Do You Know How to Keep Your Kid Safe in the Car?

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Car crashes are the leading cause of death in kids over age 3 in the U.S., and yet many parents still don’t use car seats properly or don’t know what the guidelines are for car safety restraints, finds a recent study published in the American Journal of Preventive Medicine.

In 2011, the American Academy of Pediatrics (AAP) updated its child passenger safety guidelines, which recommend:

  • Rear-facing car seats for kids until at least age 2, or when the child exceeds the maximum height and weight recommended by the car seat manufacturer
  • Forward-facing car seats with a five-point harness for kids over 2, until the child reaches the seat’s maximum weight and height
  • Booster seats until an adult seat belt fits properly, typically when the child reaches 57 inches in height (4 ft., 9 in.), between 8 and 12 years of age
  • Back seat riding with seat belt until age 13

For the new study [PDF], researchers reviewed three years of data from the National Highway Traffic Safety Administration’s 2007-09 National Survey on the Use of Booster Seats. The data included nearly 21,500 kids, who were observed in their parents’ vehicles as they pulled into gas stations, fast food restaurants, recreation centers and child care centers. The researchers interviewed the drivers about their and their child’s age, race and ethnicity, and noted what type of car safety restraints were used, where the child was seated, whether the driver was wearing a seat belt, the type of car driven and the gender of both the child passenger and the driver

(MORE: Injury Prevention Report Card: Nearly Half of U.S. States Score Low)

The data were gathered before the release of the updated AAP guidelines, but there were similar recommendations already in place. The new guidelines simply strengthened certain minimum requirements, such as pushing the minimum age and weight at which parents could transition an infant out of a rear-facing seat, from 1 year or 20 lbs. to 2 years old. The new guidelines also recommended that older children use a booster seat until at least age 8 in order to encourage states with mandates as low as 5 years to reevaluate.

The investigators found that even based on the older guidelines, few parents were restraining their children properly in the car. For example, only 3% of infants and toddlers aged 1-3 sat in rear-facing car seats, and only 2% of kids older than 7 remained in booster seats. The researchers found also that older children were more likely to ride without restraint, and were likely to be in the front seat. The authors speculate that older kids were wiggling out of their seat belts on their own or refusing to wear them because they’re uncomfortable — a problem that could be remedied by using a size- and age-appropriate booster seat.

Also, in nearly every age group, minority children were significantly less likely to use appropriate car safety restraints than white children. Black and Hispanic infants and toddlers were 10 times more likely to be unrestrained in a car, compared with white babies, for example. Thirty-five percent of black children and 26% of Hispanic children ages 4 and 5 were prematurely transitioned to seat belts, compared with 16% of white children. Overall, many kids over age 6 were sitting in the front seat.

When parents weren’t wearing a seat belt themselves, the odds were 23 times greater that their kids also weren’t buckled in.

(MORE: Kids Are Safer in the Car With Their Grandparents Behind the Wheel)

The authors note that their findings call for better community-based public education campaigns about car safety for kids and about child safety seat laws, which are implemented in 48 states — especially for minority children. “Further development and dissemination of culturally specific programs that have demonstrated success in promoting restraint use among minority children are necessary. Further, the findings may also help in developing strategies to lower the racial and ethnic disparities seen in children experiencing crash-related injuries,” said study author Dr. Michelle Macy Mott of Children’s Hospital at the University of Michigan, Ann Arbor, in a statement.

But the wake-up call applies to all parents, regardless of race or ethnicity. “The most important finding from this study is that, while age and racial disparities exist, overall few children are using the restraints recommended for their age group, and many children over 5 are sitting in the front seat,” Mott said.

MORE: Why Parents Who Carpool Tend Not to Use Booster Seats