Booster seat legislation: does it work for all children?

Department of Pediatrics and Injury Research Center, Medical College of Wisconsin, Milwaukee, Wisconsin 53233, USA.
Injury Prevention (Impact Factor: 1.89). 02/2011; 17(4):233-7. DOI: 10.1136/ip.2010.029835
Source: PubMed


To assess the impact of a booster seat law in Wisconsin on booster seat use in relation to race, ethnicity and socioeconomic status.
A longitudinal study in Milwaukee County, Wisconsin, involving repeated direct observational assessments of booster seat use rates by child passengers aged 4-7 years over five time periods, before and after legislation mandating booster seat use.
Overall, booster seat use increased from 24% to 43%, whereas proper restraint use increased pre to post-legislation from 21% to 28%. Proper use increased after legislation in white, but not in black or Latino children. White individuals had a proper booster use increase from 48% to 68% over the time period of the study. Black children's proper use dropped from 18% to 7% over the study period and Latino children's proper use rates were stable at 10%. Driver-reported household income had a significant impact on overall use, but not on proper use.
Racial/ethnic minority groups and those of lower socioeconomic status have significantly lower use and proper use of booster seats. Legislation may increase the total use of booster seats but not necessarily the correct use of the restraint, particularly in racial/ethnic minorities.

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    • "Reasons for misuse are multifactorial and continue to be explored (Bilston, Finch, Hatfield, & Brown, 2008; Brixey, Corden, Guse, & Layde, 2011; Winston, Chen, Smith, & Elliott, 2006). Racial and ethnic disparities persist and may be widening, thought to be related to lower child safety seat use by racial minorities (Durbin, 2011; Brixey et al., 2011). Proper installation, one aspect of misuse, requires the child safety seat to be secured appropriately to the vehicle. "
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