February 11, 2019

The Honorable Lawrence R. Klemin Speaker House of Representatives 600 East Boulevard Avenue Bismarck, North Dakota 58505-0360

Dear Speaker Klemin:

As representatives of leading public health and safety organizations, we urge you to support enactment of Senate Bill (SB) 2060. SB 2060 will improve North Dakota’s seat belt statute by requiring all occupants to be buckled up and will empower police officers to enforce the seat belt law without having to witness an additional violation, simplifying enforcement and raising compliance with the seat belt law. Simply put, SB 2060 will save lives and on North Dakota roads and highways.

In 2017, traffic fatalities claimed the lives of 115 people on North Dakota roads, according to the National Highway Traffic Safety Administration (NHTSA). Lack of seat belt use is a major contributing factor to fatal crashes in the state. In North Dakota, 55 percent of passenger vehicle occupants killed (44) in 2017 were not buckled up when restraint use was known (NHTSA). The observed seat belt rate in North Dakota that year was 79 percent, far below the national average of 90 percent. Insufficient seat belt use is a serious public health and safety issue in urgent need of the solution that SB 2060 provides.

Seat belts not only save lives and prevent lifelong debilitating injuries, they also save taxpayer dollars. Motor vehicle crashes cost North Dakota $706 million annually (NHTSA). Unbelted crash victims have medical bills that are 55 percent higher than belted victims, and society bears a majority of the cost through increased insurance premiums, taxes, and health care costs (NHTSA). Traffic crash costs essentially result in a “crash tax” of $784 for every person living in the U.S.

In fatal crashes in 2017, 83 percent of passenger vehicle occupants who were totally ejected from the vehicle were killed (NHTSA). Only one percent of the occupants reported to have been using restraints were totally ejected, compared with 30 percent of unrestrained occupants (NHTSA). Further, the proportion of unrestrained passenger vehicle occupants killed that were seated in the front seat was 46 percent, compared to 56 percent of unrestrained passenger vehicle occupants killed that were seated in the rear seat (NHTSA). This is why it is critically important that a seat belt law covers both front and rear seat passengers.

Unbelted rear seat passengers pose a serious threat to the driver and other vehicle occupants. Known as “back seat bullets,” unbelted rear seat passengers can be thrust at high rates of speed into other occupants, causing fatalities and serious injuries, as well as loss of control of the vehicle. “The odds of death for a belted driver seated directly in front of an unrestrained passenger in a serious head-on crash was 2.27 times higher than if seated in front of a restrained passenger.”i Seat belt use in the rear seat is especially critical as the safety infrastructure built into the vehicle is not as developed in the rear seat as it is in the front seat.ii

Furthermore, the majority of passengers in the rear seats of vehicles are teens and children, and studies have shown that seat belt usage by teens and young adults (age 16 – 24) is among one of the lowest segments of society. A poll released by the Insurance Institute for Highway Safety (IIHS) found that nearly 40 percent of people surveyed said they sometimes don't buckle up in the rear seat because there is no law requiring it. If such a law existed, 60 percent of poll respondents said it would convince them to do so.iii Enacting a primary enforcement seat belt law for all occupants will send a strong message that everyone needs to buckle up on every trip.

Primary enforcement is an essential provision in an optimal seat belt law and is consistent with other regular traffic safety laws in that no other violation need occur first. States with primary enforcement laws have higher seat belt use rates. When primary laws are passed, seat belt use rates increase from 10 to 15 percentage points as experienced in a number of states. Moreover, a study conducted by IIHS found that when states strengthen their laws from

secondary to primary enforcement, driver death rates decline by an estimated seven percent. If every state with a secondary seat belt law upgraded to primary enforcement, about 1,000 lives and $4 billion in crash costs could be saved every year, according to NHTSA.

Seat belts saved the lives of at least 44 people on North Dakota roads in 2017, and yet 18 more people could have been saved by 100 percent seat belt use (NHTSA). We urge you to advance SB 2060 to save lives, prevent injuries, and curb the unnecessary spending of taxpayer dollars.

Sincerely,

Catherine Chase Adam Johnston, BA, RN, CEN President President-Elect Advocates for Highway and Auto Safety North Dakota Emergency Nurses Association

cc: The Honorable , Majority Leader The Honorable , Assistant Majority Leader The Honorable Josh Boschee, Minority Leader The Honorable , Assistant Minority Leader The Honorable , Majority Caucus Leader The Honorable , Minority Caucus Leader

i Mayrose, James, Influence of the Unbelted Rear-seat Passenger on Driver Mortality: ‘‘The Backseat Bullet”, Academic Emergency Medicine, Volume 12, Issue 2. Article first published online: 28 June 2008. ii Sahraei at al. Reduced Protection for Belted Occupants in Rear Seats Relative to Front Seats of New Model Year Vehicles, Proc AAAM, 2010. iii Status Report, Unbelted, Vol. 52 No. 5, “Adults admit they often skip belts in rear seats”, IIHS. August 3, 2017.