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.