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Racial Differences in the Identification of Seat Belt Signs Among Pediatric Motor Vehicle Crash Occupants
Robert B Gakwaya1, Mark R Zonfrillo2, Angela M Ellison3
1Department of Emergency Medicine, Alpert Medical School of Brown University.
Pediatric Emergency Care
|August 6, 2025
Summary
Black children were significantly less likely to have seat belt signs identified after motor vehicle crashes compared to White children, even after accounting for crash factors. Further research on skin tone is needed.
Area of Science:
- Pediatric Emergency Medicine
- Trauma Surgery
- Public Health
Background:
- Motor vehicle crashes (MVCs) are a leading cause of injury in children.
- Identifying internal injuries, such as seat belt signs (SBS), is crucial for timely intervention.
- Racial disparities in healthcare are a recognized concern.
Purpose of the Study:
- To investigate potential racial differences in the identification of abdominal seat belt signs (SBS) in children experiencing blunt torso trauma from MVCs.
Main Methods:
- Secondary analysis of a prospective cohort study dataset (PECARN) from 2007-2010.
- Included children under 18 years involved in MVCs with blunt torso trauma.
- Analyzed demographics, SBS documentation, crash speed, and restraint status, using descriptive statistics and trend tests.
Main Results:
- Out of 3832 children, restraint use varied significantly by race (P<0.001).
- Black children had a lower proportion of identified SBS (7.2%) compared to White (27.0%) and Asian (26.0%) children.
- Adjusted analysis revealed Black patients were 74% less likely than White patients to have SBS observed (OR: 0.26).
Conclusions:
- Significant racial disparities exist in the identification of seat belt signs among children post-MVC.
- Further prospective research, considering skin tone, is essential to understand these observed differences.
