Arrive Alive

Injury Facts in the United States


Injury Facts in the United States 

The importance of law enforcement as well as guidance to parents on child safety are emphasized by the statistical information that has become available after extensive research in the United States.

Motor Vehicle Occupant Injury 

The Facts

Motor vehicle crashes remain the leading cause of unintentional injury-related death among children ages 14 and under. Child safety seats and safety belts, when installed and used correctly, can prevent injuries and save lives. Unrestrained children are more likely to be injured, suffer severe injuries and die in motor vehicle crashes than children who are restrained.


  • In 2001, 1,579 child occupants ages 14 and under died in motor vehicle crashes. 

  • In 2002, an estimated 227,000 children ages 14 and under were injured as occupants in motor vehicle-related crashes. 

  • In addition to physical trauma, motor vehicle injuries can have long-lasting psychological effects. One study showed that 25 percent of children, who suffered from traffic injuries, and 15 percent of their parents, were later diagnosed with post-traumatic stress disorder. 

  • As of January 1, 2004, 141 children have been killed by passenger air bags. Approximately 92 percent of these deaths were among children either unrestrained or improperly restrained at the time of the crash, including 23 infants in rear-facing child safety seats in front of a passenger air bag.


  • Seventy-five percent of motor vehicle crashes occur within 25 miles of home. In addition, 60 percent of crashes occur on roads with posted speed limits of 40 mph or less

  • Rural areas have higher motor vehicle crash incidence rates and death rates than urban areas. In addition, crashes in rural areas tend to be more severe. 

  • In 2002, 22 percent of all traffic deaths among children ages 14 and under involved alcohol. Of the children killed in alcohol-related crashes, more than half were passengers in vehicles with drunk drivers. Child restraint use decreases as both the age of the child and the blood alcohol level of the child’s driver increase.


  • Approximately 14 percent of children ages 14 and under ride unrestrained. Riding unrestrained is the greatest risk factor for death and injury among child occupants of motor vehicles. Among children ages 14 and under killed as occupants in motor vehicle crashes in 2002, 50 percent were not using safety restraints at the time of the collision. 

  • Inappropriately restrained children are nearly three and a half times more likely to be seriously injured in a crash than their appropriately restrained counterparts. 

  • Incorrect use of child safety seats is widespread. Although 96 percent of parents believe they install and use their child safety seats correctly, it is estimated that 82 percent of child safety seats are not installed and used correctly. 

  • Driver safety belt use is positively associated with child restraint use. In a recent study, nearly 40 percent of children riding with unbelted drivers were completely unrestrained, compared with only 5 percent of children riding with belted drivers. 

  • The back seat is the safest place for children to ride. It is estimated that children ages 12 and under are 36 percent less likely to die in a crash if seated in the rear of a passenger vehicle than if seated in the front seat. 

  • It is estimated that one-third of children ride in the front passenger seat, many in front of passenger air bags. Children traveling with unbelted drivers, those who are sole passengers and those ages 6 and over are more likely to be seated in front. 

  • Restraint use is lower in rural areas and low-income communities. Lack of access to affordable child safety seats contributes to a lower usage rate among low-income families. However, 95 percent of low-income families who own a child safety seat use it. 

  • American Indian and Alaska Native children ages 14 and under have a motor vehicle occupant death rate more than twice that of white children. The motor vehicle occupant death rate for Hispanic children ages 4 and under is 27 percent higher than that for non-Hispanic children.


  • Child safety seats are extremely effective when correctly installed and used in passenger cars, reducing the risk of death by 71 percent for infants and 54 percent for children ages 1 to 4, and reducing the need for hospitalization by 69 percent for children ages 4 and under. 

  • From 1975 through 2002, the lives of an estimated 6,567 children were saved by the use of child safety seats or adult safety belts. If all child passengers ages 14 and under were restrained properly, an estimated 182,000 serious injuries could be prevented annually. 

  • Adult safety belts do not adequately protect children under age 8 from injury in a crash. However, it is estimated that 83 percent of children ages 4 to 8 ride improperly restrained in adult safety belts. Although belt-positioning booster seats are the best way to protect them, only 19 percent of children who should be restrained in booster seats use them. 

  • The use of these belt-positioning booster seats lowers the risk of injury to children in crashes by 59 percent compared to the use of adult safety belts. The distribution of free seats accompanied by educational training can dramatically increase the use of booster seats among children ages 4 to 6. 

  • According to a recent survey, 61 percent of parents whose children were using booster seats cited safety as their primary concern, while 56 percent of parents whose children were not using booster seats believed their child was too big for a child safety seat.


  • All 50 states and the District of Columbia have child occupant protection laws, which vary widely in their age requirements, exemptions, enforcement procedures and penalties. 

  • Twenty-two states and the District of Columbia have improved their laws to require some older children to ride in booster seats. Twelve states require children of certain ages to ride in the rear seat of a motor vehicle. 

  • Only 20 states and the District of Columbia have primary (standard) enforcement of safety belt laws. One study has found that child restraint use increased from 45 percent to 82 percent in the two years following the passage of that state’s primary enforcement law for adult safety belts. 

  • Child occupant protection and safety belt legislation has been proven effective at increasing restraint use. Ninety percent of Americans favor stronger enforcement of laws that require all children to be buckled up.


  • The total annual cost of motor vehicle occupant-related death and injury exceeds $25.8 billion for all children ages 14 and under. 

  • Every dollar spent on a child safety seat saves this country $32.


  • All children ages 12 and under should be properly restrained in the back seat on every ride. 

  • Infants should ride in rear-facing safety seats as long as possible, until they are at least 12 months old and weigh at least 20 pounds. Children, who are at least 1 year old, weigh 20 to 40 pounds, and can no longer ride rear-facing should ride in forward-facing child safety seats. 

  • Children over 40 pounds should be correctly secured in belt-positioning booster seats or other appropriate child restraints until the adult lap and shoulder belts fit correctly (around age 8). 

  • Any child safety seat must be installed and used according to the manufacturer's instructions and vehicle owner's manual. 

[Information made available by the National SAFE KIDS Campaign]

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