Promoting seat belt use among black motorists

Nathaniel C. Briggs, M.D., M.Sc. Assistant Professor. Family & Community Medicine (615) 327-5502 Fax (Fax) 1005 Dr. D.B. Todd Boulevard. 2nd Floor, Old Hospital, Room D206, Nashville, TN 37208 nbriggs@mmc.edu. WED: Meharry Medical College - Faculty

New study investigates link between seat belt laws and racial disparities in seat belt use Seat belts reduce injuries and deaths in motor vehicle crashes, but previous studies have found that blacks buckle up significantly less often than whites. An article in the August issue of the American Journal of Preventive Medicine by researchers from Meharry Medical College may shed some new light on the racial disparity in seatbelt use, and how it could be eliminated.

Nathaniel C. Briggs, M.D. and his Meharry - State Farm Alliance research team found that racial differences in seatbelt use vary according to the type of seatbelt law enforced by individual states. In states with secondary seatbelt laws, where motorists can be cited for a seatbelt law violation only if stopped for another offense, blacks are significantly less likely to wear seatbelts than whites. In states with primary laws, where motorists can be stopped solely for not wearing a seat belt, the disparity disappears.

Although 49 states (all except New Hampshire) and the District of Columbia have seat belt laws, only 25 have primary laws. Therefore, Briggs et al. believe that, if the 24 states with secondary seatbelt laws upgraded to a primary law, the disparity in seat belt use between blacks and whites would be eliminated virtually throughout the country. In turn, this could lead to a reduction in the disproportionate number of motor vehicle crash-related injuries and deaths reported among blacks.

While two previous studies found that disparities in seatbelt use between black and white motorists were reduced under primary laws, the studies were limited in scope and the research was inconclusive.

Using data from the Fatality Analysis Reporting System (FARS), a U.S. population-based archive of information on motor vehicle crash fatalities maintained by the National Highway Traffic Safety Administration (NHTSA), investigators looked at seatbelt use among 11,574 black and 73,639 white occupants of passenger cars or light trucks who were aged 16 years and older and fatally injured in crashes between January 1, 1999 and December 31, 2003. In the 33 U.S. states with accurate reporting of decedent race, 7 states had primary seat belt laws, 22 states had secondary laws and an additional 4 states transitioned from secondary to primary laws during the study period.

Compared with secondary-law states, seat belt use in primary-law states was 18 percent higher among blacks and 15 percent higher among whites. In secondary-law states blacks are only 89 percent as likely as whites to use seatbelts, whereas in primary-law states blacks are 105 percent as likely as whites to buckle up. The low prevalence of seatbelt use in secondary law states is largely limited to urban areas, where blacks are only 75 percent as likely as whites to wear seatbelts. The black-white seatbelt use disparity in secondary law states also seems to be limited to motorists ages 16-29 and 50+. Regardless of state seat belt law, black-white seat belt use disparities were most marked at the extremes of driving age.

While it is unclear what accounts for the increased seatbelt use among black motorists in primary law states, Briggs et al. suggest that the findings may reflect concerns of blacks about the possibility of racial profiling, or differential enforcement, whereby law enforcement officers could selectively stop and cite minority motorists for seatbelt law violations.

The authors note that "The issue of differential enforcement has received little attention in the peer-reviewed literature, and should be addressed using methodologically robust epidemiologic studies. In the interim, however, the passage of primary seat belt laws, in conjunction with provisions or companion legislation to monitor and prevent racial profiling, appears to be justified given the possibility that we can achieve racial parity in motor vehicle crash mortality rates." ###

The article is "Seat belt Law Enforcement and Racial Disparities in Seat belt Use" by Nathaniel C. Briggs, M.D., M.Sc., David G. Schlundt, Ph.D., Robert S. Levine, M.D., Irwin A. Goldzweig, M.S., Nathan Stinson, Jr., M.D., Dr.P.H., and Rueben C. Warren, D.D.S., Dr.P.H.

The article appears in the American Journal of Preventive Medicine, Volume 31, Issue 2 (August 2006) published by Elsevier).

Contact: Charlotte Seidman eajpm@ucsd.edu 858-457-7292 American Journal of Preventive Medicine