Motor vehicle restraints: Primary versus secondary enforcement and ethnicity

Background: Efforts to increase motor vehicle restraint use have been broadly based rather than focused on specific populations. Identifying specific issues, including populations with low restraint use, can help target educational campaigns. Previous studies have reported differences in restraint use by ethnicity. This study was performed to determine whether differences exist in motor vehicle restraint use by ethnicity and whether these differences are altered by the presence of primary versus secondary restraint laws. Methods: Data were collected on motor vehicle crash victims admitted to two Level I trauma centers from October 1, 1997, through March 31, 1998; one in a state with primary restraint enforcement (motorist can be stopped for the restraint violation), the other with a secondary restraint law (restraint violation may be enforced if the motorist is stopped for another violation). Data were obtained concurrently with hospitalization and entered into computerized trauma registry databases. Results: Restraint use in all motor vehicle crash victims was significantly different between the primary and secondary enforcement states (58% vs. 37%, p < 0.001). Additionally, restraint use varied markedly by ethnicity in the secondary enforcement state (Caucasian, 42%; vs. African-American, 21%, and Hispanic, 26%, p < 0.02, chi(2)). Comparison of restraint use in primary versus secondary enforcement states demonstrated significantly increased restraint use in all ethnic groups (p < 0.01). Conclusion: In a state with secondary enforcement laws, restraint use varied significantly with ethnicity. Restraint use was markedly increased in all ethnic groups by the presence of a primary enforcement law. Implementation and enforcement of primary restraint laws is essential to improving motor vehicle restraint use. Educational campaigns to increase restraint use need to target specific populations.