KILLED IN MOTOR VEHICLE CRASHES IN 2020
WEREN'T WEARING SEAT BELTS
Primary Enforcement Seat Belt Laws
There were 38,824 motor vehicle crash fatalities on U.S. roads in 2020. Among passenger vehicle occupant fatalities that year, more than half (51 percent) were unrestrained when restraint use was known. For passengers that survived fatal crashes in 2020, just 16 percent were unrestrained. Seat belt use, reinforced by effective safety belt laws, is a proven lifesaver.
All states except one have seat belt use laws, but only 34 states (AL, AK, AR, CA, CT, DE, FL, GA, HI, IL, IN, IA, KS, KY, LA, ME, MD, MI, MN, MS, NJ, NM, NY, NC, OK, OR, RI, SC, TN, TX, UT, WA, WV and WI) and the District of Columbia have primary enforcement of their belt laws, and 30 states (AL, AZ, AR, CO, CT, FL, GA, ID, IA, KS, MD, MA, MI, MO, MT, NE, NV, NH, NJ, NC, ND, OH, OK, PA, SD, TN, VT, VA, WV, WY) do not have primary enforcement laws for rear seat belts. In states with primary enforcement, law officers may ticket a non-belt user when they see a violation of the seat belt law. With secondary enforcement laws, officers may issue a citation only after stopping the vehicle for another traffic infraction.
Primary enforcement laws are much more effective in increasing the use of seat belts. Seat belt use is higher in states with primary enforcement laws compared to those with secondary enforcement laws or without seat belt laws. Experience in a number of States indicates that usage rates rise from 10-15 percentage points when primary laws are passed. Primary enforcement is important not only for raising adult safety belt use, but also for increasing the number of children who are protected by occupant restraints. In 2015, children under the age of eight, being driven by a belted driver had a higher belt use rate (92 percent) than children being driven by an unbelted driver (70 percent).
Seat Belt Facts
- From 1975 to 2017, seat belts have saved over 374,000 lives and over $1 trillion in economic costs.
- Nearly 10,000 unrestrained occupants died in passenger vehicle crashes in 2019 alone.
- The use of seat belts in passenger vehicles saved an estimated 14,955 lives of occupants age five and older nationwide in 2017. An additional 2,549 lives would have been saved in 2017 if all unrestrained passenger vehicle occupants age five and older involved in fatal crashes had worn their seat belts.
- In 2019, among front seat passengers killed in crashes where restraint use was known, 41 percent were unrestrained, compared to 53 percent of fatalities lacking restraint use in the rear seat.
- In fatal crashes in 2019, 81 percent of passenger vehicle occupants who were totally ejected from the vehicle were killed, according to National Highway Traffic Safety Administration (NHTSA) data. Only one percent of the occupants reported to have been using restraints were totally ejected, compared with 26 percent of the unrestrained occupants.
Rear Seat Belt Use
- Rear seat passengers are more than twice as likely to die in a crash if they are unbelted.
- Adults are not buckling up in the rear seat as much as they are in the front seat, with rear seat belt use ten to 15 percent lower than in the front seat according to a study by the Insurance Institute for Highway Safety (IIHS) and The Children’s Hospital of Philadelphia. While 99 percent of infants, 96 percent of four-to-eight-year-olds and 93 percent of nine-to 12-year-olds were restrained in the rear seat, only 70 percent of 20 to 54-year-olds were buckled.
- Rear seat belt use by passengers in fatal crashes was lower than front seat belt use in almost every state and was substantially lower in many states.
- In 2018, 803 unbelted rear seat passenger vehicle occupants age eight and older died in traffic crashes in the United States. More than 400 of these occupants would have survived if they had worn their seat belts.
- Unbelted rear seat passengers pose a serious threat to the driver and other vehicle occupants, as well as themselves. Unbelted rear seat passengers are known as “back seat bullets” because they can be thrust at high rates of speed into the driver resulting in loss of control of the vehicle and into other occupants causing fatalities and serious injuries. The chance of death for a belted driver seated directly in front of an unrestrained passenger in a serious head-on crash was 2.27 times higher than if seated in front of a restrained passenger.
- An IIHS poll found that nearly 40 percent of people surveyed said they sometimes don’t buckle up in the rear seat because there is no law requiring it. If such a law existed, 60 percent of poll respondents said it would convince them to use seat belts in the back seat.
Seat Belt Use and Costs
- The NHTSA estimated that needless deaths and injuries resulting from non-use of seat belts cost society more than $10 billion annually in medical care, lost productivity, and other injury related costs based on 2010 data. When adjusted solely for inflation, this would equate to more than $12 billion.
- Non-use of restraints cost employers $7.4 billion in 2018 (expressed in 2019 dollars), $5.7 billion of which was attributed to off-the-job non-restraint use.
- The average inpatient costs for crash victims who don’t use seat belts are 55 percent higher than for those who use them.
- Regarding personal choice and individual rights in relation to highway safety laws, the U.S. District Court for Massachusetts held in a decision affirmed by the U.S. Supreme Court that, “…from the moment of injury, society picks the person up off the highway; delivers him to a municipal hospital and municipal doctors; provides him with unemployment compensation if, after recovery, he cannot replace his lost job; and, if the injury causes disability, may assume the responsibility for his and his family’s continued subsistence.”
- If every state with a secondary seat belt law upgraded to primary enforcement, about 1,000 lives and $4 billion (2005 US$) in crash costs could be saved every year. When adjusted solely for inflation, the cost is nearly $5.5 billion.
Rear Seat Safety Improvements Lagging Behind Front Seat
- Front seat safety improvements in recent model vehicles have closed the gap that formerly made rear seats safer than the front. Advances in safety technology have lagged in the rear seat.
- Current regulation does not require an evaluation of injuries to rear seat occupants in frontal crashes. In terms of frontal crashes, only the strength of seatbelts is evaluated in the rear seat, unlike regulations for the front seat which ensure that occupants do not suffer bodily harm by evaluating injuries of the head, neck, chest, pelvis and legs.
- To ensure rear seat safety improvements and testing are consistent with the front seat, the creation of a rear seat crashworthiness rating is needed as well as safety technology upgrades such as inflatable seat belts, rear seat belt reminders, seat belt pre-tensioners and load limiters.
- The Moving Ahead for Progress in the 21st Century Act (MAP-21) required the U.S. Department of Transportation to issue a final rule on rear seat belt reminders by 2015. The rulemaking process remains incomplete as of October 2021.
Primary Enforcement of Seat Belt Laws: Reports Addressing Racial Profiling Concerns
While numerous studies report that primary enforcement seat belt laws do not result in increased ticketing of people of color, the potential for harassment is an ongoing concern that is not limited to, nor created by, these laws.
- Meharry Medical College Study: Overall rates of seat belt compliance improved in states with primary laws compared to those with secondary laws, an 18 percent and 15 percent increase among black and white motorists, respectively. The study concluded that “black-white disparities in seat belt use were mitigated in states with primary seat belt laws,” and that “enacting primary laws in other states might reduce or eliminate racial disparities in seat belt use.”
- Meharry Medical College Study: In secondary law states, black motorists were only 67 percent as likely to wear seat belts in urban areas as white motorists.
- American Journal of Preventive Medicine: Studies of states that changed from a secondary to a primary law found either no difference in the rate of white versus non-white drivers ticketed or they found a greater increase in the proportion of white drivers ticketed after the enactment of a primary law.
- NHTSA Study of the change to primary enforcement laws in Oklahoma, Maryland and the District of Columbia made the following determinations:
- “…citation data that identified race confirmed there was either no difference in non-white versus white ticketing, comparing secondary to primary enforcement, or a greater increase in ticketing went to whites following the change to a primary enforcement law.”
- “Non-whites more than whites reported feeling the threat of receiving a ticket for not wearing a safety belt, even though there was no significant relationship between race and those who actually received a safety belt ticket.”
- NHTSA Study: The relationship between primary enforcement belt laws and minority ticketing, the share of citations for Hispanics and African Americans changed very little after states adopted primary enforcement belt laws. In fact, there were significant gains in seat belt use among all ethnic groups, none of which were proportionately greater in any minority group.
- 2021 NHTSA Study, Seat Belt Use, Race, and Hispanic Origin: Support for primary enforcement seat belt laws is strong across races including Asian, Black, Hispanic, Multiracial and White. A range from 69 percent (Multiracial) through 89 percent (Asian) agreed that “police should be allowed to stop a vehicle if they observe a seat belt violation when no other traffic laws are being broken.”
Advanced Vehicle Safety Technology
Proven and available safety technology, including automatic emergency braking, lane departure warning and blind spot detection and other advanced driver assistance systems (ADAS), should be required in all new vehicles, with a minimum performance standard, to prevent and mitigate common crash causes. When a safety feature is mass produced, costs for the systems are reduced, making them more affordable for consumers of new cars. Minimum performance standards ensure that the technology offers at least a certain level of safety regardless of manufacturer.
While proven safety technology will help to prevent crashes, seat belts are the first line of defense against injury for an occupant in a crash. According to NHTSA, airbags are lifesavers as well, but they are supplemental protection and are designed to work best in combination with seat belts. NHTSA estimates that the combination of an airbag plus a lap and shoulder belt reduces the risk of death in frontal crashes by 61 percent, compared with a 50 percent reduction for belts alone and a 34 percent reduction for airbags alone.
For a full list of citations, please download our Primary Enforcement Seat Belt Law Fact Sheet.