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Increased Safety-Belt Use -- United States, 1991

From 1980 to 1990, safety-belt use among passenger-vehicle drivers in the United States increased from 11% to 49%; in 1990, use of safety belts prevented approximately 4800 deaths and 120,000 serious injuries among front-seat occupants (1). The increased use of safety belts from 1984 through 1990 was associated primarily with the enactment of state laws (Figure 1). In recent years, however, the rate of increase in use has declined. To increase safety-belt and child passenger restraint use in the United States, in February 1991, the National Highway Traffic Safety Administration (NHTSA) initiated the "70% by `92" program to increase safety-belt use to 70% by the end of 1992 through emphasis on enforcement efforts combined with public awareness campaigns. This report summarizes an assessment of the impact of the program through 1991.

The two primary components of the "70% by `92" program are 1) Operation Buckle Down, a program designed to increase safety-belt use among police and to encourage enforcement of safety-belt laws; and 2) public information campaigns during the summers (i.e., mid-May through mid-September) of 1991 and 1992. Specific program activities designed to be coordinated at the community level include enforcement, public information, media events, and local-use surveys.

In February 1991, NHTSA regional offices and state highway safety offices initiated efforts to enlist community participation in the "70% by `92" program. Through September 1991, approximately 11,000 of the estimated 20,000 local enforcement agencies in the United States had been contacted; of these, approximately 3700 agreed to participate in program activities (2). The impact of the program during 1991 was assessed by comparing changes in safety-belt law enforcement levels and safety-belt use rates during 1990 and 1991.

Enforcement levels for 1990 and 1991 were assessed by examining citation rates (per million licensed drivers) reported through the Combined Accident Reduction Effort (CARE), a cooperative traffic-safety law enforcement effort sponsored by member law enforcement agencies in each of the 50 states and the District of Columbia. During 1990 and 1991, substantial increases in enforcement levels were documented for each of the three summer holiday periods; the greatest change occurred during the Independence Day holiday period (i.e., June 16-July 21), when citation rates increased 226% from 1990 (3).

Changes in rates of safety-belt use were assessed by examining results from local, state, and national observational surveys. During the Independence Day period, predata and postdata from 186 jurisdictions in 30 states indicated safety-belt use increased an average of seven percentage points. During the Labor Day period (i.e., August 18-September 15) predata and postdata from 390 jurisdictions in 33 states indicated safety-belt use increased an average of four percentage points. Seventy-three jurisdictions submitted three sets of safety-belt use data: pre-Independence Day (June 16), post-Independence Day (July 21), and post-Labor Day (September 15). For these jurisdictions, the average pre-Independence Day/post-Labor Day use increased 11 percentage points, from 48% to 59%. During September and October 1991, state surveys indicated safety-belt use achieved a population-weighted average for all states of 59%. Weighting these rates by annual vehicle miles traveled per state also indicated an average of 59%.

Safety-belt use rates also were assessed by analyzing data from the NHTSA 19-city survey, a trend analysis that uses quarterly observations of safety-belt use in 19 U.S. cities. The average use rate for drivers in these 19 cities increased from 50% during the first quarter of 1991 to 54% during the third quarter, immediately following the summer campaign (4).

Reported by: J Michael, J Nichol, Office of Occupant Protection, National Highway Traffic Safety Administration. Unintentional Injuries Section, Epidemiology Br, Div of Injury Control, National Center for Environmental Health and Injury Control, CDC.

Editorial Note

Editorial Note: In states with safety-belt use laws, belt use typically increases initially, then decreases modestly in the absence of enforcement, and finally stabilizes at 40%-50%. Public information and education programs without accompanying enforcement have been ineffective in changing these postlaw stabilization rates. However, evaluation data from communities participating in the "70% by `92" program suggest that the enforcement/public information approach might substantially increase safety-belt use rates. Based on previous research and program experience, this approach has the potential for increasing safety-belt use beyond the program goal of 70% (5). Assessment of statewide programs in California, Hawaii, Maryland, and Texas and demonstration projects in various Illinois, New York, and Texas cities indicate that gains of 10-30 percentage points can be achieved through highly publicized enforcement. In some localities, use rates of 70%-80% have been attained (5). In Canada, an enforcement/public information campaign was associated with an increase in the national safety-belt use rate from 58% in October 1985 to 86% in October 1991 (6).

The midterm assessment of the "70% by `92" program is subject to at least three limitations. First, the CARE citation data, used to determine the level of enforcement, are based only on the activity of state police and highway patrol agencies and only on designated roadways and, therefore, do not reflect all safety-belt and child passenger safety enforcement efforts within any state. Nonetheless, because of the relatively standard and consistent reporting procedures used, CARE data provide a useful index of enforcement levels. Second, because the safety-belt use surveys were not uniform in their sampling methods, statistical measures of significance could not be applied to results; however, the data clearly indicate a trend toward increased safety-belt use. Third, the enactment of safety-belt use laws in several states may have increased safety-belt use during 1991. Mandatory-use laws in Alabama, Arkansas, and Rhode Island took effect during the summer months, and use laws in Arizona and Oregon became effective within 6 months before the beginning of the campaign.

Reports on specific community activities indicate that, although law enforcement of safety-belt use has increased substantially in many areas, the public information component of the approach has not been as strong. Local public awareness efforts, particularly media events that highlight community campaigns, must be emphasized continually throughout the "70% by `92" program.

Because of the need for increased and sustained community support of local enforcement agencies' efforts to enforce safety-belt laws, the second year of the program will emphasize establishment of contacts between law enforcement agencies and community leaders, especially public health and health-care providers. Further information regarding the "70% by `92" program is available from NHTSA's Office of Occupant Protection, telephone (202) 366-9294.


  1. National Highway Traffic Safety Administration. Occupant protection facts. Washington, DC: US Department of Transportation, National Highway Traffic Safety Administration, 1991.

  2. National Highway Traffic Safety Administration. An assessment of the 1991 summer campaign: to increase safety belt and child safety usage. Washington, DC: US Department of Transportation, National Highway Traffic Safety Administration, 1992.

  3. Operation C.A.R.E. Operation C.A.R.E.: 1990 annual report. Richmond, Virginia: Operation C.A.R.E., 1991.

  4. National Highway Traffic Safety Administration. Occupant protection trends in 19 cities. Washington, DC: US Department of Transportation, National Highway Traffic Safety Administration, 1991.

  5. Smith MF, Furman SM. Evaluation of FY 1987 safety belt use law state enforcement grants. Washington, DC: US Department of Transportation, National Highway Traffic Safety Administration, 1991; report no. DOT-HS- 807-715.

  6. Road Safety Directorate. Estimates of shoulder safety belt use from annual surveys, 1980 to 1991. Ottawa, Ontario: Transport Canada, Road Safety Directorate, 1991.

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