Child Booster Seats

This article in the KC Star should be used as evidence that newspapers are not straight down the middle in their reporting. Kansas lawmakers are trying to decide whether it should mandated by law that children under the age of 7 be required to ride in a booster seat. Then the article cites several statistics saying that booster seats are much safer than just the use of regular seat belts.

This year, as he has for most of the last five years, Vickrey is supporting a bill in the Kansas Legislature that would require children who have outgrown child-safety seats to ride in booster seats for a few years. Similar bills also have been introduced once again into the Missouri General Assembly.

In the past, opponents have taken issue with the cost of booster seats — they’re available for $10 or $20 or even free in some places — or have bristled at the government intruding in one more aspect of their lives.
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“We know that motor-vehicle crashes are the biggest single killer of children ages 4 to 8,” said Cindy D’Ercole, a lobbyist for Kansas Action for Children.

Vehicle accidents account for about 40 percent of the deaths of children ages 1 through 14. They kill about 1,800 children younger than 16 each year and injure 280,000.
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Last year the Kansas Department of Transportation stationed observers throughout the state in places where they could look into slow-moving vehicles to see whether children were properly restrained. They estimated that 81 percent of children from birth to 4 years of age were buckled up, along with 49 percent of children ages 5 through 9, and 46 percent of children ages 10 to 14. (This would include car seats, booster seats and seat belts.)
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Legally requiring booster seats is important because parents often model their own behavior after the law, Durbin said. Even if their pediatricians recommend booster seats, he said, parents tend to think, “If it’s not in the law, it must not be important.”

Had this article not been in the KC Star and had I not recently read Freakonomics, I may have fallen hook, line and sinker for the notion that booster seats save lives. I certainly wouldn't have been in favor of making a law that makes parents' behavior criminal. I also remembered that several months back I read that booster seats weren't the child safety panacea they are marketed to be.

Sure enough Freakonomics had an article in the New York Times Magazine in July citing evidence supporting my thoughts.

They certainly have the hallmarks of an effective piece of safety equipment: big and bulky, federally regulated, hard to install and expensive. (You can easily spend $200 on a car seat.) And NHTSA data seem to show that car seats are indeed a remarkable lifesaver. Although motor-vehicle crashes are still the top killer among children from 2 to 14, fatality rates have fallen steadily in recent decades -- a drop that coincides with the rise of car-seat use. Perhaps the single most compelling statistic about car seats in the NHTSA manual was this one: ''They are 54 percent effective in reducing deaths for children ages 1 to 4 in passenger cars.''

But 54 percent effective compared with what? The answer, it turns out, is this: Compared with a child's riding completely unrestrained. There is another mode of restraint, meanwhile, that doesn't cost $200 or require a four-day course to master: seat belts.

For children younger than roughly 24 months, seat belts plainly won't do. For them, a car seat represents the best practical way to ride securely, and it is certainly an improvement over the days of riding shotgun on mom's lap. But what about older children? Is it possible that seat belts might afford them the same protection as car seats? The answer can be found in a trove of government data called the Fatality Analysis Reporting System (FARS), which compiles police reports on all fatal crashes in the U.S. since 1975. These data include every imaginable variable in a crash, including whether the occupants were restrained and how.

Even a quick look at the FARS data reveals a striking result: among children 2 and older, the death rate is no lower for those traveling in any kind of car seat than for those wearing seat belts. There are many reasons, of course, that this raw data might be misleading. Perhaps kids in car seats are, on average, in worse wrecks. Or maybe their parents drive smaller cars, which might provide less protection.

But no matter what you control for in the FARS data, the results don't change. In recent crashes and old ones, in big vehicles and small, in one-car crashes and multiple-vehicle crashes, there is no evidence that car seats do a better job than seat belts in saving the lives of children older than 2. (In certain kinds of crashes -- rear-enders, for instance -- car seats actually perform worse.) The real answer to why child auto fatalities have been falling seems to be that more and more children are restrained in some way. Many of them happen to be restrained in car seats, since that is what the government mandates, but if the government instead mandated proper seat-belt use for children, they would likely do just as well / without the layers of expense, regulation and anxiety associated with car seats.

Levitt and Dubner suggest that the best alternative is lap and shoulder belts that adjust to smaller children.