Carseats and the Limitations of American Safety Culture

One lesson they really hammer home, when you’re a new parent, is the importance of carseats.

Alarming articles about car seat fails are part of the territory for new parents. But the scaremongering stops short. Image: Today
Alarming articles about carseat failures are part of the territory for new parents. Image: Today

Hospitals won’t let you take a newborn home from the hospital unless you can show you have a carseat. And they warn you of this fact in Lamaze class and in all the parenting books and on all the parenting websites.

I had a baby six months ago, and we had our carseat installed at a fire station when I was in my third trimester. Fire stations are recommended because a lot of carseats are so complicated to install, you need help from specially trained safety officials. My child, to be sure, has never traveled a mile in a car without a carseat, so in my case, anyway, the campaign succeeded admirably.

Since people know I’m a new mom, I sometimes get sent scary articles about mistakes you can make with your carseat that can kill your child. (For the record, don’t put your child in a carseat in a winter coat, and don’t put your child in an unstrapped car seat for napping.)

There’s a lot of emphasis on carseats because the public health community has rallied around them, and for good reason. For kids under 1, carseats reduce the risk of death by 71 percent, and for kids ages 1 to 4, risk is reduced about 54 percent, according to the CDC.

So carseats are crucial and necessary, but as a tool, they have some limitations. They aren’t tested at speeds higher than 35 miles per hour. And they’re designed to minimize the damage from front end collisions, meaning they can be of limited use in side and rear impact situations.

The reality is that driving is inherently risky, especially for child passengers, and the best a carseat can do is mitigate that risk. Carseats help when you’re in a collision — the safest thing to do is avoid collisions in the first place. But when you have a baby, nobody says, “Hey to protect your kid, maybe try driving less, taking transit more, or just avoid highways and don’t drive at higher speeds.” Even the CDC’s advice for parents doesn’t go beyond recommending carseats and seat belts, with one reference to drunk driving.

That’s understandable, since parents in the United States cannot realistically avoid exposing their kids to the danger created by cars. Even the relatively rare family that has the option to limit or eliminate driving — and we happen to be one of them — must contend with the dangers of walking on car-oriented streets.

For all of America’s success in getting parents to use carseats, the number of kids killed in traffic remains appalling. In 2013, 413 kids 7 and under died in car collisions, according to the National Highway Traffic Safety Administration.

Meanwhile, in Sweden, only one child under 7 was killed in a car collision in 2012, the Economist has reported, a major public health improvement over the country’s 58 child traffic fatalities in 1970. Controlling for population, the child fatality rate is about 10 times worse in America. The lives of hundreds of kids could be saved each year if the U.S. attained Sweden’s safety record.

Sweden, of course, has embarked on a nationwide campaign, Vision Zero, to comprehensively reduce the risk of deadly crashes for everyone, emphasizing safety over speed. Children are safe because streets are designed to be safe, not only for driving but for walking too.

America is just beginning to come at the problem from a more thorough perspective, and only in some cities. In most of the country, you can barely walk anywhere without crossing a street where traffic whips by at 40 mph.

What if we had public health campaigns that went beyond safety products and asked parents to agitate for safer street designs. Hard to imagine? Too much to ask of the parents of newborns? Probably. Instead, we put our kids in carseats and cross our fingers.

  • Q: Are you worried about shark attacks? A: Oh hell yes! Sharks are scary!
    Q: Are you worried about putting your kid in a car? A: Huh? Is this a serious question?

    People just don’t get it.

  • WalkingNPR

    I have that exact graphic in a lecture for my Built Environment and Public Health course for next semester and for the exact same reason! (it came across my Facebook newsfeed while I was working on my transportation lecture). How bizarre that such images are just taken for granted as part of the dominant narrative that minivans and suburbs are the responsible way to raise kids. Horrifying image of your kid going flying for the windshield? Only solution is to take ’em out of their coat! Keep driving!

    (And yikes–I didn’t know about the 35 mph limit to testing. That is nuts.)

  • war_on_hugs

    It’s a weird quirk of human psychology that we aren’t good at processing mundane, everyday threats, while highly unlikely but unusual threats take priority.

    I’ve had conversations with friends who are new parents, many of whom decide to raise their kids in the suburbs. And hey, that makes sense for a lot of reasons – schools, affordability, etc. But safety is an odd rationale that comes up fairly frequently – for some reason they don’t feel that their kids are “safe” in a city like D.C.

    Meanwhile, car crashes are one of the leading causes of death and injury for children, which are much more likely in car-dependent suburbs. Not to mention the health impact of being unable to walk pretty much anywhere.

  • Joseph Cutrufo

    Nobody asked to see our car seat when we took our son home from the hospital — we walked home with him in a bassinet. Maybe they make an exception in some places.

  • Morris Zapp

    Those of a certain age remember standing — standing! — in the front seat, when it was common to see kids riding in the back of pick-up trucks. I didn’t even know how to use a seatbelt until I was almost a teenager.

    It’s a wonder that so many Americans born between, say, the 50s and the 90s made it to adulthood.

  • Child safety was a big part of the Dutch transformation from traffic-choked US-style hellhole to traffic safety paragon: https://dutchbikeguy.files.wordpress.com/2013/11/kindermoord-2.jpg?w=705

    STOP KINDERMOORD

  • com63

    And don’t forget to bring the fear of terrorism into that discussion too. People are afraid to go to Paris next summer, but have no problem driving around all day, everyday.

    I for one am most terrified when I am crossing the street. I think that is the way it should be.

  • davistrain

    How about people who are terribly afraid of flying in an airliner, but hop into their cars without a second thought? I’m reminded of a flight that arrived at an airport early, so the captain got on the PA system: “While we’re waiting for the gate to clear, I’d like to thank you again for choosing our airline. Also, I’d like point out that you’re about to begin the most dangerous part of your flight–driving home or to your destination on our local streets and highways. Please drive defensively and fasten your seatbelts; we want to see you again.”

  • Joe Linton

    Great article, Angie! It’s frustrating to get preached at by relatives who think it’s not safe for me to carry my daughter on bike, bus, train… while they speed-drive when my daughter and I ride in their car.

    Chuck Marohn has some similar worthwhile musings in article and podcast:
    http://www.strongtowns.org/journal/2011/12/13/best-of-blog-do-we-really-care-about-children.html
    http://shoutengine.com/StrongTownsPodcast/car-seat-nation-4768

  • Sirinya Matute

    Agreed. I spend a lot of time fretting about finding day care that does not “require” me to drive there (translation: isn’t transit-adjacent), because I want to drive as little as possible with a kid. I know that I am cutting my risk of danger/harm by transporting my kid using other modes instead.

  • That’s still way over the speed that bicycle helmets are tested: 12.5 MPH. You know the difference in energy level between 12.5 and 35 MPH? A factor of 7.84 or almost a decimal order of magnitude or 3 binary orders of magnitude. The 35 MPH test speed is because that is the crash test speed for motor vehicles. The regs require motor vehicles survive a wreck into a steel-faced concrete wall @ 35 MPH and everyone inside be able to open the nearest door and walk away from the wreck.

    Basically we have severely reduced child mortality in motor vehicles by placing the rug rats in an armored capsule that we then place inside a light armored vehicle. And we have reached the engineering limits of what that can do, while ignoring the elephant in the room that removing the light armored vehicles from the environment is required to really reduce the death toll to zero. The only way to eliminate child deaths from motor vehicle wrecks is to eliminate motor vehicle wrecks, and about the only way to eliminate motor vehicle wrecks is to eliminate the motor vehicle.

  • Joe Linton

    Yah – I get the same thing (not the pregnancy part though!) – people say “be careful bicycling home” when they’re about to drive a higher speed on a freeway… and then when I say “you be careful driving home – you’re doing something riskier than I am” they take offense. People overestimate driving’s safety, and overestimate bicycling’s risk.

  • Kevin Love

    Driving a child in a car is very dangerous due to the car pollution. It is worst inside the car. See:

    http://road.cc/content/news/129814-testing-mps-reveals-worst-air-pollution-inside-cars

    It is bad enough that car drivers launch lethal cancer poison attacks against innocent children by driving cars in urban areas where children live. To hit an innocent child with a concentrated lethal poison dose by putting a child in a car is reprehensible.

    There are alternatives. See:

  • My daycare is so great. A half mile from home, we walk every day. They even have a stroller parking area, so i don’t have to lug it back empty. Problem is, even though my walk is mostly residential streets, it’s rush hour, and drivers use them as a cut through and the walk can often be hair raising.

  • flyingember

    Freakonomics did their own study on kids over 2 and their claim is a car seat does nothing for the kid. The key thing is the kid needs to fit in the seat belt and not slide out. Look at the image in the article. A kid without a car seat would move like that too. The carseat didn’t stop them from whipping forward. In a lot of small cars their head just rammed into the seat in front of them. That could kill the kid. The car seat basically shoved them farther forward than they would have otherwise and created more danger. Without the car seat the kid would move the same distance toward but would have been against the red cushion and have more space to move forward.

    We’re not being honest about what provides safety, letting one industry control the discussion. I for one would like to see more forced comparison studies where a car seat must prove it provides more safety than not using it and more high speed studies. Maybe some seats are better but we don’t know equally if they’re not worse to use in more cases than not.

  • Kevin, the irresponsibility you’ve shown by linking to this video is truly appalling. Not a single child (or parent) was wearing a helmet. Don’t you know how dangerous that is. How many of them are going to end up dead? That’s a really terrible example you’re setting. Perhaps worse, those moms and kids all look blissfully and ignorantly happy. Don’t they know what danger they’re placing their children in?

    🙂

  • Kevin Love

    Worse yes is the subversive nature of videos like this.

    One can post all day long about boring scientific evidence about fine particles causing cancer and how car drivers poison and kill people. And how children are particularly vulnerable.

    But let’s face it, all those doctors and scientists and all those facts are a boring snoozefest.

    But a video of parents and children having fun as they travel about the city? That’s subversive. That causes dangerous thoughts like, “Hey, maybe I can also have fun with my children?”

    That could (God forbid) lead to change for the better!

  • davistrain

    May I ask if you (and your new member of the family) live in New York City? That’s one of the few places in the USA where it’s not assumed that unless you’re at the bottom of the economic ladder, you have a car or other motor vehicle.

  • flyingember

    If you’re hit by a car going faster a helmet won’t do a thing. The force of you going to the ground when hit the helmet won’t make a difference. They’re more for someone going a reasonable speed and falling off the bike. The helmet deforms or takes the shock.

    In other words, helmets protect from the actions of the bicyclist, not a car driver.

  • Joseph Cutrufo

    We do. I should’ve mentioned that.

  • I keep seeing a statistic that says something like “94% of carseats are installed improperly.”

    That tells me that there’s a design flaw. People desperately want to get this right, and the vast majority (even if I’m not remembering the stat correctly, even if it’s anything over 50%) aren’t. That’s not on the parents. That’s a problem with the product.

  • AndreL

    Some interesting points, but the suggestion to “avoid highways” is baseless and wrong. Controlled-access highways (“freeways”, Interestates and else) are the safest roadways in US, when adjusting for fatality or injury rate per passenger-mile. This is not to say we should necessarily build freeways on every single neighborhood, but to point they are safer, because they segregate cars from all other interferences and hazards of the urban environment, and they keep everyone not in a car outside the danger of being hit by a car.

    Arterial roads are the most dangerous ones, for drivers and pedestrians.

  • reasonableexplanation

    I was curious about the air quality being worse inside cars thing, so I followed your link: it’s an article about London, and the main point is: “The monitors measured the amount of microscopic carbon particles – produced largely by diesel engines.” Diesel is way more prevalent in Europe than it is in the states, so it’s not quite an apples to apples comparison.

    Additionally, you’re supposed to keep the recirculate option on when you’re in traffic, and most cars have a cabin air filter as well these days.

    Here’s an article on the topic: http://articles.latimes.com/2013/sep/12/science/la-sci-sn-recirculate-car-air-pollution-traffic-20130912

    However, I can’t quite find good numbers for how the air inside a car with a filter and recirculate enabled compares to the sidewalk.

  • R.A. Stewart

    I read shortly after the Paris attacks that a suburban school district was polling parents about whether they should go ahead with the school band’s scheduled field trip to Paris next year. No mention of how many of that car-dependent suburb’s kids will die in crashes before they graduate.

    I just looked up a related story in the Tribune and am gratified and surprised to read that most of the district’s parents seem to want to go ahead with the trip.

    “http://www.chicagotribune.com/suburbs/lake-county-news-sun/news/ct-lns-paris-attacks-study-abroad-st-1210-20151209-story.html”

  • R.A. Stewart

    Which points up an ugly fact about American culture, at least present-day American culture: in many of the ways that count most, we really don’t give a damn about our children. Sure, we’ll go nuts about “stranger danger” and carseats, and we’ll eagerly report our neighbor to the police if she lets her nine-year-old play unsupervised in a nearby park. But invest in education for every child, not just those in affluent suburbs? Give a helping hand to the families that are doing the everyday work of raising those kids? Get serious about expanding transit and developing walkable neighborhoods? Have real discussions about gun violence without giving veto power to the NRA? Never. I could be getting myself on a watch list by even suggesting such things.

  • Walter Crunch

    And yet..watch a helicopter parent freak out when you roll up with a bike trailer with small children inside.

  • neroden

    I’d still avoid
    (1) expressways in serious winter weather. Nobody drives at appropriate speeds, and the 40-car pileups are common.
    (2) particular expressways known to be filled with madmen at rush hour. Like Chicago, I-90, at rush hour, where everyone is tailgating all the time.

    The average which makes expressways seem safe includes a lot of very relaxed rural expressways. (The rural non-expressway roads are often seriously problematic to drive on, not really being designed for automobiles at all.)

  • neroden

    They switched the carseat installation system for newer cars with the introduction of “LATCH”. Maybe that was due to a history of improper installations?

  • LATCH has been standard since 2003, and I saw whatever the statistic is on a billboard last year.

  • But what is the first thing asked when a cyclist is hit? Was he wearing the magic foam hat.

  • Monty

    The (many) kids who didn’t survive aren’t around to talk about it.

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