Tribal Road Safety: Get the Facts

Motor Vehicle Traffic Crashes are a Leading Cause of Death
  • Motor vehicle traffic crashes are a leading cause of death for American Indian and Alaska Native people aged 1-44.1
  • Motor vehicle traffic crash death rates among American Indian and Alaska Native children aged 0–12 years were 2 to 6 times higher than those of other races and ethnicities.1
  • Rates of motor vehicle traffic deaths in American Indian and Alaska Native adults aged 20 years or older are more than twice that of non-Hispanic whites.1
Some Groups Have Higher Motor Vehicle Death Rates

Children

photo: fireman helping Native American mother with her child's car seat.

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 aged 0-12 years were 2 to 6 times higher than those of other races and ethnicities.1

Men

American Indians and Alaska Natives, as a group, are at increased risk for injury, but males are at especially high risk. Motor vehicle traffic death rates among American Indian and Alaska Native males aged 20 years and older are more than twice that of females.1

Low Seat Belt Use, Low Child Safety Seat Use and Alcohol Impaired Driving are Major Risk Factors
Photo: Road checkpoint sign

Low seat belt use

  • The overall rate of seat belt use in Indian Country was 77% in 2019 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 Natives (77%)4 is lower than that of the U.S. overall (91%).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 aged 7 years and younger ranged from 23% to 79% in a study of six Northwest tribes.8 A nationally representative U.S. study in 2015 found proper restraint use among children aged ≤7 years ranged from 63% to 87%.9

Alcohol impaired driving

  • American Indians and Alaska Natives have the highest alcohol-impaired driving death rates among all racial and ethnic groups.10 Alcohol-impaired driving death rates among American Indians and Alaska Natives are 2 to 17 times higher than other racial and ethnic groups in the United States.10
Prevent Injuries by Using Car Seats, Seat Belts, and Proven Strategies to Reduce Alcohol-Impaired Driving
Photo: road sign: Buckle up - it's our law

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, 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 aged 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 to travel properly buckled in an age- and size-appropriate car seat or booster seat, safety 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

Impaired driving

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 problem assessment and treatment into interlock programs shows promise in reducing repeat offenses once interlocks are removed.24
  • Exploring The Community Guideexternal icon supported strategies that might lead to a reduction in binge drinking.25
  • Providing Drug Recognition Expert (DRE) or Advanced Roadside Impaired Driving Enforcement (ARIDE) program training to law enforcement.

Teen drivers

  • 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

References

  1. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web-Based Injury Statistics Query and Reporting System (WISQARS)(online) {cited 2020 November 5}.
  2. 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
  3. Wallace LJD, Patel R, Dellinger A. Injury mortality among American Indian and Alaska Native Children and Youth — United States, 1989–1998. MMWR 2003;52(30):697–701.
  4. National Highway Traffic Safety Administration. Bureau of Indian Affairs’ Highway Safety Plan FY19. Available at https://www.nhtsa.gov/sites/nhtsa.dot.gov/files/documents/bia_fy19_hspar_0.pdfpdf iconexternal icon. Accessed March 23, 2020.
  5. National Highway Traffic Safety Administration. Traffic Safety Facts: Seat Belt Use in 2019—Overall Results. Washington, DC: US Department of Transportation, National Highway Traffic Safety Administration. 2019. Publication no. DOT-HS-812-875. Available at https://crashstats.nhtsa.dot.gov/Api/Public/ViewPublication/812875external icon. Accessed October 9, 2020.
  6. National Highway Traffic Safety Administration. 2020. Native American Traffic Safety Facts FARS 2013-2017. Available at https://cdan.nhtsa.gov/NA_report/NA_Report.htm. Accessed March 20, 2020.
  7. 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
  8. 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
  9. 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
  10. National Highway Traffic Safety Administration. Fatality Analysis Reporting System (FARS) [online]. National Highway Traffic Safety Administration, US Department of Transportation. Available at https://cdan.dot.gov/queryexternal icon. Accessed March 23, 2020.
  11. 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.
  12. 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.
  13. Arbogast KB, Jermakian JS, Kallan MJ, Durbin DR. Effectiveness of belt positioning booster seats: an updated assessment. Pediatrics 2009;124;1281–6.
  14. 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
  15. 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.
  16. 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.
  17. 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 www.nrd.nhtsa.dot.gov/pubs/812069.pdfpdf iconpdf icon.
  18. 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.
  19. 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.
  20. Richard CM, Magee K, Bacon-Abdelmoteleb P, & Brown JL. Countermeasures that work: A highway safety countermeasure guide for State Highway Safety Offices, Ninth edition. Washington, DC: US Department of Transportation, National Highway Traffic Safety Administration. 2018. Publication No. DOT-HS-812-478. https://www.nhtsa.gov/sites/nhtsa.dot.gov/files/documents/812478_countermeasures-that-work-a-highway-safety-countermeasures-guide-.pdfpdf iconexternal icon.
  21. The Community Guide. Motor vehicle-related injury prevention: reducing alcohol-impaired driving. Available at:  https://www.thecommunityguide.org/topic/motor-vehicle-injury
  22. 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.
  23. The Community Guide. Reducing alcohol-impaired driving: ignition interlocks. 2006. Available at: http://www.thecommunityguide.org/mvoi/AID/ignitioninterlocks.htmlexternal icon
  24. 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.
  25. The Community Guide. Preventing excessive alcohol consumption: increasing alcohol taxes. 2007. Available at http://www.thecommunityguide.org/alcohol/increasingtaxes.htmlexternal icon.
  26. 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.