THE ISSUES

Despite safety improvements to the motor vehicle and roadway and despite educational and legislative measures to promote safe driving, crash injuries remain the leading cause of death and serious injury for children, adolescents, and young adults. Annually, nonpedestrian motor vehicle mishaps claim more than 18,000 lives of Americans less than 25 years of age.1 The vast majority die as occupants of passenger cans. Teenage boys and young male adults are at greatest risk with annual death rates exceeding 100/100,000 population for licensed drivers aged less than 25 years. One out of every one hundred 15-year-old boys will die in a motor vehicle crash before reaching age 25 years.2

To deal with the silent "highway epidemic," the American Academy of Pediatrics launched the "First Ride—Safe Ride" program in 1980. Increasing the use of car seats by newborns was an appropriate Academy project goal as pediatricians can be particularly effective in counseling new parents. The "Every Ride—Safe Ride" program will expand this effort to deal with the more difficult task of reducing occupant injuries to older children and adolescents. This program will promote safe and responsible driving behavior and encourage the use of car seats and automobile seat belts (active restraints).

Seat belts, when used, can reduce the likelihood of a crash fatality by about 50%. Car seats can be even more effective, and there is some evidence that, when properly used, they can reduce the likelihood of death by 90% and serious injury by 70%. However, despite past educational efforts, seat belt use rates are in the 10% to 15% range and even with car seat use laws enacted in most states, actual use rates in excess of 30% to 40% have not been demonstrated.

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