Associations between sociodemographics and safety belt use in states with and without primary enforcement laws
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Updated: Jul 13, 2026

A Test Bed to Examine Helmet Fit and Retention and Biomechanical Measures of Head and Neck Injury in Simulated Impact
Published on: September 21, 2017
Laurie F Beck1, Ruth A Shults, Karin A Mack
1Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Atlanta, GA 30341, USA. ldf8@cdc.gov
Objectives:
secondary enforcement laws (police may issue a safety belt citation only if the vehicle has been stopped for another reason).
Methods:
We analyzed 2002 Behavioral Risk Factor Surveillance System data from 50 states and the District of Columbia. We performed multivariable, log-linear regression analyses to assess the effect of sociodemographic characteristics and safety belt laws on safety belt use. Analyses were stratified by the type of enforcement permitted by state laws.
Results:
Reported safety belt use was higher in states that had primary versus secondary enforcement laws, both overall and for each sociodemographic characteristic examined. Safety belt use was 85% in states that had primary enforcement laws and 74% in states that had secondary enforcement laws. Cross-sectional data suggested that primary enforcement laws may have the greatest effect on sociodemographic groups that reported lower levels of safety belt use.
Conclusions:
Primary enforcement laws are an effective population-based strategy for reducing disparities in safety belt use and may, therefore, reduce disparities in crash-related injuries and fatalities.
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