Online Program

Mortality and Seatbelt Use in Rear-Seated Adults Before and After Passage of Primary Rear Seatbelt Legislation: Findings from the Fatality Analysis Reporting System

Monday, November 2, 2015

Nicholas Moloci, MPH, Division of General Medicine, University of Michigan, Ann Arbor, NY
Patrick Dawson, MPH, Department of Epidemiology, Columbia University, NEW YORK, NY
Joyce C. Pressley, PhD, MPH, Depts of Epidemiology and Health Policy and Management, Center for Injury Epidemiology and Prevention at Columbia, Columbia University, New York, NY
Background. Seatbelt use, long associated with decreased motor vehicle mortality, is reported to be lower among rear-seated passengers. In an effort to increase belt wearing in rear-seated adults, some states have passed primary rear seat belt laws. This study examines belt use and mortality pre- and post-law in states transitioning to a primary rear seat belt law.

Methods. The Fatality Analysis Reporting System and U.S. Census data were used to examine primary rear-seat belt laws on rear-seat belt use and mortality rates (n=6,183) in 9 states (Alaska, Delaware, Illinois, Kentucky, Maine, Rhode Island, South Carolina, Washington and Wisconsin) that transitioned to a primary law between 2000-2013. Multilevel logistic regression with fixed effects was used due to multiple rear-seated occupants (1.4 ±SD 0.6) in vehicle models 1970-2013.

Results. Compared to pre-law, primary rear-seat belt laws were associated with an increase in rear-seat belt use (OR: 1.65, 95% CI: 1.45-1.88, p<0.0001) and lower mortality (OR: 0.25, 95% CI: 0.21-0.29, p<0.0001) after controlling for covariates. Of the 9 states, 6 (67%) showed declines in mortality, although half of these began to decline before the transition. Age, gender and vehicle type were associated with differential belt use and mortality.

Conclusions.  Rear-seat belt use increased and mortality declines were observed in a majority of states transitioning to a primary law. However, rear-seat mortality began to decline in several states prior to the legislation’s effective date suggesting the need for further study of other factors that may have influenced the observed improvements.

Learning Areas:

Public health or related public policy
Public health or related research

Learning Objectives:
Compare adult rear seatbelt use before and after a primary rear-seat seatbelt law was implemented in 9 states that transitioned to a primary law, 2000 and 2013 Describe mortality rates before and after a primary rear-seat seatbelt law was implemented in 9 states that transitioned to a primary law between 2000 and 2013 Explain findings from multilevel analyses of independent factors associated with adult rear-seat belt use and adult rear-seat mortality

Keyword(s): Epidemiology, Public Health Research

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: i'm a recent graduate of Columbia University's Mailman School of Public Health with my masters in Epidemiology. I presented at last years APHA conference on a very similar topic relating to seat belt use and mortality.
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.