Vital Signs Telebriefing on Restraint Use and Motor Vehicle Occupant Death Rates Among Children Aged 0–12 Years — United States, 2002–2011

OPERATOR: I'd like to thank all participants for holding. All lines will be on listen only for the question and answer portion of today’s conference. I would also like to inform participants today's call is being recorded. I’d now like to turn the call over to Tom Skinner. Thank you. You may begin.

TOM SKINNER: Thank you, Brian. And thank you all for joining us today for the release of another CDC Vital Signs, this one on restraint use and motor vehicle occupant death rates among children age zero to twelve years, United States, 2002-2011. With us today is the director of the CDC, Dr. Tom Frieden, as well as the team lead for CDC’s transportation safety team, Dr. Erin Sauber-Schatz. Both will provide opening remarks and then we will move to your questions. Dr. Frieden?

TOM FRIEDEN: Thank you very much for joining us today. This month our Vital Signs report is on the very important topic of motor vehicle occupant deaths. Each month we focus on one critical issue in our monthly Vital Signs. We will share information on trends of child passenger deaths over the past decade, and what can be done to prevent these deaths, because they are so tragic and so preventable. The broader picture is we have made a lot of progress reducing motor vehicle fatalities in the U.S. over the past decades. Our roads have gotten safer, there are fewer people getting killed on the road, but still there are far too many deaths. The death rate in the U.S. is two or three times higher than the death rate in other countries from motor vehicle crashes, and if you look within the U.S. there's a large variation between different states and between different groups, and we’ll be talking specifically today about kids and about some of the important differences among different groups of kids. The good news is that motor vehicle deaths decreased by 43 percent for children 12 and younger over the past 10 years. The tragic news is that still, with that decrease, more than 9,000 kids were killed on the road in this period. Thousands of children are at risk on the road because they're not buckled up. In 2011, of the children killed in crashes, one in three was not buckled up. There are different factors that make a difference in terms of whether or not a child is buckled up. Of children who died in a crash, a much higher proportion of African-American and Hispanic kids were not buckled compared to white kids, the difference was nearly half, 45-46 percent, versus a quarter, 26 percent. Older children were less likely to be buckled than younger children. These are troubling numbers especially since so many of these deaths could have been prevented by buckling children in age and size appropriate child restraints, that is car seats, booster seats, or seatbelts on every trip. Now using a car seat isn’t always simple and we have information in the Vital Signs to help parents and caregivers and people who want to educate the public on things that may seem tricky but are fairly straight forward. There are four different types of car seats and we have them outlined and Dr. Erin Sauber-Schatz will discuss further, and in terms of making sure that your kid is buckled safely, there are resources in every community of certified child safety educators who can give hands on information on how to buckle up and how to see if the car seat fits well. You can find that through SafeKids.org or other sites. Although we’ve made progress reducing the number of child passenger deaths, we can do more to keep our kids safe. There is really nothing more tragic for a parent than losing a child to something that could have been prevented. To share more about these latest findings in child passenger safety can be prevented, I turn now to Dr. Erin Sauber-Schatz.

ERIN SAUBER-SCHATZ: Hello. I'm Erin Sauber-Schatz. And that’s spelled E-R-I-N and my last name is S-A-U-B as in “boy” E-R hyphen S-C-H-A-T-Z. And thank you, Dr. Frieden, and thank you everyone for joining us today. As Dr. Frieden just pointed out, crash deaths have decreased significantly in the past decade. We are encouraged by this improvement, but still more than 650 children 12 and under were killed in crashes in 2011 -- that's more than a dozen children every week. Buckling up is the best way to save lives and reduce injuries and deaths from crashes, but the fact remains that too many child passengers are riding unprotected, and more needs to be done to keep children safe on the road. Previous research shows that there are proven ways to get more children buckled up. For instance, programs that combine car seat distribution along with education have shown to increase car seat use. Also, child passenger restraints law that increase the age of car seat or booster seat use result in getting more children buckled up. For example, car seat and booster seat use tripled among five states that increased the required age for car seat and booster seat use to seven or eight years, and deaths and serious injuries decreased by 17 percent. Yet only two states, Tennessee and Wyoming, have child passenger restraint laws requiring car seat and booster seat use for children age eight and under. There are additional steps that can be taken to protect the lives of child passengers. In addition to improving state child passenger restraint laws, states and communities can increase the numbers of certified child passenger safety technicians available to the public. The can also partner with researchers to develop and evaluate programs that address racial and ethnic differences in getting children buckled up. Health care providers also play a role. They can keep up to date on child passenger safety issues, and they can council parents and care givers at each well child check-up to use age and size appropriate car seats, booster seats, and seatbelts on every trip. They can also council parents and care givers about the correct time to move a child to the next seat type or to a seat belt. Health care providers can also council patients of all ages on the importance and effectiveness of buckling up. Finally, while everyone plays a role keeping our children safe and secure on the road, parents and care givers are the first line of defense. Important steps they can take include knowing how to use car seats, booster seats, and seatbelts and using them on every single trip no matter how short, installing and using car seats and booster seats according to the seat’s owner’s manual, or getting help installing them from a certified child passenger safety technician.Parents and care givers also should recognize that the safest way to buckle up changes as a child grows. Parents and care givers should also buckle children age 12 and under in a backseat in an age appropriate car seat, booster seat, or seat belt.

TOM FRIEDEN: Thank you very much, and the bottom line here is that motor vehicle crashes remain a leading cause of death for children in the U.S. There are crucial steps that need to be taken at every level to help protect the ones we love from car crashes, but the first step is a simple one: buckling up. Every child, of every age, on every trip. This simple act can save your child's life.

TOM SKINNER: Okay. Brian, I believe we're ready for questions, please.

OPERATOR: Sure. At this time if you would like to ask a question press star one. Once again, star one to ask a question and please hold for our first question.

OPERATOR: Maggie Fox NBC News, your line is open.

MAGGIE FOX: Hi, thanks very much. I’d like to ask to what do you attribute the 43 percent decrease in child deaths over that ten year period? And can I also ask, all 50 states have some kind of child seat law so what’s the problem with the variation in the laws? Thanks.

ERIN SAUBER-SCHATZ: Although we did not look at the reasons for the 43 percent decrease in the last decade, we know car seats have gotten safer, cars themselves have gotten safer, and there's also some evidence to suggest the economy contributed to this decrease.

TOM FRIEDEN: Over the past decade there has been a big increase in the use of graduated driver's licenses. We have fewer teenagers driving unsafely on the road and that’s made both their cars and the roads in general safer.

ERIN SAUBER-SCHATZ: And to your question about the variation in the laws, yes, you’re correct that all 50 states and the District of Columbia have a child passenger safety law. There are variations within the laws, but the age is different throughout the states and the states set those laws.

MAGGIE FOX: Thank you.

TOM SKINNER: Next question, Brian?

OPERATOR: Mike Stobbe, Associated Press, your line is open.

MIKE STOBBE: Hi. Thank you for taking the question. A couple questions: One, I understand that from the National Safety Council that in 2012 deaths actually went up for all ages. I was wondering if they also went up for children. I know this report only covers 2011 but you may have access to the 2012 data. What happened to the trend in 2012? And I was also wondering if you could you take me back in time to before 2002, was the trend also downward for children occupant deaths?

ERIN SAUBER-SCHATZ: Okay. So--

TOM FRIEDEN: We'd have to get back to you about data before 2002.

ERIN SAUBER-SCHATZ: Right, and for 2002 we used the Fatality Analysis Reporting System, which is NHTSA data based, and they just recently released the 2012 data set in January so we actually haven't had a chance to essentially redo our analysis for the most recent year of data. But we do know that in 2011, over 650 children died due to motor vehicle crashes and a third of those were not buckled.

MIKE STOBBE: And by the way, that 650, that’s out of what, 32,367or 22,000? What’s the correct denominator? Because 22,000 was the occupant, wasn't it?

ERIN SAUBER-SCHATZ: Right. So, I can get you the exact denominator data for that, the rates are in the MMWR. That 650, that’s for children zero through 12.

TOM FRIEDEN: So we can get back to you with more specifics right after the call.

ERIN SAUBER-SCHATZ: Yep.

MIKE STOBBE: Thank you.

TOM SKINNER: Mike, Courtney will follow up with you, okay?

MIKE STOBBE: Thank you.

TOM SKINNER: Next question, Brian.

OPERATOR: Jessica Bliss, Tennessee newspaper, your line is open.

JESSICA BLISS: Yes, thank you. You mentioned that Tennessee and Wyoming have laws that set them apart. Can you restate that, and what makes them different, and also does that mean there are less child fatalities because of those laws in those states?

TOM FRIEDEN: So, we didn't look at fatalities by state in this report, but Tennessee has long been a leader in use of infant seats and in safety of children in cars. It’s one of the two states in the country that has a requirement for booster seats up to age eight. Anything more to add?
ERIN SAUBER-SCHATZ: Right and for 2002 we used the fatality analysis reporting system, which is NHTSA database. And they just recently released the 2012 data set in January, so we actually haven't had a chance to essentially redo our analysis for the most recent year of data. But we do know that in 2011 over 650 children died due to motor vehicle crashes and a third of those were not buckled.

MIKE STOBBE: And by the way, that 650 that is how of what? 32,367 or 22,000 what’s the correct denominator? Because 22,000 was occupant, wasn't it?

ERIN SAUBER-SCHATZ: Right. So, I can get you the exact denominator data for that, the rates are in the MMWR. But that 650 that is for children 0 through 12.

TOM FRIEDEN: So we can get back to you with more specifics right after the call.

ERIN SAUBER-SCHATZ: Yep.

MIKE STOBBE: Thank you.

TOM SKINNER: Mike, Courtney will follow up with you okay?

MIKE STOBBE: Thank you.

TOM SKINNER: Next question, Brian.

OPERATOR: Tennessee newspaper, your line is open.

JESSICA BLISS: Yes, thank you. You mentioned that Tennessee and Wyoming have law that set them apart. Can you restate that and what makes them different and does that mean there's less child fatalities because of those laws in those states?

TOM SKINNER: So, we didn't look at fatalities by state in this report but Tennessee has long been a leader in use of infant seats and safety of children in cars. It is one of the two states in the country that has a requirement for booster seats up to age 8. Anything more to add?

ERIN SAUBER-SCHATZ: No. I would just add that the good news and why we weren't able to look at state differences is that the number of child fatalities at the states is small so we're not able to get accurate rates.

TOM SKINNER: Next question, Brian.

OPERATOR: Once again, to ask a question, press star one. One moment.

TOM FRIEDEN: While we waiting for the next question, I’ll just mention that one of the questions we often get is how to know when your child is old enough to no longer use a booster seat, and there’s actually a very straightforward way. If you put a seatbelt on the child with a shoulder belt and a lap belt when they are not in a booster seat and it doesn't go over their upper thighs for the belt and over their chest for the shoulder belt, shoulder and chest, then it's not time for them to move on. So in other words, if when they don’t use a booster seat, the lap belt goes over their stomach instead of their thighs or over their face instead of their shoulder, than it's not safe for them not to use a booster seat and they should continue with the booster seat. There are simple ways to get help. Because it can be confusing to know when a child graduates and what type to work best for the kid.

TOM SKINNER: Any other questions, Brian?

OPERATOR: Yes, next question from Larry Copeland USA Today. Your line is open.

LARRY COPELAND: Hi. Thanks for taking the question. I just wanted to know if you guys could talk a little bit about the reasons for the discrepancy in the difference between black and Hispanic and white children being buckled up.

ERIN SAUBER-SCHATZ: Right. So we found that in 2009 and 2010 that 46 percent of Hispanic and 45 percent of black children who died in motor vehicle crashes were not buckled up and this is compared with 26 percent of white children. We were not able to look at the reasons for not buckling up however we do know from previous research that socioeconomic status can play a role in whether or not a family has a car seat and buckled.

TOM FRIEDEN: Are there any more questions?

OPERATOR: Yes, Carrie Feibel, Houston Public Radio, your line is open.

CARRIE FEIBEL: Yes just following up with what Larry asked about, can you just spell that out a little bit more the socioeconomics, does that mean if a family can't afford a car seat they're not going to get one and there's often no other way to get one?

TOM FRIEDEN: So there can be a difficulty paying for a car seat or appropriately sized car seat and we do encourage parents to check with community resources because there are some programs in many communities that provide or subsidize or partially subsidize a car seat or booster seat, this is one of the key areas.

ERIN SAUBER-SCHATZ: And I would just add that families that do have financial limitations that there are seats that's they can buy that can be used for a longer period of time. So if they purchased a seat that has a higher height or weight limit they can use the seat longer for a child. Or for instance a convertible car seat, is what it’s called, it can be used rear facing as well as forward facing as two seats in one,so there are some recommendations for families that have financial limitations.

TOM SKINNER: Any more questions, Brian?

OPERATOR: Mike Stobbe, Associated Press. Your line is open.

MIKE STOBBE: Sorry, one more time, I was wondering if in the ten years is there any one state or particular states that consistently had a higher rate of child fatalities?

ERIN SAUBER-SCHATZ: We actually did not look at the state differences. The numbers were too small to calculate rates with accuracy over time.

TOM FRIEDEN: However, we have reported previously on rates of adult fatalities and the differences are quite striking, they're very large.

MIKE STOBBE: Okay. Thank you.

TOM SKINNER: Next question, Brian.

OPERATOR: Jessica Bliss, Tennessee newspaper. Your line is open.

JESSICA BLISS: Thanks. My question was geared towards the economic barriers, and I think that has been addressed. Thank you.

OPERATOR: This time I show no further questions.

TOM FRIEDEN: Okay, well I want to thank you all for joining us. And just to reiterate the bottom line here. Motor vehicle crashes remain a leading cause of death for kids in the U.S. There are crucial steps that need to be taken at every level to protect the ones we love in car crashes but the really the first step is buckling up, every child of every age on every trip. It is a simple act that could save a life. Thank you very much for being with us and covering this.

TOM SKINNER: Thank you all for joining us. And should you have any follow up questions feel free to call the CDC press office at 404-639-3286. Thank you.

OPERATOR: Thank you that does conclude the press conference for today. You may disconnect your phone lines at this time.

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES