Original Article

Seatbelt Law Enforcement and Motor Vehicle Crash Fatalities Among Blacks and Whites in Louisiana and Mississippi

Authors: Robert S. Levine, MD, Nathaniel C. Briggs, MD, MSC, David G. Schlundt, PHD, Nathan Stinson, Jr, MD, PHD, MPH, Rueben C. Warren, DDS, DRPH, Irwin A. Goldzweig, MS

Abstract

Background: Seatbelt laws save lives. Primary enforcement (allowing citations solely for seatbelt nonuse) is a more effective means of saving lives, yet seven southern states have no primary laws, due in part to concern about racial profiling.


Methods: Non-Hispanic, black:white (B:W), occupant motor vehicle crash mortality rate ratios (MRRs) were compared across the 15 to 64 age range over two time periods in two demographically comparable southern states (Louisiana and Mississippi).


Results: From 1992 to 1994 (when neither state had primary law) to 1996 to 1998 (when Louisiana had primary law) B:W MRRs were 0.73 (95% confidence interval = 0.61, 0.88) and 0.72 (0.60, 0.86) in Louisiana and 1.01 (0.9, 1.12) and 1.22 (1.10, 1.35) in Mississippi.


Conclusions: Successful opposition to primary seat belt enforcement may have the unintended effect of producing racial disparities in motor vehicle crash mortality that adversely affects blacks.


Key Points


* Primary enforcement of state seatbelt laws (i.e., motorists can be cited solely for violating a seatbelt law) saves more lives than secondary enforcement (i.e., motorists can be cited for nonuse of seatbelts only after being stopped for another violation).


* Concerns about differential enforcement (racial profiling) have been a major barrier to passage of primary law legislation in the South and elsewhere.


* We compared state-specific mortality among blacks and whites in the context of a natural experiment characterized by a primary law state (Louisiana) that was geographically contiguous with, and demographically comparable to, a secondary law state (Mississippi).


* Louisiana's passage of a primary law, in combination with Mississippi's failure to do so, was associated with a significantly lower black:white motor vehicle crash mortality disparity in Louisiana, and reciprocally, a significantly higher black:white motor vehicle crash mortality disparity in Mississippi.


* Successful opposition to primary seat belt laws may have the unintended effect of worsening racial disparities in mortality.

This content is limited to qualifying members.

Existing members, please login first

If you have an existing account please login now to access this article or view purchase options.

Purchase only this article ($25)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.

References

1. National Center for Injury Prevention and Control Working to prevent and control injury in the United States: fact book for the year 2000. Atlanta, GA: Centers for Disease Control and Prevention, 2000.
 
2. Centers for Disease Control and Prevention. Web-based Injury Statistics Query and Reporting System (WSQARS). Available at: http://www.cdc.gov/ncipc/wisqars. Accessed January 4, 2006.
 
3. National Highway Traffic Safety Administration safety facts, 2002: a compilation of motor vehicle crash data from the Fatality Analysis Reporting System and the General Estimates System. Washington, DC: US Department of Transportation, National Highway Traffic Safety Administration, 2002, DOT HS 809 446.
 
4. Task Force on Community Preventive Services. Motor-vehicle occupant injury: strategies for increasing use of child safety seats, increasing use of safety belts, and reducing alcohol-impaired driving. MMWR Recommendations and Reports 2001;50 (RR07):1–13.
 
5. National Highway Traffic Safety Administration. Traffic safety facts 2002: occupant protection. Washington, DC: US Department of Transportation, National Highway Traffic Safety Administration, 2002, DOT HS 809 610.
 
6. Department of Transportation. National Highway Traffic Safety Administration. Traffic Safety Facts 1996. 1997, 808–649.
 
7. Glassbrenner D. Safety belt use in 2004 – Use rates in the states and territories. Traffic Safety Facts. Research Note, 2004, DOT HS 809 813.
 
8. Rivara FP, Thompson DC, Cummings P. Effectiveness of primary and secondary enforced seat belt laws. Am J Prev Med 1999;16(1 Suppl):30–9.
 
9. Waagenar AC, Maybee RG, Sullivan KP. Mandatory seat belt laws in eight states:a time-series evaluation. J Safety Res 1988;19:51–70.
 
10. Evans WN, Graham JD. Risk reduction or risk compensation? The case of mandatory seat belt laws. J Risk and Uncertainty 1991;4:61–73.
 
11. Winniki J. Safety belt use laws: evaluation of primary enforcement and other provisions. Washington, DC: Department of Transportation National Highway Traffic Safety Administration, 1995, DOT HS 808 324.
 
12. US Census Bureau. Census 2000. Appendix A. Geographic terms and concepts. Available at:http://www.census.gov/geo/www/tiger/glossry2.pdf. Accessed May 9, 2005.
 
13. Clark DE, Cushing BM. Predicting regional variations in mortality from motor vehicle crashes.Academic Emergency Medicine 1999;6:125–130.
 
14. Braver ER. Race, Hispanic origin, and socioeconomic status in relation to motor vehicle occupant death rates and risk factors among adults. Accid Anal Prev 2003;35:295–309.
 
15. Preusser DR, Preusser CW. Evaluation of Louisiana's safety belt law change to primary enforcement. Washington, DC: US Department of Transportation, National Highway Traffic Safety Administration. 1997, DOT HS 808 620.
 
16. Solomon MG, Nissen WJ. Evaluation of Maryland, Oklahoma, and The District of Columbia's seat belt law change to primary enforcement. Washington, DC: US Department of Transportation, National Highway Traffic Safety Administration, 2000, DOT HS 809 213.
 
17. Eby DW, Vivoda JM, Forcyce TA. The effects of standard enforcement on Michigan safety belt use.Accid Anal Prev 2002;34:815–823.
 
18. Martin M, Leonard M, Allen S, et al. Commentary: using culturally competent strategies to improve traffic safety in the black community. An Emerg Med 2004;44:414–418.
 
19. Davis JW, Bennink L, Kaups KL, et al. Motor vehicle restraints: primary versus secondary enforcement and ethnicity. J Trauma 2002;52:225–228.
 
20. Reinfurt DW, Campbell BJ, Stewart JR, et al. North Carolina's occupant restraint law: a three year evaluation. Chapel Hill, University of North Carolina Highway Safety Research Center, 1988, UNC/HSRC-88/10/5.
 
21. US Department of Transportation, National Highway Traffic Safety Administration. Highway safety needs of US Hispanic communities: issues and strategies. Washington, DC: National Highway Traffic Safety Administration, 1995, DOT HS 808 373.
 
22. Hennekens CH, Buring JE. Epidemiology in Medicine. Boston, Little Brown, 1987.
 
23. FedStats. Available at: http://www.fedstats.gov. Accessed May 9, 2005.
 
24. Armitage P, Berry G, Matthews JNS. Statistical Methods in Medical Research, 4th ed. Oxford, Blackwell Science, 2002.
 
25. Newman SC. Biostatistical Methods in Epidemiology. New York, John Wiley & Sons, 2001.
 
26. Centers for Disease Control and Prevention, National Centers for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS) [online]. Available at:http://www.cdc.gov/ncipc/wisqars. Accessed January 4, 2006.
27. National Highway Traffic Safety Administration. 1998 Motor Vehicle Occupant Safety Survey. Available at: http://www.nhtsa.dot.gov/people/injury/research/safetysurvey/1998_Vol3/CSSR_Index.hti. Accessed August 19, 2004, per Citation 18.
28. US Department of Justice Statistics. Contacts between police and the public, 1999. Available at:http://www.ojp./gov/bjs/pub/pdf/cpop99.pdf. Accessed August 19, 2004 per Citation 18.
29. United States Preventive Services Task Force. Guide to Clinical Preventive Services, 2nd ed, 1996. Available at: http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=hstat3.section.10513. Accessed May 3, 2005.
30. Ellis HM, Nelson B, Cosby O, Morgan L, et al. Achieving a credible health and safety approach to increasing seat belt use among African Americans. J Health Care Poor Underserved 2000;11:144–50.