Study: We Are Pathetically Failing at Safely Putting Children in Cars

Kids are not buckled up, not riding in the back, not using car seats, and on and on. You guys. Here are the rules, again.


Desmond Boylan/Reuters

PROBLEM: Being that the leading cause of death in children over the age of three is motor vehicle collisions, parents should do everything possible to get their kids to buckle up and to keep smaller children from sitting in the deathtrap otherwise known as the front seat. But the American Academy of Pediatrics (AAP) Guidelines for Child Passenger Safety, last revised in 2011, are a lot more specific than that. They stipulate the appropriate age and weight at which children can begin to move up the graduated steps from rear-facing car seat to a front-facing and then booster seat. With these safety ideals in mind, this study looked at the reality on the road.

METHODOLOGY: This study was a secondary analysis of three years of data collected the old-fashioned way: Researchers hit the streets and accosted cars with child passengers as they pulled into gas stations, fast-food chains, recreation centers, and child care centers. As data provided by parents of their children's weight was judged unreliable, age was used as the main indicator of whether children were appropriately restrained. 21,476 children aged 13 and under were included in the analysis.

RESULTS: Predictably, as children got older (and more aware of/able to vocalize what's "cool"), they were less likely to use safety restraints and more likely to move to the front seat. Overall, high proportions of children were either not wearing seatbelts or restrained inappropriately.

  • In almost every category, black and Hispanic children fared the worst. Most strikingly, the proportion of infants and toddlers who were not restrained at all was ten times greater in minority populations. 
  • Only 3 percent of children aged 1-3 were in rear-facing car seats, and only 2 percent of children over 7 remained in booster seats. The rest were upgraded prematurely: the AAP recommendations stipulate that children should remain rear-facing until at least age 2 and basically for as long as they fit in the car seat, and that they should remain in booster seats until around age 11.
  • Having more kids in the car was associated with less seatbelt use, although they were more likely to stay in the back seat. 
  • When the driver wasn't wearing a seatbelt, children had 23 times higher odds of not being buckled in.

CONCLUSION: Regardless of age and racial disparities, children are overwhelmingly at risk when traveling by car, due to improper or age-inappropriate use of restraints and to sitting in the front seat.

IMPLICATIONS: The authors of the study recommend specific focuses for car safety education campaigns based on the most rampant problems they found.

  • Parents should be encouraged to keep their children in rear-facing car seats beyond their first year. 
  • Children should remain in booster seats until they are 4 feet 9 inches tall, which is when they will fit properly in an adult seatbelt. 
  • The front seat should be off-limits to all children under the age of 13.

The full study, "Child Passenger Safety Practices in the U.S.: Disparities in Light of Updated Recommendations," is published in the American Journal of Preventive Medicine.