Lack of Proper Child Passenger Restraints Seen in Majority of Fatal Car Crashes

TUESDAY, Aug. 12, 2025 (HealthDay News) — Nearly 70 percent of U.S. children in car crashes with a fatality are not using proper child passenger restraints, according to a study published online July 31 in Traffic Injury Prevention.

Arthi S. Kozhumam, from the Northwestern University Feinberg School of Medicine in Chicago, and colleagues identified child, driver, vehicle, neighborhood, and policy-level factors associated with suboptimal child passenger safety practices in motor vehicle collisions (MVCs) with a fatality. The analysis included data from child passengers (younger than 13 years old) in cars and light trucks with known restraint status and seating location identified from the Fatality Analysis Reporting System database (2011 to 2021).

The researchers found that 73.3 percent had a known restraint (29.4 percent child passenger restraint system, 50.7 percent seatbelt, 19.9 percent unrestrained) and seating position (15.2 percent in front seat). Among 26,731children, those aged 4 to 12 years had the highest proportion of suboptimal practices identified. The strongest predictors of suboptimal practices were child age (4 to 7 years versus younger than 4 years: odds ratio, 1.10) and vehicle over capacity (odds ratio, 1.09). With increasing vehicle model year, Child Opportunity Index level, fines, and law scores, there was a decrease in suboptimal child passenger safety practices. Seventy-five counties were identified as hotspots for overall suboptimal practices and for premature transitions, 45 were hotspots for riding unrestrained, and 64 were hotspots for traveling in the front seat.

“Given the continued problem of suboptimal child passenger safety practices among children across the country, there is a need for innovative, targeted programs to promote correct and consistent use of age-appropriate car seats, restraints, and seating locations,” Kozhumam said in a statement.

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