Seat Belt Use Among American Indians/Alaska Natives and Non-Hispanic Whites

• Published in: American journal of preventive medicine 2007-09, Vol.33 (3), p.200-206
• Main Authors: Garcia, Andrea N., BA, Patel, Kushang V., PhD, Guralnik, Jack M., MD, PhD
• Format: Article
• Language: English
• Subjects: Accidents, Traffic; Adolescent; Adult; Aged; Alaska; Alaska Native people; American Indian people; Behavioral Risk Factor Surveillance System; Bias; European Continental Ancestry Group - ethnology; Female; Geography; Humans; Indians, North American - ethnology; Internal Medicine; Law; Male; Middle Aged; Motor vehicles; Risk-Taking; Seat Belts - legislation & jurisprudence; Seat Belts - utilization; Seatbelts; Self Disclosure; United States; Users
• ISSN: 0749-3797; 1873-2607
• DOI: 10.1016/j.amepre.2007.04.032

Background Accidents (including motor vehicle injuries) are a leading cause of death among American Indians/Alaskan Natives (AI/AN). The purpose of this study was to examine geographic variation and the existence of a seat belt law on seat belt use among AI/AN and non-Hispanic whites (NHW). Methods Self-reported seat belt behavior data from the 1997 and 2002 Behavioral Risk Factor Surveillance System were analyzed in 2006–2007 and were restricted to AI/AN ( n =4310 for 2002, and n =1758 for 1997) and NHW ( n =193,617 for 2002, and n =108,551 for 1997) aged 18 years and older. Results Seat belt non-use varied significantly across geographic regions for both AI/AN and NHW. For example, AI/AN living in the Northern Plains (odds ratio [OR]=12.4, 95% confidence interval [CI]=6.5–23.7) and Alaska (OR=10.3, 95%CI=5.3–19.9) had significantly higher seat belt non-use compared to AI/AN living in the West. In addition, compared to those residing in urban areas, those living in rural areas were 60% more likely in NHW and 2.6 times more likely in AI/AN not to wear a seat belt. Both AI/AN and NHW living in states without primary seat belt laws were approximately twice as likely to report seat belt non-use in 2002 as those living in states with primary laws. In states with primary laws enacted between 1997 and 2002, AI/AN experienced greater decline in seat belt non-use than NHW. Conclusions Seat belt use among AI/AN and NHW varied significantly by region and urban–rural residency in 2002. Primary seat belt laws appear to help reduce regional and racial disparities in seat belt non-use.