A recent study reveals whats going wrong and where with child car-seat and seatbelt use
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Nearly 70% of U.S. children under 13 in crashes involving a fatality were using restraints improperly or not at all.
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Common misuses include moving too soon to less protective restraints, seating children in the front, or failing to buckle them in.
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The risk is highest among older kids (412), in low-resources communities, and in certain geographic hotspots; stronger state policies seem to help.
We all know car crashes can be deadly especially for children. But a new study shows just how often safety fails when it comes to using child restraint systems (CRS), like car seats and seatbelts.
According to research out of Lurie Childrens Hospital, nearly 70% of children under age 13 involved in U.S. car crashes with at least one fatality were not in a properly used or age-appropriate restraint.
That means even when seats, belts and laws exist, the people entrusted with children too often arent getting it quite right. The implications are huge: safety isnt just about having the right gear, but about using it correctly, all the time.
Given the continued problem of suboptimal child passenger safety practices among children across the country, there is a need for innovative, targeted programs to promote correct and consistent use of age-appropriate car seats, restraints and seating locations, lead author Arthi Kozhumam, MScGH, said in a news release.
The study
To understand what went wrong and where, the researchers tapped into a massive data source: the Fatality Analysis Reporting System (FARS) a national database that records car crashes resulting in deaths.
Heres what they focused on:
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Who: Children under 13 years old involved in crashes with at least one fatality.
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What they measured: Whether the child was using an age-appropriate CRS, whether they were prematurely moved to a less protective restraint, whether they were unrestrained at all, and whether they were seated in the front seat.
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Where and when: The study covered crashes from 2011 to 2021 across the U.S., and also examined community-level factors such as resources (Child Opportunity Index) and geographic concentration (hotspots) of poor restraint use.
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Policy angle: They also checked how state laws (how strict the laws are, fines for first time seatbelt or restraint violations) related to correct restraint use.
The results
The findings are sobering. Among the ~50,000 children studied:
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36% were moved too early to a less protective restraint (for example, transitioning from a car seat to a booster or booster to seatbelt before safe to do so).
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20% were unrestrained no seatbelt, no CRS.
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15% were riding in the front seat (which is less safe for younger children overall).
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Further, 9% of those front-seat riders were unrestrained.
Certain groups were at greater risk:
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Kids aged 4-7 and 8-12 had higher rates of suboptimal restraint use.
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Children in communities with lower resources (using the Child Opportunity Index as a measure) were more likely to be improperly restrained.
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Certain counties across the U.S. stood out as hotspots where improper practices are much more common.
On a brighter note, the study found that in states with stronger child restraint laws including larger fines for first-offense violations there were significantly lower odds of children being improperly restrained.
A novel contribution of this research is our finding of geographic concentrations of suboptimal child passenger safety practices. These areas can be targeted for interventions, especially in the most vulnerable age groups, senior author Michelle Macy, M.D., M.S., said in the news release.
In addition to identifying individual factors and geographic areas that can be targeted for interventions, we show that state policy makes a huge difference in promoting safer transportation practices for child passengers.
Posted: 2025-09-19 18:40:26
