Predictors of rear seat belt use among U.S. adults, 2012

Bhat, Geeta; Beck, Laurie; Bergen, Gwen; Kresnow, Marcie-jo · 2015 · OpenAlex-citations

DOI: 10.1016/j.jsr.2015.03.011

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Summary

This study investigates the predictors of rear seat belt use among U.S. adults, addressing a critical gap in injury prevention research. While seat belts significantly reduce injury and fatality risks, rear seat usage remains consistently lower than front seat usage, with rear seat occupants representing 26% of adult non-driver deaths in 2012. Prior literature often lacked detailed individual-level data for rear passengers or focused on general seat belt use. This research aimed to identify demographic and legislative factors associated with rear seat belt compliance to inform effective interventions. The authors analyzed data from the 2012 Summer ConsumerStyles survey, a web-based survey of 4,754 U.S. adults, yielding 4,170 responses. After excluding those who never ride in the back seat, the final sample comprised 3,953 adults. Data were weighted to match U.S. demographic proportions. Respondents self-reported their frequency of rear seat belt use, categorized as "always" or "less than always." The study linked respondents to state-level seat belt laws, classifying them as primary enforcement (ticketable without other violations), secondary enforcement, or no law. Multivariable log-binomial regression was used to calculate adjusted prevalence ratios (APR) for always wearing a seat belt, controlling for age, gender, race, income, education, marital status, region, and metropolitan status. Results indicated that 62% of adults reported always wearing a rear seat belt. Significant variations were observed by geography and legislation. In multivariable analysis, respondents in states with primary rear seat belt laws were 23% more likely (APR: 1.23) to always wear a seat belt compared to those in states with no law. Those in secondary law states were 11% more likely (APR: 1.11). Regionally, Western residents were 25% more likely to use rear seat belts than those in the Midwest or Northeast, and 20% more likely than those in the South. Metropolitan residents were 11% more likely to use rear seat belts than non-metropolitan residents. Age also influenced usage; adults aged 45–64 and 65+ were 14% and 16% more likely, respectively, to always wear a seat belt compared to those aged 25–44. Notably, young adults (18–24) showed higher usage rates than the 25–44 age group, contrary to general trends. Gender differences were not statistically significant. The study concludes that primary enforcement laws covering all seating positions are strongly associated with increased rear seat belt use. Given that only 40% of the U.S. adult population was covered by such laws in 2012, the authors recommend expanding primary enforcement to all seating positions as an effective intervention. This policy change could increase compliance, particularly among demographic groups with historically lower usage rates, thereby reducing motor vehicle injuries and fatalities among rear-seat occupants. The findings highlight the importance of legislative enforcement alongside demographic and geographic factors in shaping safety behaviors.

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Topics

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• seat belt use
• child passenger safety

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• Empirical Findings: observational prevalence