Coverage gaps in seat belt use laws

Making the case for laws that improve health: a framework for public health law research

CONTEXT

Public health law has received considerable attention in recent years and has become an essential field in public health. Public health law research, however, has received less attention.

METHODS

Expert commentary.

FINDINGS

This article explores public health law research, defined as the scientific study of the relation of law and legal practices to population health. The article offers a logic model of public health law research and a typology of approaches to studying the effects of law on public health. Research on the content and prevalence of public health laws, processes of adopting and implementing laws, and the extent to which and mechanisms through which law affects health outcomes can use methods drawn from epidemiology, economics, sociology, and other disciplines. The maturation of public health law research as a field depends on methodological rigor, adequate research funding, access to appropriate data sources, and policymakers' use of research findings.

CONCLUSIONS

Public health law research is a young field but holds great promise for supporting evidence-based policy making that will improve population health.

Geographic and sociodemographic variation in self-reported seat belt use in the United States

BACKGROUND

With new data available, we sought to update existing literature on the prevalence of self-reported seat belt use by state, region, and rural/urban status and to estimate the strength of the association between seat belt use and rural/urban status adjusted for type of seat belt law and several other factors.

METHODS

We examined data on self-reported use of seat belts from 50 states, the District of Columbia, and three territories using the 2008 Behavioral Risk Factor Surveillance System, a state-based random-digit-dialed telephone survey (n=406,552). Reported seat belt use was assessed by state, U.S. Census regions, and U.S. Department of Agriculture (USDA) rural/urban continuum codes.

RESULTS

Overall, 85% of adults in the United States reported they always used seat belts. Regionally, the West had the highest prevalence of persons who reported that they always wear seat belts (89.6%) and the Midwest had the lowest (80.4%). States with primary seat belt laws had the highest prevalence of reported seat belt use, compared with states with secondary or no laws. After adjusting for various sociodemographic characteristics, body mass index, and type of seat belt law, persons in the most densely populated metropolitan areas were significantly more likely to report always wearing seat belts than those in most sparsely populated rural areas (adjusted odds ratio=2.9).

CONCLUSION

Our findings reinforce the evidence that primary enforcement seat belt laws are effective for increasing seat belt use, and suggest that upgrading to primary enforcement laws will be an important strategy for reducing crash-related fatalities in rural areas.

Restraint use patterns for older child passengers in Michigan

The purpose of the present study was to conduct the first statewide direct observation survey of restraint use designed specifically for older child passengers (4-15 years of age). We also sought to determine the factors that were related to belt use by older child passengers in Michigan so that effective programs could be developed to promote use of restraint devices in this age group. The study found that older child restraint use was about 58% statewide. Restraint use was highest in regions where overall belt use was higher, when the driver was using a safety belt, in sport utility vehicles and vans/minivans, and in the front-right seating position. No difference in restraint use was found for the day of week, the sex of the child, or the type of site where data was collected. The study provides the largest scale analysis to date on older child occupant restraint use patterns. The data provide some much needed empirical data on the restraint use patterns of older child passengers for development of theory to better understand and predict lack of restraint use in this age group.