to use their seat belts in 2000. Efforts to improve safety belt usage can be enhanced by identifying specific factors that motivate belt use. Method: Motorist survey data were used to examine the effect of Perceived Risk of being Ticketed (PRT) for a seat belt infraction on self-reported seat belt use. Results: Analyses indicated that individuals and groups of individuals who have higher PRT typically report higher belt usage. Factorial analyses indicated that this perceived risk to belt use relationship holds both within groups with generally high (e.g., upper income) and generally low (e.g. young men) overall self-reported belt use. Discussion: Applications of PRT to improve seat belt use are discussed. Impact on Industry: Enforcement of existing laws, perhaps through selective traffic enforcement programs, and strengthening laws to create a higher perception of being ticketed by motorists should increase safety belt use thereby saving lives and reducing cost for individuals, government, and industry.

Self-Reported Seat Belt Use in Four Countries: A Telephone Survey

A telephone survey was conducted in four countries in November 1998 to compare drivers in the United States with those in Australia, Canada, and the United Kingdom regarding their attitudes toward seat belts and belt use laws. More than 90 percent of the 2251 respondents said they thought seat belts are effective, but self-reported belt use was significantly lower in the United States than in the other countries. Respondents in Australia and the United Kingdom had similar views about what they thought were important reasons for using seat belts and had the highest self-reported use. Reasons given for using belts by Canadian and US respondents were quite similar to one another, yet US respondents had significantly lower self-reported use rates, a difference thought to be due to vigorous enforcement of the law in Canada. US drivers were less likely than Australian and UK drivers to say they used belts out of habit, to avoid a ticket, or because it is required by law and more likely to say they used belts for situational reasons. US drivers were least likely to be in favor of belt use laws. Canadian drivers reported the most experience being checked by police for belt use and were most likely to think that nonusers would be caught. US drivers in primary enforcement jurisdictions were more likely than those in secondary jurisdictions to think that drivers not using belts would be caught and more likely to say they always used belts. Results of this survey indicate that seat belt use in the United States could be increased by adoption of primary enforcement laws and highly visible enforcement programs of the type used in Canada, and that seat belt use could be increased in all countries by increasing the penalties for nonuse.

Seat belt use and accident involvement: A comparison of driving behavior before and after a seat belt law

In an earlier study, researchers at the University of North Carolina Highway Safety Research Center found drivers classified as seat belt nonusers on the basis of direct observation and self-reported belt use to be overrepresented in prior accidents and violations. This study represents a follow-up and extension of the earlier study where accident and violation rates over a 2.5-year interval following the classification by seat belt use status are compared. Seat belt nonusers were again found to be overrepresented in both accidents and violations. In other analyses of these data, changes in seat belt use status were found not to be associated with changes in accident or violation rates, and seat belt use rates reported by police in accidents following the mandatory seat belt law greatly exceeded both the observed and self-reported use rates. This was especially pronounced for drivers who responded that they rarely or never used seat belts.

Observed and self-reported seat belt wearing as related to prior traffic accidents and convictions

During the summer of 1987, 10,000 color-coded mailback questionnaires that identified belted and unbelted North Carolina drivers were handed out at the 72 sites that constitute the probability sample for determining the statewide belt use rate in North Carolina. By obtaining identifying information to determine the winner of a $500 prize from among the 5,074 respondents, police-reported traffic accident and conviction records from the North Carolina driver history file were linked to the belted and unbelted respondents. Analyses found that drivers who had been observed not wearing seat belts had 35% more accidents and 69% more convictions than did belted drivers in the previous four-year period. Similar findings were obtained from self-reported belt use.

The Validity of Self-Reported Behavioral Risk Factors

Data from state telephone surveys of self-reported seatbelt use, driving while intoxicated, and drinking five or more alcoholic drinks at one sitting were compared with objectively observed belt use in traffic and evidence of blood alcohol in fatally injured drivers. Self-reported belt use overstates actual use by more than 20 percentage points on average. Self-reported alcohol use is not predictive of the percentage of fatally injured drivers with evidence of blood alcohol among the states.