Original ArticlesFactors Associated with Pediatric Mortality from Motor Vehicle Crashes in the United States: A State-Based Analysis
Section snippets
Methods
We performed a retrospective analysis of data to inform state-level policy. We compiled our analytic dataset from multiple sources. The primary source was the Fatality Analysis Reporting System (FARS), a nationwide census providing publicly available data on fatalities associated with MVCs. The FARS includes all fatal crashes in the US, defined as crashes that occur on a public road and result in ≥1 death (adult or pediatric) within 30 days. Data collection is supervised by the National Highway
Results
After applying the inclusion and exclusion criteria, we established a cohort of 18 116 children (Figure 1). This national cohort had a mean age of 6.9 years (SD 4.4) and was 51% male. The majority of children involved in a fatal crash lived in the South (52%), with 21% in the West, 19% in the Midwest, and 7.5% in the Northeast. Of the 18 116 children involved in a fatal crash, 2885 died (15.9%) within 30 days, of which 1424 died at the scene of the MVC. This corresponded with an overall AAMR
Discussion
We analyzed data from the National Highway Traffic Safety Administration's FARS to assess geographic variation of pediatric mortality from MVCs in the US and found substantial variation by state in AAMR as well as percentage of children who die of those involved in a fatal crash. Percentage of nonuse or misuse of restraints was a key predictor for both outcomes. Additional state-level characteristics that predicted increased risk of death included a greater percentage of crashes on rural roads
References (50)
- et al.
Rear seat safety: variation in protection by occupant, crash and vehicle characteristics
Accident Anal Prev
(2015) - et al.
Child passengers killed in reckless and alcohol-related motor vehicle crashes
J Safety Res
(2014) - et al.
70-mph speed limit and motor vehicular fatalities on interstate highways
Am J Emerg Med
(2003) - et al.
Crossing county lines: the impact of crash location and driver's residence on motor vehicle crash fatality
Accident Anal Prev
(2006) - et al.
Urban-rural differences in motor vehicle crash fatality and hospitalization rates among children and youth
Accident Anal Prev
(2006) - et al.
Child passenger safety policy and guidelines: why change is imperative
J Pediatr Health Care
(2016) - et al.
Child passenger safety laws in the United States, 1978-2010: policy diffusion in the absence of strong federal intervention
Soc Sci Med
(2014) - et al.
Child passenger injury risk in motor vehicle crashes: a comparison of nighttime and daytime driving by teenage and adult drivers
J Safety Res
(2006) - et al.
Trauma systems are associated with increased level 3 trauma centers
J Surg Res
(2015) - et al.
Safety impacts due to the incompatibility of SUVs, minivans, and pickup trucks in two-vehicle collisions
Accident Anal Prev
(2008)
Safety for whom? The effects of light trucks on traffic fatalities
J Health Econ
Systemwide implications of the repeal of the national maximum speed limit
Accident Anal Prev
A nationwide speed limit ≤65 miles per hour will save thousands of lives
Am J Surg
Changes in motor vehicle occupant fatalities after repeal of the national maximum speed limit
Accident Anal Prev
Effect of repeal of the national maximum speed limit law on occurrence of crashes, injury crashes, and fatal crashes on Utah highways
Accident Anal Prev
Vital signs: unintentional injury deaths among persons aged 0-19 years—United States, 2000-2009
MMWR Morb Mortal Wkly Rep
Restraint use in motor vehicle crash fatalities in children 0 year to 9 years old
J Trauma Acute Care Surg
Effectiveness of child safety seats vs seat belts in reducing risk for death in children in passenger vehicle crashes
Arch Pediatr Adolesc Med
Child passenger safety: decisions about seating location, airbag exposure, and restraint use
Risk Anal
Seating positions and children's risk of dying in motor vehicle crashes
Inj Prev
Child passenger deaths involving alcohol-impaired drivers
Pediatrics
Risk factors for death among older child and teenaged motor vehicle passengers
Arch Pediatr Adolesc Med
Alcohol and motor vehicle-related deaths of children as passengers, pedestrians, and bicyclists
JAMA
Child passenger safety
Pediatrics
Recommendations to reduce injuries to motor vehicle occupants increasing child safety seat use, increasing safety belt use, and reducing alcohol-impaired driving
Am J Prev Med
Cited by (38)
Safety/booster seats in pediatric motor vehicle crashes: Public health concern
2024, American Journal of Emergency MedicineImproper Restraint Use in Fatal Pediatric Motor Vehicle Collisions
2024, Journal of Pediatric SurgeryAge-specific characteristics of road traffic injuries among children and adolescents in South Korea
2023, Traffic Injury PreventionUrban and Rural Child Deaths from Motor Vehicle Crashes: United States, 2015-2019
2022, Journal of PediatricsCitation Excerpt :Numerous previous studies have shown an increased risk of severe injury and death among children who are not optimally restrained in a crash.5-7,19-21 In an earlier study of child MVC deaths using FARS data, Wolf et al found that both suboptimal restraint use and crashes occurring on rural roads were key predictors of mortality.21 The most effective way to prevent injuries and deaths in a crash is by using age- and size-appropriate restraints on every trip.5-7,22
Improper Restraint Use in Pediatric Patients Involved in Motor Vehicle Collisions
2022, Journal of Surgical ResearchCitation Excerpt :Multiple barriers continue to prevent the efficacious application of restraint initiatives, such as lack of understanding of age-related differences with regards to risk factors and injury patterns,8,9 limited pediatric healthcare provider knowledge,10 and failure to provide passenger safety information in both primary care and acute care settings. Socioeconomic accessibility of items such as booster seats, determination of precise geographical areas to target prevention efforts,11 lack of available funding within high-risk populations, and the day-to-day enforcement of such initiatives in specific areas12 have also been implicated in making pediatric harm prevention challenging. In order to implement the appropriate strategies where there is the highest need, an understanding of our community’s restraint practices and the level to which it is deficient is crucial.
Supported by the American College of Surgeons Resident Research Scholarship (to L.W.) and the US National Institute of Health/National Institute of Arthritis and Musculoskeletal and Skin Diseases (K24AR057827-02 [to E.L.]). A.H. is the PI of a contract (AD-1306-03980) with the Patient-Centered Outcomes Research Institute entitled “Patient-Centered Approaches to Collect Sexual Orientation/Gender Identity in the ED” and a Harvard Surgery Affinity Research Collaborative (ARC) Program Grant entitled “Mitigating Disparities Through Enhancing Surgeons' Ability To Provide Culturally Relevant Care.” The other authors declare no conflicts of interest.
Portions of this study were presented as an oral presentation at the American Academy of Pediatrics National Conference & Exhibition in San Francisco, California, October 21-25, 2016.