Racial differences in child safety restraint use in Tennessee

Objectives: To evaluate the appropriate use of child safety restraints ( CSR) in black and white children. Design: Cross sectional, observational study of drivers of children age 0-10 years involving an on-site vehicle and CSR inspection and brief driver interview. Results: Data were obtained on 244 white and 204 black children; results were stratified by race due to effect modification of race on driver restraint use and CSR use. Twenty four percent of black and 13% of white child passengers aged 4-10 years were completely unrestrained ( p = 0.003). Of the 168 black and 220 white child passengers aged 0-10 years who were restrained, 64% of black and 58% of white children had inappropriate restraint use. Appropriate CSR use was significantly lower in 4-8 year old passengers compared with appropriately restrained children aged,4 years and 9-10 years ( p < 0.0001 for both black and white child passengers). Conclusions: Black child passengers and all child passengers aged 4-8 years are at increased risk of being inappropriately restrained. Educational efforts should address specific barriers to booster seat use in these populations.