Car accidents are one of the top causes of death for Americans aged 1-54 years old [4]. Luckily, seat belts are one of the most effective tools we have for reducing the risk of death or serious injury in a crash. In fact, an estimated 2,549 lives could’ve been saved in one year alone had all vehicle occupants been wearing seat belts [6].
For most of us, buckling up today is second nature. It wasn’t always this way, however, and seat belt laws were met with years of resistance [8]. While the federal government first required all new cars to have lap and shoulder belts in the front seat beginning in 1968, there were no laws mandating seat belt use at that time, and only about 11-14% of Americans were regularly using them in the late 1970s and early 1980s [9]. In 1984, New York passed the first mandatory seat belt law and many states followed suit, which is when seat belt use began to increase across the country [8].
We’ll cover these seat belt laws in more detail below, as well as how many lives have been saved by seat belts and more. Buckle up, and let’s get started.
Key takeaways
- In 2022, the national seat belt usage rate was 91.6% [10], up over 10% since 2000 [3]
- More females (93%) wear seat belts than males (88%) [5]
- Young adults (18-24), males, and adults in non-urban settings are least likely to wear seat belts [7]
- Seat belts have saved an estimated 374,276 lives from 1975-2017 [3]
- Seat belts saved 14,955 lives in 2017 alone [7]
- Seat belts reduce the risk of serious injuries and death by about 50% [7]
- 51% of passenger vehicle occupants killed were unbelted, down almost 10% since 2000 [3]
- Unrestrained occupants are 30 times more likely to be ejected from the vehicle in a car accident [11]
- By 1996, all states but New Hampshire had mandated seat belt laws in place [9]
- There have been over 1,000 seat belt recalls issued by respected brands such as Ford, Honda, GM, and Toyota since 1966 [15]
How many drivers wear seat belts?
Thankfully, nationwide seat belt use is high. About 91% of drivers and 90% of front-seat passengers reported wearing seat belts [5]. This number is slightly lower for backseat passengers at just 80% [5].
Seat belt use by demographics
In 2020, the below percentage of people in the front seat wore seat belts by gender [5]:
- Female: 93%
- Male: 88%
And age group [5]:
- 16-24: 87%
- 25-69: 91%
- 70+: 92%
Overall, the below groups are least likely to wear seat belts [7]:
- Young adults (18-24)
- Males
- Adults who live in non-urban settings (compared to those in metropolitan areas)
Saving hundreds of thousands of lives
Seat belts have saved an estimated 374,276 lives from 1975-2017, or close to 9,000 lives per year [3]. They also reduce the risk of the following [3]:
- Front seat passenger car deaths by 45%
- Serious front seat passenger car injuries by 50%
- Front seat light truck (vans, SUVs, pickups) deaths by 60%
- Serious front seat light truck injuries by 65%
Crash fatalities and seat belt usage
As seen above, seat belts greatly reduce the risk of death; however, despite the likes of audible seat belt reminders in all new cars [5], many still choose not to buckle up. Below, see the percentage of those who died wearing seat belts in 2020 compared to those who died unrestrained.
Occupants who died [3]:
- Restrained: 49.04%
- Unrestrained: 50.96%
Occupants who survived [3]:
- Restrained: 84.32%
- Unrestrained: 15.68%
Of those who died in 2020, 44% of drivers and 49% of front-seat passengers were wearing seat belts. Only 26% of back-seat passengers (13 and older) wore seat belts [5].
Seat belt deaths by demographics
When looking at demographics, male vehicle occupants are more likely to die without wearing seat belts in car accidents than females [3]:
Male occupant deaths:
- Restrained: 45.01%
- Unrestrained: 54.99%
Female occupant deaths:
- Restrained: 56.96%
- Unrestrained: 43.04%
Regarding age as a factor, the youngest and oldest occupants are least likely to die from being unrestrained [3]. See the below percentage of unrestrained vehicle passengers killed in car accidents by age [3]:
- 0-4 years old: 32%
- 5-9 years old: 46%
- 10-15 years old: 51%
- 16-20 years old: 57%
- 21-24 years old: 60%
- 25-34 years old: 61%
- 35-44 years old: 58%
- 45-54 years old: 51%
- 55-64 years old: 47%
- 65 to 74 years old: 36%
- 75 and older: 29%
Risks of being unrestrained
Wearing a seat belt keeps vehicle occupants from coming into contact with the vehicle interior or being ejected in a car crash. Unrestrained occupants are 30 times more likely to be ejected from the vehicle in a car accident [11]. To put this into perspective, about 75% of those ejected in a crash die [12].
Seat belts also prevent occupants from being thrown into other occupants in the vehicle. Simply being in a car with unrestrained occupants increases the risk of injury or death to other occupants by 40%; in a frontal crash, an unrestrained backseat passenger sitting behind a restrained driver increases the driver’s risk of death by a whopping 137% when compared to a restrained back seat passenger [5].
How do seat belts work?
Three-point seat belts include two belts in a lap and diagonal configuration, meant to hold the wearer’s lap and torso in place. By gradually decelerating restrained occupants in car crashes, the crash force is spread across stronger parts of the body.
Three-point seat belts should always be worn properly, meaning they should lie across the center of the chest and shoulder as well as the upper thighs or low on the hips [5]. What’s more, just because a car has airbags doesn’t mean seat belts aren’t needed; rather, these two safety features are meant to operate together.
Seat belt injuries and malfunctions
Of course, even if properly worn, seat belts can cause injury on impact during a crash. As three-point seat belts make contact with the wearer’s shoulder, chest, and abdomen, these are the areas that are likely to be injured by the force of impact when buckled up in a crash [12].
The most common injuries caused by seat belts during crashes are as follows [15]:
- Fractured ribs
- Bruising
- Chest and sternum injuries
- Shoulder damage
- Dislocations
- Abdominal soft tissue injury
- Herniated discs
Seat belt malfunctions
There have been over 1,000 seat belt recalls issued by respected brands such as Ford, Honda, GM, and Toyota since 1966 [15]. These are mostly due to failures and design flaws and can occur during the design, manufacture, or installation of the seat belt during a car’s build or repair. Below are some of the most common defects [15]:
- False latching: the seat belt doesn’t properly engage when needed
- Inertial unlatching: the seat belt unlatches on impact
- Webbing issues: the mesh webbing material that makes up a seat belt breaks during a crash
- Retractor failure: the retractor that locks to hold wearers in place either fails or releases too much slack
- System mounted improperly: the adjustable anchor system malfunctions
Defective seat belts can lead to serious injury or death. For example, if a seatbelt fails, the wearer can be ejected from the vehicle in an accident and may sustain neck and spinal cord injuries which can result in paralysis [15].
Seat belt laws
While recalls minimize the risk of death and serious injury when wearing seat belts, laws reduce the risk of death or serious injury by not wearing seat belts. By 1996, all states but New Hampshire had mandated seat belt laws in place [9]. By 2000, usage rates had reached around 80%; today’s usage rates have climbed about 10% over the last two decades as well [3].
As with many laws, seat belt laws vary by state. These depend largely on age and seating placement within the car. However, seat belt laws can be categorized into two distinct groupings: primary and secondary.
Primary seat belt laws are those which allow police officers to pull over vehicles and ticket occupants who aren’t wearing seat belts, regardless of whether or not another traffic offense was committed [1]. Secondary seat belt laws only allow police officers to ticket unrestrained drivers and passengers if, and only if, they were first pulled over for another offense [1].
Below is more information regarding adult seat belt laws [1]:
- 34 states, in addition to Washington, D.C., have primary seat belt laws in place for drivers and front seat passengers.
- 15 states have secondary seat belt laws for drivers and front seat passengers
- 40 states, as well as Washington, D.C., have laws to enforce rear seat belt use
- New Hampshire is the only state without adult seat belt laws. This state does, however, have a primary child seat belt law, requiring all drivers and passengers under the age of 18 in any seat to wear seat belts.
Child seat belt laws
Regarding child seat belt laws, every state has child safety requirements in place, but they vary based on age, height, and weight [2]. Many laws require children to sit in the backseat, with most states requiring children over a certain age, height, and weight to use seat belts [2].
Penalties range from $10-$500 fines up to points on a violator’s driver’s license [2].
Below is more information regarding child laws [2]:
- Most states, including Washington, D.C., require children who have outgrown car seats but are still too small for adult seat belts to use booster seats (or similar)
- 23 states plus Washington, D.C. require rear-facing car seats for children younger than two
Effectiveness of these laws
As previously mentioned, seat belts were a point of contention for years. The most recent seat belt usage rates of about 91.6% are roughly 6.5 times the usage rate seen in 1983, the year before the first seat belt law was passed, which was significantly low at about 14% [5].
Interestingly, states with primary laws see higher seat belt usage rates (92%) compared to those with secondary seat belt laws (85%) [7]. Primary seat belt laws also prevent more deaths than secondary laws [9].
The lowest usage rates are seen in New Hampshire. True to its “live free or die” motto, New Hampshire is the only state without any mandatory seat belt laws for adults, which is why we see the state’s usage rates at about 20% lower than the national average [8].
Conclusion
Overall, our national seat belt usage is high, with the vast majority of Americans buckling up. While not every state has primary laws, or even any seat belt laws (looking at you, New Hampshire), that doesn’t mean seat belts shouldn’t be worn.
They have saved hundreds of thousands of lives since 1975 and are one of the most effective ways to reduce your risk of death in a car crash. Hopefully, these statistics have served to inform you, as both drivers and passengers, of the risk you take when not using seat belts.
Sources:
- Governors Highway Safety Association
- Governors Highway Safety Association
- National Safety Council
- Centers For Disease Control and Prevention
- Insurance Institute for Highway Safety
- Centers For Disease Control and Prevention
- Centers For Disease Control and Prevention
- History
- Centers For Disease Control and Prevention
- NHTSA
- Children’s Hospital of Philadelphia
- Wikipedia
- CDC
- National Highway Traffic Safety Administration
- StatsPearls
