Rear Seat Belt Safety

Motor vehicle accidents were the 13th leading cause of death in the U.S. in 2017 (NHTSA 2020).

• In 2020, 5.4 million traffic crashes were reported to the police in the U.S., resulting in 39,000 deaths and 2.3 million injuries (NHTSA 1 2022).
• Non-fatal passenger injuries in car accidents resulted in $62 billion in lifetime medical and lost work hour costs in 2017 (CDC 2020).

Safety feature improvements have reduced the risk of injury or death in the front seat (Mitchell 2015).

• As a result, passengers in the back seat may now experience more severe injuries than passengers in the front row (Mitchell 2015; Jermakian 2019).

Impacts of seat belts on injury and death

About 91.9% of drivers, 90% of front seat passengers, and 78% of those in rear seats wear seat belts (NHTSA 3 2022; NHTSA 2023).

• Children ages 8-15 are the most likely (93.3%) and people ages 16-24 are the least likely (88.2%) to wear seat belts (NHTSA 3 2022).

Seat belts reduce serious injuries and fatalities from crashes by about half (CDC 2020).

• In 2017, seat belts saved about 15,000 lives, and could have saved 2,549 more people if everyone wore a seat belt (NHTSA n.d.).
• 51% of all passenger deaths in car crashes in 2020 were not wearing a seat belt (CDC 2020).

Rear seat belt use. Wearing a seat belt in the rear seat reduces the risk of death by 55% in a passenger vehicle and 74% in light trucks and vans (NHTSA n.d.).

• 60% of people who died while in the back seat during a car crash were not wearing a seat belt.

Impacts on other passengers. A passenger without a seat belt increases the risk of injury to others in the vehicle by 40% (MacLennan 2004).

• In a frontal collision, the risk of death for the driver increases 137% when the passenger behind the driver is not wearing a seat belt (Bose 2013).

State policies

All states except NH require front seat passengers to wear a seat belt (IIHS 2022). 33 states (e.g., KS, IL, KY) require rear seat passengers to wear a seat belt.

• In MO, seat belts are required in the front seat.

Figure 1. States with primary and secondary enforcement.

34 states and DC are “primary law states”, where drivers can be pulled over solely because passengers are not wearing a seat belt. In “secondary law states” (e.g., MO), police officers can only issue a ticket for passengers not wearing a seat belt if the driver was pulled over for another offense (Figure 1; NHTS 2023)

• Seat belt use in primary states was 92.2% and 89.5% in secondary states in 2022 (NHTS 2023).
• Fatality rates during motor vehicle crashes were lower by 2.5 per 100,000 people in primary states compared with secondary states (Lee 2015).

References

Bose, D., Arregui-Dalmases, C., Sanchez-Molina, D., Velazquez-Ameijide, J., & Crandall, J. (2013). Increased risk of driver fatality due to unrestrained rear-seat passengers in severe frontal crashes. Accident Analysis & Prevention, 53, 100–104. https://doi.org/10.1016/j.aap.2012.11.031  

Centers for Disease Control and Prevention (CDC). (2020, October 7). Seat belts: Get the facts. Centers for Disease Control and Prevention. Retrieved April 27, 2023, from https://www.cdc.gov/transportationsafety/seatbelts/facts.html  

Insurance Institute for Highway Safety (IIHS). (2022, August). Seat belts. IIHS HLDI. Retrieved April 27, 2023, from https://www.iihs.org/topics/seat-belts  

Jermakian, J. S., Edwards, M. A., Fein, S., & Maltese, M. R. (2019). (rep.). Factors contributing to serious and fatal injuries in belted rear-seat occupants in frontal crashes. Insurance Institute for Highway Safety (IIHS). Retrieved April 27, 2023, from https://www.iihs.org/topics/bibliography/ref/2178.  

Lee, L. K., Monuteaux, M. C., Burghardt, L. C., Fleegler, E. W., Nigrovic, L. E., Meehan, W. P., Schutzman, S. A., & Mannix, R. (2015). Motor vehicle crash fatalities in states with primary versus secondary seat belt laws. Annals of Internal Medicine, 163(3), 184–190. https://doi.org/10.7326/m14-2368  

MacLennan, P. A., McGwin, G., Metzger, J., Moran, S. G., & Rue, L. W. (2004). Risk of injury for occupants of motor vehicle collisions from unbelted occupants. Injury Prevention, 10(6), 363–367. https://doi.org/10.1136/ip.2003.005025  

Mitchell, R. J., Bambach, M. R., & Toson, B. (2015). Injury risk for matched front and rear seat car passengers by injury severity and crash type: An exploratory study. Accident Analysis & Prevention, 82, 171–179. https://doi.org/10.1016/j.aap.2015.05.023  

U.S. Department of Transportation National Highway Traffic Safety Administration (NHTSA). (2020). (rep.). Motor Vehicle Traffic Crashes as a Leading Cause of Death in the United States, 2016 and 2017. Retrieved April 27, 2023, from https://crashstats.nhtsa.dot.gov/Api/Public/Publication/812927#:~:text=Motor%20vehicle%20crashes%20were%20the,11%2C%20and%2017%20to%2022. 

U.S. Department of Transportation National Highway Traffic Safety Administration (NHTSA). (n.d.). Seat belts. NHTSA. Retrieved April 27, 2023, from https://www.nhtsa.gov/risky-driving/seat-belts     

U.S. Department of Transportation National Highway Traffic Safety Administration (NHTSA 1). (2022). (rep.). Traffic Safety Facts. Retrieved April 27, 2023, from https://crashstats.nhtsa.dot.gov/Api/Public/ViewPublication/813369. 

U.S. Department of Transportation National Highway Traffic Safety Administration (NHTSA 2). (2022). (rep.). Overview of Motor Vehicle Crashes in 2020. Retrieved April 27, 2023, from https://crashstats.nhtsa.dot.gov/Api/Public/Publication/813266.  

U.S. Department of Transportation National Highway Traffic Safety Administration (NHTSA 3). (2022). (rep.). Occupant Restraint use in 2021: Results From the NOPUS Controlled Intersection Study. Retrieved April 27, 2023, from https://crashstats.nhtsa.dot.gov/Api/Public/ViewPublication/813344.  

U.S. Department of Transportation National Highway Traffic Safety Administration (NHTSA). (2023). (rep.). Seat Belt Use in 2022 – Overall Results. Retrieved April 27, 2023, from https://crashstats.nhtsa.dot.gov/Api/Public/ViewPublication/813407.