By Barbara Westlake-Kenny

Seat belt researcher
In February of 1997, 25-year-old Wendy Nolan Moss ran off a rural north Georgia road one mile from her home, hitting a tree and dying instantly of a massive head injury. For reasons no one understands, she was not wearing a seat belt.

Wendy was a seat-belt user, say friends who had ridden with her. “She wouldn’t even put her car in drive without buckling up first,” said one good friend at Wendy’s funeral last year. “And she would make sure we did, too. We just can’t understand why she didn’t do it that night.”

Each year, more than 40,000 Americans are killed in motor vehicle crashes. The carnage on our American roadways has far eclipsed the death toll of all our wars combined. Nearly every American family has been touched in some way. In fact, traffic accidents are the number one cause of death for Americans age 5 to 34—and public health officials insist that up to half of these lives could be saved if everyone wore seat belts.

More than 70 percent of the 1,020 people killed in crashes on Alabama roads in 1996 weren’t wearing seat belts, according to an Alabama Department of Public Health survey. In fact, Alabama has one of the lowest rates of seat-belt usage in the nation. Not surprisingly, our state ranks 12th in the nation for deaths on its roadways.

Why Seat Belts Work

According to the National Highway Transportation Safety Administration (NHTSA), lap-shoulder belt systems reduce the risk of fatality and serious injury by 50 percent when used by drivers and front-seat passengers. “Seat belts are your first line of defense against injuries or death,” declares Ricardo Martinez, NHTSA administrator. From 1975 through 1996, it is estimated that safety belts saved 90,425 lives, including 10,414 lives saved in 1996.

Kenneth Mann, Ph.D., of UAB’s Biomedical Engineering Department, says that the three-point safety-belt restraint, which includes a combination of lap belt and shoulder-to-hip belt, “protects the internal organs in a crash as it controls the forward motion of the body and the accompanying rotation of the pelvis.” The device, he says, also minimizes head contacts and excessive neck motion, preventing head and neck injuries.

When crashes occur, unrestrained drivers are thrown against their steering wheels or ejected from their cars, while unbelted passengers hit the dashboard or go through the windshield. People who are ejected in crashes are 25 times more likely to be killed than those who remain within the vehicle.

Paying the Price

Vehicle crash costs also skyrocket when occupants aren’t wearing seat belts, because unbelted victims sustain more severe injuries. Of the people who survive car crashes, unbelted victims stay three-to-five times longer in a hospital and incur two-to-seven times the medical costs of those wearing safety belts, according to the NHTSA.

Failure of some to wear safety belts also affects everyone through higher insurance premiums, higher medical costs, and higher taxes. In fact, the taxpayer burden caused by those who fail to wear seat belts is estimated to be around $137 billion every year—more than $10 billion in medical costs alone. Ironically, studies show that unrestrained victims are more frequently uninsured, underinsured, or supported by the government through workers’ compensation, Medicare, or Medicaid. They also tend to be less educated than those who do wear seat belts.

An Unenforceable “Law”

Drivers in the Southeast are less likely to buckle up than the rest of the nation’s drivers, and the fatal crash rate in the region is 20 percent higher than in other parts of the United States.

Reasons for the Southeast’s higher traffic death rates are varied. First of all, the region has a large number of rural roads, which its population uses more than interstate highways. Interstates are considered safer because they provide more driving lanes and better visibility than rural roads (and thus fewer reasons for sudden braking). When a vehicle crashes on a secondary road and the passengers are not wearing seat belts, the consequences are typically more serious than if the wreck occurs along a major highway.

According to NHTSA research, 75 percent of all traffic deaths and injuries occur within 25 miles of victims’ homes, at speeds of less than 40 miles per hour. Being thrown against a dashboard in a 30 mile-per-hour crash is like striking the ground after falling from a third-floor window. Even a crash at only 12 miles per hour can be fatal.

The Southeast also has fewer states with “primary” seat-belt laws—which authorize officers to ticket drivers specifically for not buckling up. According to a recent NHTSA study, states with primary safety-belt laws have usage rates 10-to-15 percent higher than states with secondary laws and so have lower death and injury rates.

Most Southeastern states, including Alabama, have “secondary” laws that make it impossible for officers to stop drivers solely because of failure to wear safety belts. Instead, drivers must be detained for other violations before officers can write seat-belt violation tickets. Alabama passed its secondary seat-belt law in 1991, and legislation to make it a primary law is now pending.

Infringement of Rights?

Denise Hornbuckle, who until recently served as UAB’s prevention and highway safety coordinator in the School of Medicine’s Department of Psychiatry, says that many surveys have been done to try to determine why some people don’t use their seat belts. “Some say they’re afraid of being trapped in their vehicle if it goes into water or catches fire,” she says. “Others say they’d rather be thrown from a car than remain in it—yet 70 percent of people thrown from vehicles are killed, and the majority of the survivors sustain irreversible brain injuries.

“Some find seat belts uncomfortable—particularly the chest strap—or they complain that seat belts wrinkle their clothes. A few people even feel they shouldn’t be forced to wear a seat belt—that seat-belt legislation is an infringement of rights.

“But I think the biggest problem is just not being in the habit. People simply need a little incentive to use their seat belts, and, once they get in the habit, they will continue because they get used to the feeling of security a seat belt provides.

“Families with young children are far more likely to buckle up, partly because their kids get the message in school and pass it on to their parents.”

Seat-belt advocates say that requiring belts to be used in a moving vehicle is no more an infringement of personal rights than requiring motorists to obey speed limits or traffic signals. Both, they point out, are within government authority and its obligation to protect its citizens.

This article originally appeared in the Spring 1998 issue of UAB Magazine