Defining Contextual Variables Related to Seat Belt Use in Fatal Crashes

Raymond, Paula; Redden, Carrie; Searcy, Sarah; Head, Weston; Jackson, Steve · 2021 · ROSA P / United States. Department of Transportation. National Highway Traffic Safety Administration

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Summary

This study investigates the relationship between contextual environmental variables and seat belt use in fatal motor vehicle crashes, aiming to explain significant geographic variations in unrestrained fatality rates across U.S. counties. Motivated by the observation that 47% of passenger vehicle occupants killed in crashes were unrestrained in 2018, and that county-level data reveals substantial disparity even within states with high overall belt use, the research explores how physical environment characteristics influence restraint behavior. Specifically, the authors examined whether the density of alcohol outlets and tourism locations predicts the likelihood of unrestrained fatalities, hypothesizing that greater densities of these venues would correlate with lower seat belt usage. The researchers conducted an exploratory analysis using data from the Fatality Analysis Reporting System (FARS) for the years 2012 to 2016. The dependent variable was the restraint status (known restrained or unrestrained) of 101,389 fatally injured passenger vehicle occupants. Independent variables included county-level densities of on-premises alcohol outlets (e.g., bars), off-premises alcohol outlets (e.g., liquor stores), and tourism locations, calculated as the number of establishments per 1,000 residents using North American Industry Classification System (NAICS) codes. The study employed a series of logistic regression models, including single-variable, base multivariable, and expanded models that controlled for person-, county-, and state-level demographic covariates. An exploratory model further disaggregated on-premises outlets into subcategories such as bars, dancing venues, stage performance locations, and tasting rooms. The results provided mixed support for the initial hypotheses. As predicted, higher densities of off-premises alcohol outlets were consistently associated with an increased likelihood that a crash fatality was unrestrained across all models. However, contrary to expectations, the overall density of tourism locations and general on-premises alcohol outlets showed no significant association with unrestrained fatalities in the base and expanded models. When on-premises outlets were disaggregated, increased densities of bars and stage performance drinking places were associated with a higher likelihood of unrestrained fatalities. Conversely, higher densities of dancing and tasting drinking places were associated with a decreased likelihood of unrestrained fatalities, and tourism locations generally showed a decreased likelihood in some models. The study concludes that specific types of alcohol outlets, particularly off-premises stores and certain on-premises venues like bars, are contextual factors linked to lower seat belt use in fatal crashes. These findings suggest that environmental characteristics can influence safety behaviors beyond individual demographics. However, the authors note limitations, including the inability to account for alcohol sales at restaurants and grocery stores due to data constraints, and the possibility that outlet densities reflect broader cultural or environmental factors. The results are considered preliminary and not yet ready for direct translation into practice, but they highlight potential areas for targeted countermeasure deployment and further research into how physical environments shape occupant protection behaviors.

Key finding

Greater densities of off-premises alcohol outlets in a county were associated with an increased likelihood that crash fatalities were unrestrained, while overall on-premises alcohol outlet density and tourism location density were not.

Methodology

dataset

Sample size: 101389

Provenance

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Summary generated by qwen3.6-27b-prismaquant on 2026-06-10; verification: verified.

Topics

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• seat belt use
• demographic disparities
• incidence prevalence
• comparative international
• urban rural setting

Information type

What kind of knowledge this paper contributes, grouped by family — independent of topic (what it is about) and method (how it was studied).

• Empirical Findings: crash risk outcomes, observational prevalence