Tribal Road Safety: Get the Facts
- Motor vehicle traffic crashes are a leading cause of death for American Indian and Alaska Native people.1
- Motor vehicle traffic crash death rates among American Indian and Alaska Native children and youth age 0–19 years were about 2 to 5 times higher than those of other racial and ethnic groups.1
- Rates of motor vehicle traffic deaths among American Indian and Alaska Native adults age 20 years or older are more than twice that of non-Hispanic White persons.1
American Indian and Alaska Native children experience the highest injury death rates among all racial and ethnic groups in the United States.1-3 Motor vehicle traffic death rates among American Indian and Alaska Native children and youth age 0-19 years were about 2 to 5 times higher than those of other racial and ethnic groups.1
In general, motor vehicle traffic death rates are higher among men than women. American Indian and Alaska Native persons, are at increased risk for injury, but American Indian and Alaska Native men are at especially high risk. Motor vehicle traffic death rates among American Indian and Alaska Native men age 20 years and older are more than twice that of women.1
Low seat belt use
- The overall rate of seat belt use in Indian Country was 76% in 2020 according to the National Highway Traffic Safety Administration (NHTSA) and the Bureau of Indian Affairs Indian Highway Safety Program.4 Although belt use varies greatly across reservations, seat belt use among American Indians and Alaska Native persons (76%)4 is lower than that of the United States overall (90%).5
- 2 out of 3 passengers who died in crashes on reservations were not wearing seat belts at the time of the crash.6
Low child safety seat use
- American Indian and Alaska Native child safety and booster seat use rates are much lower than that of other racial and ethnic groups, although these rates can vary greatly across reservations.7 Proper restraint use among American Indian and Alaska Native children age 7 years and younger ranged from 23% to 79% in a study of six Northwest tribes.8 A nationally representative study in 2015 found proper restraint use among U.S. children age ≤7 years ranged from 63% to 87%.9
- American Indian and Alaska Native persons have the highest alcohol-impaired driving death rates among all racial and ethnic groups.10 Alcohol-impaired driving death rates among American Indian and Alaska Native persons are 2 to 17 times higher than other racial and ethnic groups in the United States.10
Proven strategies to reduce motor vehicle crashes, injuries, and deaths are well established. Strategies to prevent crashes include graduated drivers licensing laws, blood alcohol concentration (BAC) laws, sobriety checkpoints, and ignition interlocks for those convicted of driving while intoxicated. Increasing car seat and booster seat use through child passenger restraint laws that require car seat and booster seat use for all children until at least age 9 years, increasing seat belt use through primary enforcement seat belt laws that cover all seating positions, and high visibility enforcement are proven ways to prevent crash-related injuries and deaths. These strategies can be successfully tailored to tribal communities.
Car seat and booster seat use
- Car seat use reduces the risk for injury in a crash by 71-82% for children, when compared with seat belt use alone.11,12
- Booster seat use reduces the risk for serious injury by 45% for children age 4–8 years when compared with seat belt use alone.13
- There is strong evidence that child passenger restraint laws that require all children until at least age 9 years to travel properly buckled in an age- and size-appropriate car seat or booster seat, car/booster seat distribution and education programs, community-wide education and enforcement campaigns, and incentive-plus-education programs are effective at increasing car seat and booster seat use.14-16
Seat belt use
- Seat belt use reduces the risk for death and serious injury by about half for older children and adults.17,18
- There is strong evidence that primary enforcement seat belt laws that cover all seating positions and high visibility enforcement are effective at increasing seat belt use.19,20
Proven measures to reduce alcohol-impaired driving include:
- Enforcing BAC laws, minimum legal drinking age laws and zero tolerance laws for drivers younger than 21 years old.20,21
- Utilizing publicized sobriety checkpoints. Checkpoints can reduce alcohol-related crash deaths by 9%. 22
- Requiring ignition interlock use for all people convicted of alcohol-impaired driving, starting with their first offense.23 Additionally, incorporating alcohol use disorder assessment and treatment into interlock programs shows promise in reducing repeat offenses once interlocks are removed.24
- Implementing the The Community Guideexternal icon supported strategies that can reduce binge drinking.25
- Providing Drug Recognition Expert (DRE) or Advanced Roadside Impaired Driving Enforcement (ARIDE) program training to law enforcement.
- There are proven methods to help teens become safer drivers. Graduated driver licensing (GDL) systems are designed to delay full licensure while allowing teens to get their initial driving experience under low-risk conditions by granting driving privileges in 3 stages.
- Research indicates that GDL systems are associated with reductions of about 19% for injury crashes and 21% for fatal crashes for 16 year olds.26 Comprehensive GDL systems include:
- Stage 1: Learner’s permit
- Minimum age of 16 years
- Mandatory holding period of at least 12 months
- Stage 2: Intermediate or provisional license
- Restrictions against nighttime driving between 10:00 pm and 5:00 am (or longer)
- Limit of zero or one for the number of young passengers without adult supervision
- Stage 3: Full Licensure
- Minimum age of 18
- Stage 1: Learner’s permit
- Roadway to Safer Tribal Communities Toolkit
- Best Practices Guide
- Tribal Road Safety: Publications
- Tribal Road Safety Feature
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web-Based Injury Statistics Query and Reporting System (WISQARS)(online) Accessed October 15, 2021.
- Murphy T, Pokhrel P, Worthington A, Billie H, Sewell M, Bill N. Unintentional Injury Mortality Among American Indians and Alaska Natives in the United States, 1990-2009. AJPH 2014:104-S3:S470-S480
- West BA, Rudd RA, Sauber-Schatz EK, Ballesteros MF. Unintentional injury deaths in children and youth, 2010–2019. Journal of Safety Research 2021; https://doi.org/10.1016/j.jsr.2021.07.001
- Chaffe RHB, Leaf WA, Solomon MG. 2020 Safety Belt Use Estimate for the Indian Nations. Albuquerque, NM: Bureau of Indian Affairs, Indian Highway Safety Program Office. 2020.
- National Highway Traffic Safety Administration. Traffic Safety Facts: Seat Belt Use in 2020—Overall Results. Washington, DC: US Department of Transportation, National Highway Traffic Safety Administration. 2021. Publication no. DOT-HS-813-072. Available at https://crashstats.nhtsa.dot.gov/Api/Public/ViewPublication/813072external icon. Accessed October 18, 2021.
- National Highway Traffic Safety Administration. 2020. Native American Traffic Safety Facts FARS 2014-2018. Available at https://cdan.nhtsa.gov/NA_report/NA_Report.htmexternal icon. Accessed November 8, 2021.
- LeTourneau RJ, CE Crump, Bowling JM, Kuklinski DM, Allen CW. Ride Safe: A Child Passenger Safety Program for American Indian and Alaska Native Children. Maternal Child Heath 2008. DOI 10.1007/s10995-008-0332-6
- Lapidus JA, Smith NH, Lutz T, Ebel BE. Trends and correlates of child passenger restraint use in six Northwest Tribes: The Native children always ride safe (Native CARS) project. American Journal of Public Health 2013;103(2);355-61
- National Highway Traffic Safety Administration. The 2015 National Survey of the Use of Booster Seats. Washington, DC: US Department of Transportation, National Highway Traffic Safety Administration. 2016. Publication No. DOT-HS-812-309
- National Highway Traffic Safety Administration. Fatality and Injury Reporting System Tool (FIRST) [online]. National Highway Traffic Safety Administration, US Department of Transportation. Available at https://cdan.dot.gov/queryexternal icon. Accessed March 23, 2020.
- Arbogast KB, Durbin DR, Cornejo RA, Kallan MJ, Winston FK. An evaluation of forward-facing child restraint systems. Accident Analysis and Prevention 2004;36(4):585-9.
- Zaloshnja E, Miller TR, Hendrie D. Effectiveness of child safety seats vs safety belts for children aged 2 to 3 years. Archives of Pediatrics and Adolescent Medicine 2007;161:65-8.
- Arbogast KB, Jermakian JS, Kallan MJ, Durbin DR. Effectiveness of belt positioning booster seats: an updated assessment. Pediatrics 2009;124;1281–6.
- Zaza S, Sleet DA, Thompson RS, et al. Task Force on Community Preventive Services. Reviews of evidence regarding interventions to increase use of child safety seats. American Journal of Preventive Medicine. 2001;21(4S):31-47
- Ehiri JE, Ejere HOD, Magnussen L, Emusu D, King W, Osberg SJ. Interventions for promoting booster seat use in four to eight year olds travelling in motor vehicles. Cochrane Database of Systematic Reviews 2006;1.
- Eichelberger AH, Chouinard AO, Jermakian JS. Effects of booster seat laws on injury risk among children in crashes. Traffic Injury Prevention 2012;13:631–9.
- Kahane CJ. Lives saved by vehicle safety technologies and associated Federal Motor Vehicle Safety Standards, 1960 to 2012 – Passenger cars and LTVs. Washington, DC: US Department of Transportation, National Highway Traffic Safety Administration. 2015. Available at https://crashstats.nhtsa.dot.gov/Api/Public/ViewPublication/812069.
- National Highway Traffic Safety Administration. Final regulatory impact analysis amendment to Federal Motor Vehicle Safety Standard 208. Passenger car front seat occupant protection. Washington, DC: US Department of Transportation, National Highway Traffic Safety Administration. 1984. Publication no. DOT-HS-806-572.
- Dinh-Zarr TB, Sleet DA, Shults RA, et al. Reviews of evidence regarding interventions to increase the use of safety belts. American Journal Preventive Medicine 2001; 21(4S): 48-65.
- Venkatraman V, Richard CM, Magee K, Johnson K. National Highway Traffic Safety Administration (NHTSA). Countermeasures that work: A highway safety countermeasures guide for State Highway Safety Offices, 10th edition, 2020 (Report No. DOT HS 813 097). U.S. Department of Transportation, National Highway Traffic Safety Administration; July 2021. Available at: https://www.nhtsa.gov/sites/nhtsa.gov/files/2021-09/15100_Countermeasures10th_080621_v5_tag.pdf
- The Community Guide. Motor vehicle-related injury prevention: reducing alcohol-impaired driving. Available at: https://www.thecommunityguide.org/content/task-force-findings-motor-vehicle-injury#alcohol-impaired-drivingexternal icon
- Bergen G, Pitan A, Qu S, Shults RA, Chattopadhyay SK, Elder RW, Sleet DA, Coleman HL, Compton RP, Nichols JL, Clymer JM, Calvert WB, Community Preventive Services Task Force. Publicized sobriety checkpoint programs: A Community Guide systematic review. Am J Prev Med 2014;46(5):529-39.
- The Community Guide. Reducing alcohol-impaired driving: ignition interlocks. 2006. Available at: https://www.thecommunityguide.org/findings/motor-vehicle-injury-alcohol-impaired-driving-ignition-interlocks
- Voas RB, Tippetts AS, Bergen G, Grosz M, and Marques P. Mandating treatment based on interlock performance: evidence for effectiveness. Alcohol Clin Exp Res 2016;40(9):1953–60.
- The Community Guide. Preventing excessive alcohol consumption: increasing alcohol taxes. 2007. Available at https://www.thecommunityguide.org/sites/default/files/assets/Alcohol-Increasing-Alcohol-Taxes_0.pdfpdf iconexternal icon
- Masten SV, Thomas FD, Korbelak KT, Peck RC, Blomberg RD. Meta-analysis of GDL laws. Washington, DC: US Department of Transportation, National Highway Traffic Safety Administration. 2015. Publication No. DOT-HS-812-211. Available at https://www.nhtsa.gov/sites/nhtsa.dot.gov/files/812211-metaanalysisgdllaws.pdfpdf iconexternal icon.