Buckle up: non-seat belt use and antisocial behavior in the United States

The prevalence of seat belt use among drivers and passengers: a systematic review and meta-analysis

BACKGROUND

Seat belts might save people's lives in car accidents by preventing severe collision damage and keeping passengers safe from critical injuries. This meta-analysis was performed to assess the prevalence of seat belt use among drivers and passengers.

METHODS

The databases of PubMed, Web of Science (WOS), and Google Scholar were searched from the beginning of 2000 to late December 2020 to identify studies that investigated the prevalence of seat belt use among drivers and passengers. The pooled prevalence was calculated using a random-effects model. The STATA-v14 software was used to perform data analysis.

RESULTS

Sixty-eight studies that met the inclusion criteria and were suitable for this meta-analysis were identified. The pooled prevalence of seat belt use was 43.94% (95% CI: 42.23-45.73) among drivers, 38.47% (95% CI: 34.89-42.42) among front-seat passengers, and 15.32% (95% CI: 12.33-19.03) among rear-seat passengers. The lowest seat belt use among drivers and passengers was observed in Asia, the Middle East, and Africa, while the highest use was reported in Europe and America. Moreover, the prevalence of seat belt use was higher among women drivers [51.47% (95% CI: 48.62-54.48)] than men drivers [38.27% (95% CI: 34.98-41.87)] (P < 0.001). Furthermore, the highest prevalence of seat belt use was seen among drivers (68.9%) and front-seat passengers (50.5%) of sports utility vehicles (SUVs); in contrast, the lowest prevalence was observed among drivers and passengers of public vehicles such as buses, minibuses, and taxis.

CONCLUSIONS

In general, the prevalence of seat belt use was not high among drivers and was even lower among passengers. Moreover, drivers and passengers in Asia, the Middle East, and Africa had the lowest prevalence of seat belt usage. Additionally, drivers and passengers of public transportation (buses, minibuses, and taxis) had a lower rate of seat belt use, especially among men. Therefore, effective interventional programs to improve seat belt use should be designed and implemented, particularly among these at-risk populations in Asia, the Middle East, and Africa.

Toward a typology of driving under the influence of alcohol and drugs

PURPOSE

Most research on driving under the influence (DUI) has relied upon variable-centered methods that examine predictors/correlates of DUI. In the present study, we utilize a person-level approach-latent class analysis (LCA)-to model a typology of individuals reporting DUI. This allows us to understand the degree to which individuals drive under the influence of a particular substance or do so across multiple substance types.

METHODS

We use public-use data collected between 2016 and 2019 from the National Survey on Drug Use and Health. The analytic sample was 189,472 participants with a focus on those reporting DUI of psychoactive substances in the past-year (n = 24,619). LCA was conducted using self-reported DUI of past-year alcohol, cannabis, cocaine, heroin, hallucinogens, and methamphetamine as indicator variables.

RESULTS

More than 1 in 10 Americans reported a DUI within the past-year. One in five people who reported DUI of one substance also reported DUI of at least one additional substance. Using LCA to model heterogeneity among individuals reporting DUI, four classes emerged: "Alcohol Only" (55%), "Cannabis and Alcohol" (36%), "Polydrug" (5%), and "Methamphetamine" (3%). Rates of risk propensity, drug involvement, illicit drug use disorders, and criminal justice system involvement were highest among members of the "Polydrug" and "Methamphetamine" classes.

CONCLUSION

Drug treatment centers should take care to include discussions of the dangers and decision-making processes related to DUI of the full spectrum of illicit substances. Greater investment in drug treatment across the service continuum, including the justice system, could prevent/reduce future DUI episodes.

Prevalence of unmasked and improperly masked behavior in indoor public areas during the COVID-19 pandemic: Analysis of a stratified random sample from Louisville, Kentucky

Wearing a facial mask can limit COVID-19 transmission. Measurements of communities' mask use behavior have mostly relied on self-report. This study's objective was to devise a method to measure the prevalence of improper mask use and no mask use in indoor public areas without relying on self-report. A stratified random sample of retail trade stores (public areas) in Louisville, Kentucky, USA, was selected and targeted for observation by trained surveyors during December 14-20, 2020. The stratification allowed for investigating mask use behavior by city district, retail trade group, and public area size. The total number of visited public areas was 382 where mask use behavior of 2,080 visitors and 1,510 staff were observed. The average prevalence of mask use among observed visitors was 96%, while the average prevalence of proper use was 86%. In 48% of the public areas, at least one improperly masked visitor was observed and in 17% at least one unmasked visitor was observed. The average prevalence of proper mask use among staff was 87%, similar to the average among visitors. However, the percentage of public areas where at least one improperly masked staff was observed was 33. Significant disparities in mask use and its proper use were observed among both visitors and staff by public area size, retail trade type, and geographical area. Observing unmasked and improperly masked visitors was more common in small (less than 1500 square feet) public areas than larger ones, specifically in food and grocery stores as compared to other retail stores. Also, the majority of the observed unmasked persons were male and middle-aged.

Getting Young Drivers to Buckle Up: Exploring the Factors Influencing Seat Belt Use by Young Drivers in Malaysia

Many car drivers in Malaysia, especially young drivers, ignore the importance of wearing seat belts. This questionnaire study employed an extended version of the theory of planned behaviour (TPB) by including habit as a new construct to explain the factors influencing the behavioural intention and expectation of young Malaysian drivers to use seat belts. A total of 398 young drivers from the state of Selangor in Malaysia participated in this study. Analyses used a covariance-based structural equation modelling (CB-SEM) approach. The results showed that the variance, which indicates the intention of young Malaysian drivers to use seat belts (R2 = 0.76), is influenced by drivers’ habits and three basic constructs of the TPB (attitude, subjective norms, and perceived behavioural control). The basic TPB constructs have a direct and positive impact on the intention of young Malaysian drivers to use seat belts. Drivers’ habits have a positive and direct influence on their intention to use seat belts, and an indirect influence via the attitude and perceived behaviour control constructs. Drivers’ habits do not influence subjective norms. The authors recommend implementing effective measures to encourage Malaysian drivers to use seat belts and ensure sustainable traffic safety.

Trends in Socioeconomic Inequalities in Motor Vehicle Accident Deaths in the United States, 1995-2010

Motor vehicle accident (MVA) mortality has been declining overall, but little is known about trends by socioeconomic position. We examined trends in education-related inequalities in US MVA death rates from 1995 to 2010. We used mortality data from the National Center for Health Statistics and population estimates from the Current Population Survey, and we calculated vehicle- and person-miles traveled using data from the National Household Travel Survey. We used negative binomial regression to estimate crude and age-, sex-, and race-adjusted mortality rates among adults aged 25 years or more. We found larger mortality decreases among the more highly educated and some evidence of mortality increases among the least educated. Adjusted death rates were 15.3 per 100,000 population (95% confidence interval (CI): 10.7, 19.9) higher at the bottom of the education distribution than at the top of the education distribution in 1995, increasing to 17.9 per 100,000 population (95% CI: 14.8, 21.0) by 2010. In relative terms, adjusted death rates were 2.4 (95% CI: 1.7, 3.0) times higher at the bottom of the education distribution than at the top in 1995, increasing to 4.3 times higher (95% CI: 3.4, 5.3) by 2010. Inequality increases were larger in terms of vehicle-miles traveled. Although overall MVA death rates declined during this period, socioeconomic differences in MVA mortality have persisted or worsened over time.

Alcohol involvement and other risky driver behaviors: effects on crash initiation and crash severity

OBJECTIVE

Alcohol-involved drivers or those with blood alcohol concentrations greater than 0.00 percent have more frequent and more severe crashes than other drivers. Alcohol use, because it delays perception and response and impairs coordination, increases the risk of a crash. However, those using alcohol may take additional driving risks, which may also lead to crashes. This study was done to learn whether risks besides alcohol involvement contributed to crash initiation and whether crash severity increased with alcohol involvement or with those other risky behaviors.

METHODS

Data that represented nearly 1.4 million motor vehicle crashes were accessed from an NHTSA database. Analyses evaluated whether alcohol-involved driving was associated with other driving risks and whether driver alcohol involvement, alone or together with other risks, increased the likelihood of initiating a 2-vehicle crash or in the event of a crash or increased crash severity.

RESULTS

Alcohol-involved drivers were less likely to use seat belts, drove faster, and were more likely to be distracted than others. Those who initiated 2-vehicle crashes were more likely to be alcohol involved or to have taken other driving risks than others from the same crashes. Crash severity was significantly greater for alcohol-involved drivers than for other drivers, but severity increased further if additional risks were taken. Crashes involving only drivers who had not used alcohol were also sometimes severe, and that severity was associated with risky driving behaviors. When crashes involved 2 drivers, the behaviors of both affected crash severity.

CONCLUSIONS

Risky driving behaviors, including alcohol involvement, increased the risk of a crash. Crash severity tended to increase with any risky behavior and to increase further with multiple risky behaviors. Other risky behaviors were associated with both alcohol involvement and crashes. Therefore, if effects from those other risky behaviors were not accommodated for, those effects would confound apparent associations between alcohol involvement and crashes. Therefore, this study's use of multivariate models that accommodated for effects from those other behaviors provided a truer picture of alcohol's association with crashes than simpler models would have. Supplemental materials are available for this article. Go to the publisher's online edition of Traffic Injury Prevention to view the supplemental file.