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APHA Scientific Session and Event Listing

Nathaniel C. Briggs, MD, MSc¹, Irwin A. Goldzweig, MS¹, David Schlundt, PhD², Robert S. Levine, MD³, and Nathan Stinson, Jr, MD, PhD¹. (1) Family & Community Medicine, Meharry Medical College, 1005 D.B. Todd Blvd., Nashville, TN 37208, 615-327-5502, nbriggs@mmc.edu, (2) Psychology, Vanderbilt University, 21st Ave So, Nashville, TN 37232, (3) National Center for Primary Care, Morehouse School of Medicine, 720 Westview Drive SW, Atlanta, GA 33010

Motor vehicle crashes cause over 40,000 fatalities annually, disproportionately taking lives of Hispanic motorists. Because seatbelts can reduce crash fatality risk by 50%, promotion of seatbelt use among Hispanics least likely to buckle up could reduce the existing Hispanic:White crash fatality disparity. However, Hispanic subpopulations for whom interventions would benefit most remain poorly defined. We analyzed US population-based data from the Fatality Analysis Reporting System (FARS) to look at seatbelt use among 60,758 nonHispanic Whites and 7,521 Hispanics killed in crashes from 1999-2003; such an analysis only recently became possible because ethnic data were not collected by FARS until 1999. In a logistic regression analysis adjusting for age, gender, seatbelt law, seat position, and income, the odds ratio and 95% confidence interval (CI) for seatbelt use among Hispanics (nonHispanic Whites=1.00) was 1.30 (95% CI:1.24-1.38). By Hispanic subtype, odds ratios were 1.66 (95% CI: 1.44-1.91) for Central Americans/South Americans, 1.33 (95% CI:1.25-1.42) for Mexicans, 1.17 (95% CI:0.95-1.44) for Puerto Ricans, 1.04 (95% CI:0.85-1.28) for Cubans and 1.03 (95% CI:0.86-1.22) for Other Hispanics. These results suggest that the Hispanic:White disparity in motor vehicle crash fatalities is not explained by seatbelt use disparities. However, the reverse seatbelt use disparity evident for some Hispanic subtypes indicates protective factors may exist that could be promoted to offset heretofore unidentified crash fatality risk factors. Because significant reverse disparities were absent for other Hispanic subtypes, our findings also underscore the potential for residual confounding in epidemiologic studies that treat Hispanics as a single homogeneous risk group.

Learning Objectives:

• State the approximate annual prevalence of motor vehicle crash fatalities in the US
• Explain how motor vehicle crash mortality rates differ by Hispanic ethnicity
• State the approximate magnitude of impact that seatbelt use has on motor vehicle crash fatality risk
• Name the most definitive source of population-based data on traffic fatalities in the US and explain why it could not be used to investigate ethnic disparities in the association between seatbelt use and traffic fatalities until recently
• State one type of methodologic problem that can arise with epidemiologic study designs that treat Hispanic ethnicity as comprising a single homogeneous population

Keywords: Hispanic, Motor Vehicles

Presenting author's disclosure statement:

Any relevant financial relationships? No