Online-only: Many parents ignore child safety seat recommendations
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* Teddi Dineley Johnson

Keeping their precious cargo safe in the car is a responsibility parents and caregivers take seriously. But a new study published in the *American Journal of Preventive Medicine* finds many parents are slacking off when it comes to following child passenger safety recommendations.

Released in August, the study found that many parents and caregivers are choosing to ignore recommended age-appropriate child passenger restraints, and many children are being placed at risk by being permitted to ride in the front seat.

Conducted by researchers at the University of Michigan, the study uncovered persistent differences in the numbers of black and Hispanic children who were unrestrained compared with white children, ranging from a ten-fold difference among infants and toddlers to a two-fold difference for older children. Among children younger than 3, only 17 percent of whites used rear-facing car seats, although minority groups were even less likely to put their toddlers in rear-facing car seats. Moreover, minority children were more likely to be transitioned to seat belts before they were old enough.

To help parents ensure that kids ride as safely as possible, the American Academy of Pediatrics in 2011 issued new guidelines for child passenger safety. The guidelines call for rear-facing car seats until at least age 2; forward-facing car seats with a five-point harness for as long as possible, or until the child is the maximum weight and height suggested by the manufacturer; booster seats until an adult seat belt fits properly, or when a child reaches the height of 57 inches — which is the average height of an 11-year-old; and riding in the back seat until age 13.

“We found that few children remain rear-facing after age 1, fewer than 2 percent use a booster seat after age 7 (and) many over age 6 sit in the front seat,” said study co-author Michelle Macy, MD, MS, of the University of Michigan’s Child Health Evaluation and Research Unit.

In conducting the study, researchers evaluated data from the National Highway Traffic Safety Administration’s National Survey on the Use of Booster Seats. Additionally, trained data collectors observed 21,476 children, recording data about drivers with child passengers as they arrived at community sites such as gas stations, fast food restaurants, recreation centers and child care centers. The investigators recorded child restraint types and seat row, adult and child gender, driver restraint use and vehicle type. Drivers were asked to state their ages and the ages of the children they were transporting, as well as the children’s race and ethnicity.

“The most important finding from this study is that, while age and racial disparities exist, overall few children are using the restraints recommended for their age group, and many children over 5 are sitting in the front seat,” Macy said. “Our findings demonstrate that not all children have been reached equally by community-based public education campaigns and the passage of child safety seat laws in 48 states.”

According to the researchers, the findings may lead to the development of strategies to lower the racial and ethnic disparities seen in children experiencing crash-related injuries.

For more information or to obtain a copy of the study, visit [http://www.ajpmonline.org/webfiles/images/journals/amepre/AMEPRE\_3475-stamped.pdf](http://www.ajpmonline.org/webfiles/images/journals/amepre/AMEPRE_3475-stamped.pdf).

*   Copyright The Nation’s Health, American Public Health Association