Publication Date: 
Wednesday, July 31, 2019

The Problem: In 2018, the seatbelt usage rate in the U.S. was 89.6%. Seat belt usage saved an estimated 14,955 lives in 2017. National Highway Traffic Safety Administration (NHTSA)  However, despite rising rates of safety belt use in the United States over the past 20 years, a lack of usage can lead to long-term chronic health consequences as well as death. David J. Houston and Lilliard E. Richardson, Jr. Getting Americans to buckle up: The efficacy of state seat belt laws.Accident Analysis and Prevention, 37 (2005) 1114–1120, at 1114. 

The Law: Enhanced enforcement of safety belt laws may include increased numbers of officers on patrol, increased numbers of tickets issued for safety belt violations during normal patrols, and setting up safety belt checkpoints. Dinh-Zarr TB, et al. Reviews of evidence regarding interventions to increase the use of safety belts. Am J Prev Med. 2001;21(4S): 48-65. These programs are usually publicized through media campaigns. Enhanced enforcement programs usually take the form of short, intense efforts (called waves or blitzes) lasting for days or weeks.

The Evidence: The Community Guide reviewed 15 studies that measuring the effectiveness of enhanced enforcement programs, focusing on programs that targeted safety belt use and excluding studies of programs that simultaneously targeted other driving practices. Dinh-Zarr TB, et al. Reviews of evidence regarding interventions to increase the use of safety belts. Am J Prev Med. 2001;21(4S): 48-65.  The reviewed studies analyzed a variety of city, county, state, provincial and national programs in the United States and Canada. Enhanced enforcement programs were found to be effective in reducing both fatal and nonfatal injuries as well as in increasing the frequency of safety belt use.  The two studies measuring the effects of enhanced enforcement programs on injury rates found a reduction of 7 percent and 15 percent. Across the studies, the median increase in safety belt use was 16 percent.  

The Bottom Line: Seat belt laws work, and there is strong evidence that enhanced seat belt enforcement interventions can substantially increase seat belt use and its associated benefits.

Additional Information: The Community Guide provides an online table listing the enhanced enforcement programs underlying the reviewed studies.

Impact: Effective