State and Federal Efforts to Increase Adult Seat Belt Use

By Samantha Bloch | Vol . 28, No. 16 | May 2020


The increase in seat belt use in the United States between 1975 and 2017 saved over 374,000 lives, according to the National Highway Traffic Safety Administration (NHTSA). NHTSA estimates that over 386,000 additional lives would have been saved during this time period if 100% of people had buckled up. 

In 2019, 90.7% of American adult front-seat passengers used seat belts. This represents only a slight rise from 89.6% in 2018, but the overall rate increased from 81.7% to 90.7% during the last 15 years.

Seat belt use rates vary widely between states. In 2018, they ranged from 76.4% in New Hampshire to 97.8% in Hawaii. While there used to be a notable difference in seat belt use between urban and rural areas, 2019 data shows that only slightly more urban vehicle occupants (90.8%) than rural occupants (90.4%) are wearing seat belts. Increased seat belt use has led to fewer fatalities among unrestrained occupants in daytime crashes, from 46.4% to 38.5% between 2005 and 2018.

Increased seat belt use has led to fewer fatalities among unrestrained occupants in daytime crashes, from 46.4% to 38.5% between 2005 and 2018.

Rear-seat belt use among occupants 8 years and older increased from 70% in 2009 to 76.1% in 2018, the most recent year for which data is available. The number of occupants who buckle up in the back seat, however, continues to be significantly lower than front-seat belt users. Additionally, a study suggests that rear-seat belt use is higher in private vehicles than in taxis, and results are mixed regarding ride-hailing services such as Uber and Lyft.

State Action

Each state determines its seat belt laws. Some states require all occupants to buckle up while others require seat belt use only in front seats. Additionally, these laws can authorize primary enforcement, allowing law enforcement to stop and cite a driver specifically for not wearing a seat belt. Secondary enforcement laws allow officers to cite drivers for non-compliance, but only when they are pulled over for another primary violation.

According to NHTSA, the greatest jump in belt use occurred between 1984 and 1987 as seat belt laws took effect in 29 states. Research affirms that seat belt laws significantly increase seat belt use and that primary enforcement laws are more effective than secondary enforcement laws. In 2019, 92% of front-seat occupants in states with primary enforcement laws buckled up, in contrast to 86.2% of front-seat occupants in states with secondary enforcement or no laws.

The effect of seat belt laws on rear-seat occupants is also noteworthy. In 2018, 81% of occupants in back seats used belts in states with seat belt laws for all seating positions, while 68.7% of occupants in rear seats used belts in states with front-seat-only belt laws.

New Hampshire and American Samoa are the only state and territory without a seat belt law for adults. However, New Hampshire is currently considering a secondary adult seat belt law for all seats.

With the boom in ride-hailing services, there is heightened interest in rear seat belt usage in for-hire vehicles. Most states exclude taxi drivers and riders from seat belt requirements. Some states explicitly require passengers in for-hire vehicles to buckle up.

In Massachusetts, taxi and livery drivers are not required under state law to wear a seat belt, but passengers are. Oregon’s safety belt law requires occupants of privately owned commercial vehicles transporting 15 or fewer persons to use belts, including passengers in shuttles, taxis, limousines and vans. Nevada expressly requires taxi drivers and adult passengers in the front and back seats to wear a seat belt, allowing a $25 citation for violations and requiring taxi operators to post signs informing passengers that they must buckle up. New York recently amended its seat belt laws to require passengers older than 16 to buckle up in the back seat of for-hire vehicles. Previously, only passengers in the front seat were required to do so. New York also passed a bill mandating that all stretch limousines be equipped with one seat belt in the rear for each passenger by Jan. 1, 2023.

Federal Action

NHTSA promotes several local and statewide seat belt public service campaigns such as Buckle Up America and Click It or Ticket (CIOT). The Buckle Up campaign provides marketing tools that help counter misperceptions and inform communities about the importance of wearing seat belts. The yearly CIOT campaign focuses on strong laws and increased seat belt enforcement periods in addition to safety education. It lasts several weeks, starting with public awareness operations followed by a high-visibility enforcement period.

The Fixing America’s Surface Transportation (FAST) Act, which passed in 2015 and expires later this year, included Section 405, the National Priority Safety Program, which provides grant funding to address certain traffic safety issues. Specifically, 405b, Occupant Protection, provides federal funding to states to encourage them to implement effective programs to reduce highway deaths and injuries resulting from people riding unrestrained or improperly restrained in motor vehicles. States must satisfy specific criteria in order to receive funding, including whether their seat belt use rates are above or below 90%.