Online Program

Association between states' boating regulations and children's rate of life jacket use

Sunday, November 3, 2013

Wendy Chow, MPH, Health Services Division, John Snow Inc. (JSI), Boston, MA
Mihaly Imre, M.D., Health Services Division, JSI Research & Training Institute, Inc., Boston, MA
Thomas Mangione, Ph.D., Health Services Division, JSI Research & Training Institute, Inc., Boston, MA
Background. During 1999-2011, about 3.3% of boating-related fatalities annually in the United States involved children under age 13; many resulted from drowning. Since 2003, federal law mandated life jacket wear among children age<13 on boats underway to cover states without wear regulations. The federal law did not supersede state statutes, so variations in coverage by age and boat size exist. Methods. Using US National Life Jacket Wear Observation Study data (1999-2012), we examine life jacket wear rates by different levels of regulation (no law, coverage age<6 only, <10 only, or coverage <13), stratified by children's age. Results. Children age<5 had significantly higher wear rates when there were laws than when there were none (93% v. 83%). Among children age 6-12, rates differed significantly by level of mandate: 63% when no laws exist, 73% when coverage age<6, 82% when coverage age<10, and 83% when coverage <13. Overall, 86% of children age<13 wore life jackets if mandated versus 71% not mandated. Also, children covered by mandates without boat size exceptions had the highest wear (87%), followed by mandates that only apply to certain boat categories (86%), and children otherwise covered but exempted due to boat size had lower wear (81%). Conclusions. In all age categories <13, greater restrictions in boating regulations were associated with higher life jacket wear. Mandates are complex, multi-layered and their effectiveness potentially impacted by varying levels of enforcement. Policymakers should consider how mandate specifications influence behavior when developing regulations to reduce boating-related fatalities and protect this vulnerable population.

Learning Areas:

Advocacy for health and health education
Conduct evaluation related to programs, research, and other areas of practice
Planning of health education strategies, interventions, and programs
Public health or related laws, regulations, standards, or guidelines
Public health or related organizational policy, standards, or other guidelines
Public health or related public policy

Learning Objectives:
Describe differences and changes in life jacket wear regulations across the U.S. and the impact these make on children’s life jacket wear.

Keyword(s): Injury Control, Regulations

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a Research Associate at JSI and have worked on the US National Life Jacket Wear Observational Study since 2008, including conducting data analyses, as well as evaluations of special demonstration projects testing the efficacy of mandatory regulations and educational campaigns.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.