Child Car Seat Stats: Knowing The Leading Cause of Death To Children
Do you know the car seat statistics show the leading cause of death to children ages 3-14 in the United States is motor vehicle crashes?
In 2019 in the United States, 1,053 children 14 years and younger died in car crashes. In comparison, 2018 saw 1,049 deaths. During 2018 in the birth to 12 years age range, basically the ages most children should be in some sort of child restraint, 636 children died. (Of all the children birth to 12 who died in a crash in 2018, 33% did not have a restraint in use.)
And fatalities represent only the tip of the iceberg. Crashes injured more than 183,000 children in this birth to 14 years range in 2019.
Crashes occur all the time. You never know when a crash will involve you. A crash is reported to the police every 5 seconds (only about a third are reported). A person gets injured every 13 seconds. And a person dies in a crash every 14 minutes. Comparatively, someone gets murdered every 30 minutes. (CPS Instructor Guide, 1-16)
Many of these injuries and deaths can be prevented. Placing children in age- and size-appropriate car seats and booster seats reduces serious and fatal injuries by more than half.
What Do The Child Car Seat Statistics Show?
- More of the older children (48% of 8-12 year olds) were not buckled up compared with younger children (33% of 4-7 year olds; 21% of children under age 4) in 2016
- Restraint use among young children often depends upon the driver’s seat belt use. Almost 40% of children riding with unbelted drivers were themselves unrestrained.
- More than two-thirds of fatally injured children were killed while riding with a drinking driver.
One CDC study found that, in one year, more than 618,000 children ages newborn to 12 rode in vehicles at least some of the time without the use of a restraint be it car seat, booster seat or seat belt.
Are You Using Your Child Car Seat Restraint Safely?
Good you keep your child in a child restraint because obviously it’s safer. Do you know how many restraints are used incorrectly?
Any where from 52% (AAA and National Safety Council) to 90% of child restraints show some sort of misuse. The percentage varies by study. For instance, a 2016 Oregon Health and Science University Hospital study showed 4 out of 5 (80%) car seats are installed incorrectly but car seat misuse was even higher among new parents, at 93%.
The National Highway Traffic Safety Administration shows 46% of misuse that can interfere with the safety for the child in the child restraint. Specifically by type of restraint:
- 61% of forward-facing car seats (73% according to AAA),
- 44% of rear-facing convertible car seats,
- 49% of rear-facing infant car seats,
- 16% of highback belt-positioning boosters, and
- 24% of backless belt-positioning boosters,
- 90% of of children using just a seat belt under the age of 10 should still be in a car or booster seat.
The most common forms of misuse are using the wrong seat for the child’s age and weight, loose safety belt attachment to the car seat and loose harness straps on the child.
A 2015 study by National Highway Traffic Safety Administration (NHTSA) shows that almost all parents use the harness straps but at least 40% have the harness too loose, 34% have the chest clip in the wrong position and 30% have the harness straps twisted. These numbers are specifically for forward-facing car seats but the rear-facing numbers are very similar.
This is scary because another statistic says 96% of parents believe their child safety seats are installed correctly. Results of the NHTSA study shows similar results of parents feeling at least somewhat to very confident they installed the car seat correctly.
Meanwhile these misuses increase a child’s risk of injury during a crash. It may be because of the parent’s confidence they they did the car seat correctly that results in parents not reading the car seat manual or the vehicle manual. The car seat manual includes how to properly install and use the car seat. Sixty-one percent of parents reported reading that. That’s pretty good. Whereas only 13% of parents reported reading the vehicle manual. The vehicle manual includes information about in what positions you can use the LATCH system or seat belt system to install the car seat.
Using The Car Seat Correctly For Child Safety
Using the car seat correctly is important because incorrect use correlates to your child being 3 and a half times more likely to attain a serious injury during a crash. Part of using it correctly includes installing it in the car correctly.
The government required car manufacturers to install LATCH systems in cars since 2002 in hopes that it would make installing car seats easier. Unfortunately, it tends to add to the confusion.
A study completed in 2010 by Safe Kids looked at 79,000 car seat installations. Parents installed car seats with LATCH 30% of the time and with the seat belt 68% of the time. When looking at correct usage for forward-facing harness seats, 46% of car seats installed with LATCH were incorrect. Meanwhile 56% of car seats installed with the seat belt were incorrect. The study didn’t go into why more than twice the people chose the seat belt.
What makes it even more confusing is the lower anchors of the LATCH system have a weight limit. So when the child reaches a certain weight (combined with the weight of the particular car seat), a parent needs to reinstall the car seat using just a seat belt.
What about booster age (4-10 year old) children specifically?
NHTSA says booster seat use among 4- to 7-year-old children stood at 46% in 2013, up a mere 3% from 2008. NHTSA’s result is from the National Survey of the Use of Booster Seats (NSUBS), the only probability-based nationwide child restraint survey that observes restraint use and obtains age by interview. The NSUBS found that in 2013:
- 46% of children ages 4-7 were using booster seats (either high-backed or backless),
- 33%were not properly restrained;
- 24% were in seat belts and
- 9% did not use a restraint.
This indicates that as many as 33% of children 4 to 7 in the United States were not properly protected (24% in seat belts and 9% unrestrained).
Compare that to 98% of children under age one and 96% of children from ages 1-3 who were restrained. Why are there so fewer restrained in the booster age range?
Is It Safe For A Child of Age 8 Or Under To No Longer Be Secured?
Nearly 70% of drivers believe it is safe to not secure children age 8, or under, in a child safety seat or booster seat, as one study states. The good news is this statistic has improved. In 1999 the number of children 4-8 using booster seats was a mere 4% and by 2004 it was up to 27%.
Booster seat misuse is 41%. (That seems like a lot for something that supposed to be easier to use doesn’t it?)
Download our report: Common Car Seat Mistakes and How to Fix Them
How do we get better child car seat statistics?
The good news is the rate of use of child restraints has been improving.
- In 1999 it was 15%;
- 2008 it was 80%;
- 2013 it was 91%.
That is good, in and of itself. Studies show child safety seats reduce fatal injury by
- 71% for infants,
- 54% for toddlers ages 1-4 and
- 45% for children ages 4-8.
We can improve the statistics more by using the car seats more correctly and not “graduating” children to seat belts too early. That’s where more education comes in.
Child restraints saved the lives of an estimated 284 children under age 5 in 2012.
Plus, we can keep children in the rear vehicle seat longer. We reduce the injury risk by 64% for newborn to 8 year olds and 31% for 9-12 year olds by keeping them in the rear seat.
And a big kicker, if we think it’s important enough to buckle ourselves, we’re more likely to buckle our children. As with everything else, they do as we do. If we emphasize keeping our selves buckled, they are more likely to keep themselves buckled especially as they get older. Almost 40% of children riding with unbelted drivers also ride unrestrained.
What about car seat safety for the booster age specifically?
The 2011 recommendations from the American Academy of Pediatrics suggest as best practice: all children whose weight or height is above the forward-facing limit for their car seat use a belt positioning device, like a booster seat or RideSafer® Travel Vest, until the vehicle lap-shoulder belt fits properly or when they pass the 5-step seat belt fit test. Typically the belt will fit properly when the child has reached 4 feet 9 inches and are between 8 and 12 years of age. According to Children’s Hospital of Philadelphia (CHOP) booster seats reduce injury risk by 45% compared to seat belts alone.
As of April 2013, 48 states have “booster seat laws” requiring the use of child restraints, booster seats or other appropriate devices, like the RideSafer, for children who have outgrown their car seats and do not fit correctly in the adult seat belt. The only states without “booster seat” laws are Florida and South Dakota (child restraint required up to age 5). Though Florida did up the age requirement a couple of years ago to age 6 and are state legislators are trying to increase the age again.
(We put “booster seat laws” in quotes because really they are car seat laws that go up through “booster seat” age. And as you have read there are other options rather than just a booster seat.)
Just out of curiosity, how are older children doing when it comes to car safety?
Compared with other age groups, youths 16-24 have the lowest seat belt use rate.
In 2011, 82% of teens in the age range wore seat belts. (There are more male than female of those who don’t buckle up.) In fact, in 2011 the majority (58%) of young people 16 to 20 years old involved in fatal crashes were unbuckled.
Guidelines for Parents and Caregivers
- Use a seat belt on every trip, no matter how short. This sets a good example.
- Properly buckle your children in a child restraint, booster seat or seat belt, whichever is appropriate for the car seat stage they are in by age, height and weight.
- All children younger than 13 years should ride in the back seat. Airbags can kill young children riding in the front seat. Never place a rear-facing car seat in the front seat or in front of an air bag.
- Place children in the middle of the back seat when possible, because it is the safest spot in the vehicle.
What do you think about the car seat safety stats? Share your comments below.
By Amie Durocher, Creative Director at Safe Ride 4 Kids and certified CPS Tech since 2004
Copyright 2021 Safe Ride 4 Kids. All rights reserved. You may not publish, broadcast, rewrite or redistribute this material without permission. You are welcome to link to Safe Ride 4 Kids or share on social media.
We originally published this post in April 2013. We updated the article with current car seat statistics.
Sources of car seat stats:
- Safe Kids USA,
- NHTSA,
- CDC,
- SeatCheck.org,
- CHOP,
- Governors Highway Safety Association
Some of the statistics are pretty frightening, especially the one being that 96% of parents believe they are installing the car seats correctly, when in fact 72-84% of the people are misusing car seats!
I’d like to have more context for the statement: “as child safety seats have been shown to reduce fatal injury by 71% for infants and 54% for toddlers ages 1-4 and 45% for children ages 4-8”.
Can you site the studies that show these numbers and state what the control was?
Those stats came from the CDC website on the Risk Reduction tab.
CDC sites these two studies:
• Durbin, D. R. (2011). Technical report—Child passenger safety. Pediatrics, 127(4). Advance online publication. doi:10.1542/peds.2011-0215.
• Arbogast KB, Jermakian JS, Kallan MJ, Durbin DR. Effectiveness of belt positioning booster seats: an updated assessment. Pediatrics 2009;124;1281–6.
The studies, if they are there are bs, check the fatalities by year from 1970 onwards, no difference
It looks like steady decline as car seats became legally required then more and more used. Can you link to data where you are seeing no difference?
Graph from Pines Saloman Injury Lawyers
This graph is based on data from IIHS, Fatality Facts 2019: Children.
If it can be fixed, you’ve missed the word “as” in the last paragraph of: How do we get better child car seat safety statistics.
“…to keep themselves buckled especially (as) they get older.”
Other than that great article that I’d love to use as a source. I had no idea the stats were so significant in difference since 1999, less than 20 years ago!
what about compared to heat related deaths? The numbers in heat related deaths seem to be rising.
Hi Rosario, Heat related deaths reached a high number in 2018 of 52 children who died in hot cars. Whereas 794 children ages 0 to 12 died in car crashes in 2017. (Numbers have not been released for 2018 yet.) And an estimated 3,000 pregnancies are lost every year in car crashes. So yes hot car related deaths get a lot of media and the numbers do seem to be rising (average over the years is 38 per year) but it is still dramatically lower than car crash deaths.
Thanks for this helpful information. Can you please clarify the data above related to race? Are more Black and Hispanic children unbuckled because they don’t have access to a car seat or because they have a seat that they aren’t using?
Those statistics came from the CDC and they did not specify a reason for the discrepancy. It might go into more detail in whatever study they pulled it from. They have a list of 15 studies. I checked a couple that I thought it might have come from but didn’t see it.
My 8month old granddaughter was killed 5/3/21 because her mother was in the front seat with her without a car seat. Can her mother be charged with child endangerment in the state of NY?
Here is New York state car seat law:
NEW YORK – Car Seat Law (Section 1229-c, search child restraint then choose 1229-c)
Law: Children must remain in an appropriate child restraint system until the age of eight (8). An appropriate child restraint system is one that meets the child’s size and weight and the specifications of the manufacturer of such system. A child restraint system may be a child safety seat, harness, vest or a booster seat.
Specifically:
Children under the age of four must be restrained in a specifically designed seat which meets FMVSS 213 and is either permanently affixed or affixed with a seat belt.
So sounds like she could be charged with something if she did not have the child properly secured. However, I would confirm with a lawyer.
Great read! Hopefully this article can open some parent’s eyes. I would love to see an article published highlighting unsafe car seat additives such as aftermarket inserts, toys, covers, etc. !
Hi Celia, We used to have one but I deleted it until I can update and rewrite it. It’s on our list!
I’ve heard you can get a free car seat at a designated Sheriff’s office or Hwy Patrol and they can show you how to install the car seat properly. Is this true for California? What is the age and weight a child graduates from using a car seat? Also are there any restraint devices that may properly help keep a seatbelt in place with a child who has difficulties keeping a seatbelt on?
Hi Marcia,
1. Various places offer free or low-cost car seats. Sometimes it’s only during certain times of the year. You would have to contact local child passenger safety technicians to find a place that offers that in California.
2. Legally graduates and safely graduates often differ, depending on the state car seat law. Best practice says that a child can “graduate” from a child restraint to just the seat belt when the child can pass the 5-step seat belt fit test which is usually when a child is at least 4’9″ (57″) tall. Sometimes a child will be 12 years old before they hit this height.
3. You could try a RideSafer vest to properly position the seat belt on a child who would otherwise move it to an unsafe position.
I can’t find the data that shows how many deaths in rear facing seats vs fwd facing seats. Have a 3 year old legs are all folded up in the rear facing position and thought it would be safer to have her fwd facing sitting properly. But couldn’t find any death data on fwd vs rear. Thanks
Hi Kim, I cannot find data comparing rear facing and forward facing child crash fatalities. I imagine it’s not a part of death certificates to list if a child was in a rear-facing or forward-facing car seat. And it may or may not be mentioned in a police report. The idea that a child should be rear facing for as long as possible is based on studies looking at crash data and injuries. Studies also show that leg injuries are more likely to occur in forward facing children. You can read more about keeping your child rear facing longer here.