A leading cause of child deaths in America are motor vehicle crashes.
For children 12 years and younger the proper use of a child restraint
could make the difference between moderate and severe injury, and even
death. Through uncommon access to both crash and hospital records, this
manuscript investigates the circumstantial and socioeconomic
characteristics associated with a child being properly restrained at the
time of a motor vehicle crash. Zip code level data of the childhood
crash victims are also aggregated and studied to learn of the community
factors related to restraint use. Results suggest that 10.5% of children
during the study period were either not restrained at all or improperly
restrained at the time of the crash. Properly restrained children were
between 10 and 20 times less likely to die compared to unrestrained or
improperly restrained children. Black children were some nine percentage
points, and Hispanic children were almost six percentage points, less
likely to be properly restrained compared to White children. Children
of all races covered by Medicaid were also nearly seven percentage
points less likely to be properly restrained compared to others.
Unrestrained children suffered worse injuries that resulted in higher
hospital charges and Medicaid bills compared to restrained children.
Children residing in zip codes with relatively high rates of poverty and
carlessness are especially overrepresented as not being properly
restrained. A binary logistic model estimates that children aged four
through eight are also significantly less likely to be properly
restrained. Recommendations are made for targeted interventions and for
regulatory changes to ensure greater pediatric restraint compliance.
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