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Prepared for: The Office of Highway Safety, Division of Public Safety Planning, Mississippi Department of Public Safety February 2003

Prepared by: James W. Landrum and David R. Parrish Social Science Research Center Mississippi State University Mississippi State, MS 39762


Highway safety continues to be a major health problem for children in Mississippi. The key factor in the number of death and crippling injuries for Mississippi’s children is not dues to measles, mumps etc., but due to the lack of or the improper use of child restraint in motor vehicles. Consider the alarming facts in the text box below. These figures are provided by the Center for Disease Control (CDC) on their web page. (See below in text box)

TAKEN FROM NATIONAL CENTERFOR INJURY PREVENTION AND CONTROL Motor vehicle injuries are the greatest public health problem facing children today. In fact, they are the leading cause of death among children at every age after their first birthday. • In 2000, 1,471 child passengers ages 0 to14 died in motor vehicle crashes in the United States (NHTSA 2001a), and more than 250,000 sustained injuries requiring treatment in an emergency department (WISQARS 2001). Many of these injuries could have been prevented. Of the children ages 0 to 12 years who were killed in motor vehicle crashes during 1999–2000, 52% were unrestrained, 18% were incorrectly restrained, and 35% were riding in the front seat. (NHTSA 2001a). Fewer than 10% of 5- to 8-year-olds use booster seats, the recommended safety seat for this age group (Durbin 2001). Child safety seats reduce the risk of death in passenger cars by about 70% for infants and by about 55% for toddlers ages 1 to 4 (NHTSA 2001b). The National Highway Traffic Safety Administration recommends booster seats for children over 40 pounds until at least age 8 (NHTSA 2002). For children ages 9 years and older, car seat belts reduce injury risk by about 50% (NHTSA 2001b). All children ages 12 years and younger should ride in the back seat. This eliminates the injury risk of deployed front passenger-side airbags and places children in the safest part of the vehicle in the event of a crash. Riding in the back seat is associated with a 46% reduction in the risk of fatal injury in cars with a front passenger-side airbag and at least a 30% reduction in the risk of fatal injury in cars with no front passenger-side airbag (Braver 1998). 2

• • • • •

BACKGROUND Each year citizens, governmental agencies and private advocacy groups participate in a major effort to combat this needless death and injury to our children. Tickets are written to those who violate the child restraint law. Large numbers of child restraint clinics staffed by highly trained child restraint technicians are provided at no cost to the public. A sizable amount of time, effort and money are devoted to increasing child restraint use. These efforts included media campaigns, brochures, programs, providing free child restraint seats to those who cannot afford them etc. In order to help evaluate the effect of these programs, child restraint surveys are conducted in cities in every geographical area of Mississippi. The surveys are not truly scientific, but do provide an over all raw analysis on child restraint use in Mississippi. Since these surveys are only observational they do not provide a measure of the proper use of child, except in a very general way, i.e., incorrectly placing children in rear facing seats on the front seat in front of airbags. These efforts have had gratifying results in that child restraint use in Mississippi has continued to rise over time. However, in comparison to other states, child restraint use in Mississippi continues to be low and proper restraint use probably abysmally low.

PROJECT METHODOLOGY The current child restraint survey was conducted in 30 Mississippi municipalities at 269 observation sites covering every region in the state of Mississippi. Table 1 provides a list of the sample cities, the number of unique locations, the total number of observations, percent of observations with regard to the total number of observations and the populations of the various cities.


Table 1: Survey Cities, Number of Locations, Number of Observations
Number of Locations 8 8 8 9 8 8 8 8 8 8 8 8 8 8 29 8 8 8 8 7 8 8 8 15 9 8 8 8 8 8 269 Total Number Of Observations 85 164 95 181 226 162 75 143 195 241 200 47 150 96 1,554 84 160 238 200 195 213 211 108 428 202 164 213 399 420 500 7,349 Percent of Total Observations 1.2 2.2 1.3 2.5 3.1 2.2 1.0 1.9 2.7 3.3 2.7 0.6 2.0 1.3 21.2 1.1 2.2 3.2 2.7 2.7 2.9 2.9 1.5 5.8 2.8 2.2 2.9 5.4 5.7 6.8 100.0 City Population 50,644 16,436 9,861 12,911 13,841 23,347 25,944 14,054 11,681 18,425 14,879 71,127 44,779 12,066 184,256 18,393 14,692 13,337 39,968 15,851 18,464 17,225 11756 26,200 21,961 11,714 20,173 28,977 34,211 14,550 873,356

1.Biloxi 2.Brandon 3.Brookhaven 4.Canton 5.Cleveland 6.Clinton 7.Columbus 8.Corinth 9.Gautier 10.Greenwood 11.Grenada 12.Gulfport 13.Hattiesburg 14.Indianola 15.Jackson 16.Laurel 17.Madison 18.McComb 19.Meridian 20.Moss Point 21.Natchez 22.Ocean Springs 23.Oxford 24.Pascagoula 25.Pearl 26.Ridgeland 27.Southaven 28.Starkville 29.Tupelo 30.Yazoo City

. Due to the size of Jackson, data were collected from 29 sites within the city. Although 21 percent of the observations were made in Jackson, the population of Jackson represents over 21 percent of the populations of the sample cities. Using the population figures in the 2000 census, 29 of 37 cities with at least a population of 10,000 persons were included in the survey. One city, Brookhaven, had a population of less than 10,000. Brookhaven’s population dropped from over 10,000 in the 1990 census to slightly under 10,000 in the 2000 census. Sample cities are located in every geographical area of the State of Mississippi. 4

An attempt was made to select sites in each city that would provide a cross sample of the population. A systematic sample was selected by obtaining sites from four different types of locations: (1) a day care or controlled intersection with a signal light; (2) county or city health departments, welfare, or social service offices; (3) hospitals or pediatric offices; (4) shopping centers and fast food establishments. Where it was feasible, local observers were utilized because they were familiar with the diversity of people in the area and could determine the most appropriate site locations. Previous observers were employed when available to promote consistency. Additional information was collected for each car. These data were the driver’s gender, the time of day, the day of week, the weather during the time period of the observation, and whether or not the driver was wearing a seat belt. Each surveyor was given a checklist for making observations. Locations were observed for 40-minute periods and surveyors were instructed to skip cars when they were unsure of the observation. The following instructors were given to the surveyors: (1) record the use of vehicles only with children as passengers; (2) observe all children under the age of five. Devices designed to be rear facing are recorded as infant seats. Devices designed to be forward facing devices are recorded as toddler seats. (3) Correct use of an infant restraint is determined if the seat installed facing the rear of the vehicle, along with proper use of the harness system and a compatible vehicular restraint system. (4) Correct use of a toddler seat is determined if a harness and/or shield apparatus in the forward facing position protects the toddler. (5) Proper booster seat use is determined when the vehicular restraint system is correct for the size of the child.


RESULTS There were children in 5,009 cars observed during the survey period. These cars contained a total of 7,349 children under the age of 5, in 30 municipalities. Our 2002 survey report indicates that 69% of the children in the survey were restrained In Table 2, information is provided on the type of location, the number of children observed and whether they were restrained. It should be noted that none of the locations are definitive of that type of location, but only provide some indication of the level of use.

Table 2: Child Restraint Use by Type of Location
Not Using Fast Foods Large Shopping Mall Grocery Store Daycare or Child Learning Center Health Department or Human Resources Medical Care Complex or Physicians Office Playground, Park, Museum or Zoo Small Shopping Center or Wal-Mart Discount or Dollar Store Street Intersection Church, Church Nursery Service Station Restaurant Post Office/Banks 238 57 207 292 100 142 65 346 47 534 171 5 66 5 2,275 Using 512 106 291 527 175 345 389 657 52 1132 735 14 125 10 5,070 Total 750 163 498 819 275 487 454 1003 99 1666 906 19 191 15 7,345 % Using 68.3 65.0 58.4 64.3 63.6 70.8 85.7 65.5 52.5 67.9 81.1 73.7 65.4 66.7 69.0


In Table 3, the percentage of drivers using seat belts by gender is presented. Of the drivers observed, 67% of the female drivers were belted while only 55% of the male drivers used their seat belts. Overall, 63% of the adults observed were belted.

Table 3:

Restraint Use of Driver by Gender
Sex of Driver * Is Driver Belted? Crosstabulation
Is Driver Belted? Yes No 1153 33.2% 63.0% 23.1% 677 44.8% 37.0% 13.6% 1830 36.7% 100.0% 36.7% Total 3477 100.0% 69.7% 69.7% 1512 100.0% 30.3% 30.3% 4989 100.0% 100.0% 100.0%

Sex of Driver


Count % within Sex of Driver % within Is Driver Belted? % of Total

2324 66.8% 73.6% 46.6% 835 55.2% 26.4% 16.7% 3159 63.3% 100.0% 63.3%


Count % within Sex of Driver % within Is Driver Belted? % of Total


Count % within Sex of Driver % within Is Driver Belted? % of Total

CHILD RESTRAINT USE BY SEATING POSITION OF CHILD It is known that the safest place for a child to be restrained, or for that matter to ride unrestrained, is on the back seat of a car. It would therefore be expected that adults putting children in the back seat of a car would also have more awareness of the importance of using child restraints. The seating position, as well as whether the child was restrained, was recorded


in the present survey. As expected children on the back seat of automobiles were restrained at a higher rate than were those on the front seat. Children in the back seat were restrained at a rate of 72.4% while children on the front seat were restrained at only a rate of 60.9%

Table 4:

Child Restraint by Position of Child Restrained Not Restrained
Number 813 1448 2261 Percent 39.1 27.6 30.8

Number 2079 5254 7333 Percent 28.4 71.6 100.0

Seating Position Front Seat Back Seat Total

Number 1266 3806 5072

Percent 60.9 72.4 69.2

Male drivers were slightly more likely to place a child on the front seat than were female drivers. Children in cars driven by male drivers were placed on the front seat of the car 32 % of the time as compared to 27% when the driver of the vehicle was female. However, female drivers who placed their children on the front seat were much more likely to use child restraints than were male drives with children on the front seat. Only 54% of the children on the front seat were restrained when the driver was male, while over 64% of the children in cars driven by females were restrained. Children placed on the front seat were much more likely to be unrestrained regardless of the sex of the driver. Interestingly, male and female drivers choosing to place their children on the back seat were fairly comparable in restraining the children. Children placed on the back seat were restrained a much higher percentage of time than were those whose driver placed them on the back seat, regardless of the gender of the driver.


Obviously educational efforts directed at placing children on back seat have had some effect. These findings are presented in Table 5.

Table 5: Use of Child Restraints by Position of Child by Gender of Driver
MALE DRIVERS Using restraint Number 377 Front Seat 1039 Back Seat 1416 Totals FEMALE DRIVERS Using restraint Number Front Seat Back Seat Totals 887 2758 3645 Percent 64.8 73.7 71.1 Not using restraint Number 494 986 1480 Percent 35.8 26.8 28.9 Total Number 1381 3744 5125 Percent 26.9 73.1 100.0 64.7 773 35.3 2189 100.0 69.5 457 30.5 1496 68.3 Percent 54.4 Not using restraint Number 316 Percent 45.6 Total Number 693 Percent 31.7

CONCLUSIONS Child Restraint Use in Mississippi was found to be 69% for the year 2002. This is almost identical to the rate found in 2001, showing that child restraint usage is being sustained. In short, the effort toward increasing and improving child restraint use has been both extensive and intensive. There is also little doubt that having a primary child restraint law has made a significant impact on the increase of the use of child restraints in Mississippi. The next challenge is to raise child restraint usage to an even higher level.


References Braver ER, Whitfield R, Ferguson SA. Seating position and children's risk of dying in motor vehicle crashes. Injury Prevention 1998;4:181--–7.

CDC.Web-based Injury Statistics Query and Reporting System [Online]. (2001). National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (producer). Available from: URL: [1 Jul 2002]. Durbin DR, Kallan NJ, Winston FK. Trends in booster seat use among young children in crashes. Pediatrics2001;108(6):E109. National Highway Traffic Safety Administration, U.S. Department of Transportation. Buckle Up America: Child passenger safety week. Washington (DC): NHTSA; 2002 [cited 2002 May 15]. Available from URL s/index.html. National Highway Traffic Safety Administration, U.S. Department of Transportation. Fatality analysis reporting system 2000 [queried 2002 March 1]. Washington (DC): NHTSA; 2001(a) Available from: URL: National Highway Traffic Safety Administration, U.S. Department of Transportation. Traffic Safety Facts 2000:Occupant protection. Washington: NHTSA; 2001(b) [cited 2002 April 1]. Available from: National Highway Traffic Safety Administration, U.S. Department of Transportation. National occupant protection usesurvey–1996. Research Note, Aug. 1997. Washington (DC): NHTSA; 1997. National Highway Traffic Safety Administration, U.S. Department of Transportation. Observed patterns of misuse of child safety seats. Traffic Tech, Sept. 1996. Washington (DC): NHTSA; 1996.


Appendix A Percent of Observations by Day of Week

Sunday 3% Monday Saturday 15% 15%

Friday 10%

Tuesday 15%

Thursday 12% W ednesday 29%



Time of Observation

20 19

13 10 8 8 5 0
oo N 1p 2p 3p 4p 5p 6p 7 8a 9a 10 11 am m m m m m m am m m am n



7 5