Despite laws, many children in cars and trucks are not buckled in
August 5, 2025
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Nearly 70% of children under 13 involved in fatal car crashes from 2011 to 2021 were not properly restrained, despite clear laws and safety guidelines.
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Inappropriate safety practices were concentrated in certain U.S. counties and among children in under-resourced communities.
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Stronger child restraint laws and higher seat belt fines are associated with better safety outcomes.
Police departments across the U.S. have cracked down on drivers and passengers who arent wearing seatbelts, with a nationwide "Click it or Ticket" campaign. But when it comes to children, the stakes are higher and the requirements are more demanding.
Infants must be in approved back seat infant carriers, and toddlers must be in booster seats, secured by seat belts.
But despite these requirements, a new study published in Traffic Injury Prevention reveals that nearly 70% of children under age 13 involved in fatal car crashes between 2011 and 2021 were not using appropriate child restraint systems (CRS), raising fresh concerns about gaps in vehicle safety compliance and enforcement nationwide.
Despite longstanding national guidelines and state laws mandating child car seat use, researchers found a widespread pattern of misuse or non-use, especially among children aged four to 12. The findings suggest that millions of children remain vulnerable due to premature transitions to seat belts, riding unrestrained, or being seated in unsafe positions like the front seat.
Given the continued problem of suboptimal child passenger safety practices there is a need for innovative, targeted programs to promote correct and consistent use, said lead author Arthi Kozhumam, in a press release.
Whos most at risk?
The study identified disparities based on age, geography, and socioeconomic status. Inappropriate safety practices were disproportionately seen among:
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Children aged 47 and 812
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Kids traveling with drivers from under-resourced communities, defined by low Child Opportunity Index (COI) scores
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Residents of 75 identified county-level hotspots across the country
Dr. Michelle Macy, senior author of the study, pointed to the geographic clustering of these safety lapses as an opportunity for targeted intervention.
A novel contribution of this research is our finding of geographic concentration, she said. These areas can be targeted for interventions, especially in the most vulnerable age groups.
The numbers tell a sobering story
The analysis, which drew on over 50,000 child-involved crashes from the national Fatality Analysis Reporting System (FARS), found:
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36% of children were prematurely moved to a less protective restraint
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20% were completely unrestrained
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15% were riding in the front seat
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Of those in the front seat, 9% were also unrestrained
These statistics translate into daily tragedies: an average of three children die and more than 400 are injured every day in U.S. motor vehicle crashes.
Policy can make a difference
The study found that states with stricter child restraint laws and higher penalties for seat belt violations had lower rates of safety breaches.
We show that state policy makes a huge difference in promoting safer transportation practices for child passengers, Macy said. The Child Opportunity Index also may provide a lens for targeted prioritization of educational interventions.
The researchers urge the development of focused, data-driven interventions that prioritize under-resourced communities and high-risk age groups. The findings also underscore a pressing need for renewed education efforts, stricter enforcement, and community-based outreach to reduce preventable child injuries and deaths on American roads.
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