Expert Commentary

Seat belt use in America: A primer and research roundup

U.S. road deaths are approaching their highest levels in over a decade. We explore research offering potential solutions to get more Americans to buckle up.

seat belt
(Chris Martin / Unsplash)

This piece was updated on May 18, 2022, to reflect new crash death estimates from the federal government covering all of 2021.

Upcoming long weekends like Memorial Day and Independence Day will mean more Americans behind the wheel, so it’s a good time for journalists to remind audiences that a simple action — buckling a seat belt — can prevent tragedy.

Nearly 43,000 people were killed in motor vehicle crashes in 2021, according to new statistical modeling estimates from the National Highway Traffic Safety Administration.

That means last year was the deadliest on U.S. roads since 2005.

It also marks a continuation of high fatality rates — a measure of crash deaths relative to miles driven — since the pandemic began, which stand at levels unseen in over a decade.

Department of Transportation Secretary Pete Buttigieg in February called rising crash fatalities during the COVID-19 pandemic a “national crisis.”

NHTSA research published in October 2021 links those deaths with speeding, drunk driving and less seat belt use among people in crashes.

Coming soon: driving season

People were ejected from their vehicles at higher rates through most of 2020 and 2021 compared with 2019, though ejection rates in 2021 were lower than in 2020.

An ejection typically indicates a severe crash and that the person ejected was not wearing their seat belt, according to the NHTSA research from last fall.

Seat belts saved 14,955 lives in 2017, the most recent year those estimates are available from NHTSA.

An additional 2,549 lives could have been saved in 2017 if everyone wore a seat belt, according to NHTSA.

Since 1975, seat belts have saved 374,276 lives and would have prevented another 386,719 deaths if they had been universally used.

It’s too soon to tell how seat belt use and ejection rates will fare this year. While high gas prices could keep some Americans from driving this summer, government projections suggest otherwise.

The U.S. Energy Information Administration forecasts $3.84 per gallon during summer driving season.

That would put gas prices nearly 80 cents higher on average than last summer.

Still, the EIA forecasts more gasoline consumption this summer than last summer — meaning more driving.

The agency points to low unemployment and “decreasing effects of the COVID-19 pandemic on travel” as factors for the rosy summer travel outlook.

Stagnating seat belt use rates

Despite rising crash fatalities, seat belt use rates nationally among drivers and passengers remain historically high at over 90% each year from 2019 to 2021 — though the 2021 rate of 90.4% is slightly down from the 2019 rate of 90.7%.

But seat belt use has stagnated.

According to NHTSA, “gains have plateaued in recent years, and traffic safety researchers seek to understand why approximately 10% of the U.S. population does not consistently wear a seat belt while driving, and a much larger portion admit to not consistently wearing belts when riding in rear seats or other situations.”

Parsing the seat belt use data reveals potential areas for improvement.

For example, seat belt use rates vary by state, suggesting there is work to do in certain parts of the country.

The most recent data for seat belt use by state comes from 2019 — because of the pandemic, NHTSA gave states a pass on conducting seat belt use surveys in 2020. Those surveys usually happen in June, the month after the federal government and state governments launch their Click It or Ticket marketing campaigns.

Click It or Ticket advertisements run on TV, radio, digital and social media, roadside billboards and other media. The annual campaign to encourage seat belt use began in 2003 and targets 18-to-34 year old men.

The 2021 national budget was $8 million.

New Hampshire is the only state that does not require adult drivers and front seat passengers to wear seat belts. With a rate of 71% in 2019, New Hampshire is last in the nation for seat belt use, according to the 2019 NHTSA data.

Other states below 80% include South Dakota, Wyoming and Nebraska.

At a rate of 97%, Hawaii tops the nation in seat belt use. Other states over 95% include California, Georgia and Oregon, as well as the District of Columbia.

The federal government provides millions of dollars in grants to states that enact laws promoting road safety, including if states meet certain thresholds for seat belt use.

Those thresholds vary by state based on past seat belt use rates.

California, for example, had a target of 97.5% seat belt use in 2019. Wyoming had a target rate of 81.2%.

Vehicle type matters when it comes to seat belt use. Some 91% of passenger car occupants use a seat belt along with nearly 93% of van and SUV occupants.

But in pickup trucks, the rate is lower — about 86%. The rate is the same for medium and heavy-duty commercial truck drivers, according to 2016 survey data, the most recent available from the Federal Motor Carrier Safety Administration.

Nationally, urban and rural areas see roughly equal levels of seat belt use, but speeds tend to be higher in rural areas, increasing the risk of a severe crash.

Enforcement laws also make a difference. Those laws fall into two categories: primary and secondary.

  • Primary laws allow police to pull over a driver solely for not wearing a seat belt.
  • Secondary laws require police to pull over a driver for another reason before enforcing a seat belt law.

There are 34 states, plus the District of Columbia, with primary seat belt laws.

In 2019, the seat belt use rate was 92% in primary enforcement states, compared with 86% in secondary enforcement states.

First offenses for seat belt law violations can result in monetary fines of less than $25 in most states, according to the Centers for Disease Control and Prevention.

How to increase seat belt use: What the research says

Academic and government researchers have explored potential solutions to encourage people to buckle up.

One paper, “Does Driver Seat Belt use Increase Usage among Front Seat Passengers? An Exploratory Analysis,” published in May 2021 in the Journal of Safety Research, points to a nuanced angle the federal government and states could bring to their marketing campaigns.

The paper parses seat belt use data from 2017 to 2019 in Wisconsin to explore how driver seat belt use affects whether passengers buckle up.

Wisconsin’s overall seat belt use rate was just over 90% in 2019, on par with the national rate.

When a driver uses a seat belt, women in the passenger seat are more likely than men to also wear their seat belt, finds author Tracy Buchman, an assistant professor of occupational and environmental safety at the University of Wisconsin-Whitewater.

But male passengers were more likely to buckle up when the driver wearing their seat belt was a woman.

When a female driver was wearing their seat belt, male passengers buckled up 96% of the time in 2019, Buchman finds. When a male was driving and buckled, male passengers wore a seat belt 94% of the time.

The data was collected as part of the National Occupant Protection Use Survey, which NHTSA oversees and uses for its national and state figures.

All drivers were over age 16, but the paper does not break down the results by age. Buchman explains that the goal was simply to explore how driver seat belt use behavior affected passengers.

“It’s always been known males don’t wear their seat belts as often as females, so ad buys target males — and that’s valid and important,” she says. “But I think if females know they can make a difference with seat belt compliance, maybe we start targeting females with ad buys and try to get that last 5% or 10% to be even more compliant.”

Federal marketing campaigns, such as Click it or Ticket, typically try to get people who don’t wear a seat belt to buckle up. Buchman adds it’s worthwhile to consider a “multi-pronged” approach targeting drivers carrying seat-belt reluctant passengers.

“Tell your passengers to put their seat belt on,” she says, “they’ll listen to you.”

Further reading

Factors Impacting the Choice of Seat Belt Use, Accounting for Complexity of Travelers’ Behaviors
Mahdi Rezapour and Khaled Ksaiabti. Future Transportation, February 2022.

What the study shows: Based on observations of 18,286 vehicles recorded in 2019 at 289 roadside sites across Wyoming, the authors find a variety of reasons drivers don’t buckle up, including vehicle type, time of day and number of lanes on a road. Men were generally less likely to be buckled. SUV and minivan drivers were more likely to buckle, which the authors suggest could be because families are more likely to use those vehicles. Seat belt use rates in Wyoming are the third lowest in the country at 78%, according to 2019 data. But 71% of drivers in this study with out-of-state tags were unbuckled.

The authors write: “The fact that drivers in rural areas are more likely to be unbuckled is expected to be related to the drivers with non-Wyoming plate registration. This could be an indication that travelers from outside the state that come to Wyoming for a possible reason of leisure are more prone to be unbuckled. Therefore, more attention should be given to the seat belt use of outside-the-state travelers by placing billboards about seat belt use at state borders.”

Characteristics and Predictors of Occasional Seat Belt Use
Christian Richard, et. al. National Highway Traffic Safety Administration report, February 2020.

What the study shows: Drivers who only sometimes wear a seat belt tend to be older and male. The authors did not explore race and ethnicity because almost all of the participants taking 1,676 trips in the study were non-Hispanic white drivers. GPS and video data of participants were collected as part of a broader federal transportation research program. Despite drivers generally reporting they were not at greater risk when driving unbelted, participants did tend to buckle up during riskier driving situations, such as night driving.

The authors write: “It is important to note that across most of the trips reviewed, when a person buckled or unbuckled for a reason other than entering or exiting the vehicle, they generally stayed in the same buckled state until the end of the trip. As such, persistent and attention-grabbing belt reminders may be an effective way to get drivers to buckle up and remain buckled.”

Nighttime Seat Belt use among Front Seat Passengers: Does the Driver’s Belt Use Matter?
Kwaku Boakye, Ruth Shults and Jerry Everett. Journal of Safety Research, September 2019.

What the study shows: Using data collected from 33,310 vehicles across five east Tennessee counties from March 2015 to May 2017, the authors find that when drivers were belted at night, passenger seat belt use was 92%, compared with 42% when drivers didn’t buckle up.

The authors write: “This finding suggests that part-time seat belt users might be heavily influenced by the seat belt status of their traveling companions.”

Executive Function and Dangerous Driving Behaviors in Young Drivers
Yusuke Hayashi, Anne Foreman, Jonathan Friedel and Oliver Wirth. Transportation Research: Traffic Psychology and Behaviour, January 2018.

What the study shows: In a survey of 136 college students — 59 men and 77 women aged 18 to 24 at Pennsylvania State University — the authors find that not wearing a seat belt and other dangerous driving behavior, like speeding and texting, were related to poor impulse control and poor strategic planning abilities. Texting while driving, speeding and driving drunk were most closely linked to poor impulse control. Driving without a seat belt was most strongly related to poor strategic planning. Impulse control and strategic planning are part of what neuroscientists call executive function. The survey included 27 questions related to participants’ levels of executive function. The authors note that further research is needed, including larger surveys with more diverse populations.

The authors write: “These results suggest that different behavioral or cognitive processes are involved in different dangerous driving behaviors and different interventions may be needed to target each underlying process.”

Rural and Urban Differences in Passenger-Vehicle-Occupant Deaths and Seat Belt Use among Adults
Laurie Beck, Jonathan Downs, Mark Stevens, and Erin Sauber-Schatz. Morbidity and Mortality Weekly Report, Surveillance Summaries, September 2017.

What the study shows: Using national traffic fatality and seat belt use data from 2014, the authors find that death rates among people driving or riding in passenger vehicles were higher in rural versus urban areas. Seat belt use among people killed in a crash was likewise lower in rural areas.

The authors write: “Improving seat belt use remains a critical strategy to reduce crash-related deaths in the United States, especially in rural areas where seat belt use is lower and age-adjusted death rates are higher than in urban areas. States and communities can consider using evidence-based interventions to reduce rural-urban disparities in seat belt use and passenger-vehicle-occupant death rates.”