Seat Belt Use Among American Indians/Alaska Natives and Non-Hispanic Whites
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.
Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, Maryland
Address correspondence and reprint requests to: Jack M. Guralnik, MD, PhD, Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, Gateway Building, Suite 3C-309, 7201 Wisconsin Ave., MSC 9205, Bethesda MD 20892-9205.
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