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When you get in a motor vehicle, one simple action — wearing a seat belt — can save your life.

Seat belts save thousands of lives in the U.S. each year. They saved almost 15,000 lives in 2017, according to the National Highway Traffic Safety Administration (NHTSA).

Despite that, not everybody wears a seat belt. According to NHTSA data, 90.4% of front-seat passengers wear seat belts. But that still leaves almost 10% of drivers and passengers who do not.

Under Pennsylvania law, all drivers and front-seat passengers must wear a seat belt at all times. Children under 18 must wear a seat belt at all times, no matter where they are in the vehicle.

But wearing a seat belt is critical even if not required. Not wearing a seat belt, including in the rear seat, puts you and other occupants at greater risk of severe injury or death in the event of a motor vehicle accident.

“Nobody is expecting to be involved in a car crash before it happens,” says Christian Martin-Gill, MD, chief, Division of Emergency Medical Services (EMS), UPMC, and associate medical director, UPMC Prehospital Care. “We all have to be vigilant and think about what may happen and do those things that decrease the likelihood that we would be injured in a car crash, as we would in other aspects of our lives.”

Seat Belt Safety Statistics

According to NHTSA, seat belts:

• Reduce your risk of fatal injury by 45% and moderate to critical injury by 50% if you buckle up in the front seat of a passenger car.
• Reduce your risk of fatality by 60% and moderate to critical injury by 65% if you buckle up in a light truck.
• Saved an estimated 14,955 lives in 2017.
• Would have saved an estimated 2,549 more people in 2017 if they had buckled up.

What’s the risk when not wearing a seat belt?

If you do not wear a seat belt, you have a much higher risk of serious injury or death in a crash.

• More than half — 51% — of the drivers and passengers killed in 2020 were not wearing seat belts.
• Americans die in crashes every year. Nearly 11,000 unbuckled passenger vehicle occupants died in
  2020.
• 58% of people killed in nighttime motor vehicle accidents in 2020 were not wearing seat belts.
• 42% of children under 14 who were killed in motor vehicle accidents in 2020 were not wearing seat belts.

“You are with the majority if you are appropriately wearing your seat belt, but certainly those that do not are still out there,” Dr. Martin-Gill says. “And certainly, those folks can have worsened injuries.”

Seat Belt Myths and Facts

There are many misconceptions about the need to wear seat belts. It’s important to know the facts of how seat belts save lives.

Myth: Cars have become much safer, so I don’t need to wear a seat belt.

Fact: Seat belts are still an essential part of vehicle safety.

It’s true that vehicle safety has improved over time. But seat belts play an enormous role in the overall safety of the vehicle.

“Motor vehicle manufacturers are continuously incorporating safer components and additional safety devices in vehicles, including electronic warning devices, multiple airbags, and improved crumple zones,” Dr. Martin-Gill says. “Individuals may feel safer and that all of that is going to protect them in an accident. But the truth is that without a restraint device like a seat belt, that person could still suffer significant trauma or be ejected from the vehicle even when other safety components are working appropriately.”

Myth: My car has many airbags. I don’t need to wear a seat belt, too.

Fact: Seat belts can save you from serious injury or death, even with airbags.

Airbags can save lives, too — they saved an estimated 2,790 lives in 2017, according to NHTSA data. But seat belts are also crucial for saving lives: They saved nearly 15,000 people in 2017.

Airbags and seat belts should work together to save lives. Even if your car has airbags, wearing a seat belt helps to keep you restrained in the event of a crash instead of getting propelled forward. Not wearing a seat belt puts you at risk of getting propelled outside the vehicle or even inside it, which can cause severe injury or death to you and to other passengers.

“Without seat belts, people are more likely to suffer head injuries because they could travel within or outside of the vehicle,” Dr. Martin-Gill says. “They are at increased risk of spinal injuries, including significant neck trauma. They would be more likely to suffer significant internal damage to organs in the chest or the abdomen because of their trajectory and movement during a collision.”

Myth: I’m driving slowly, and/or I’m not going far. I don’t need a seat belt.

Fact: Seat belts are crucial no matter how fast or far you’re driving.

You may feel safe if you’re in your neighborhood, you’re moving slowly, or you’re only going a couple of blocks. But accidents can happen at any time, including those caused by other vehicles on the road. Seat belts can protect you when they happen.

Myth: Seat belts can trap you in your car if it’s underwater or on fire, so you shouldn’t wear them.

Fact: Seat belts can help you avoid serious injury in order to escape.

According to NHTSA data, less than 1% of crashes involve fire or water. But seat belts can protect you from serious injury, which can enable you to escape your car if it is on fire or underwater. If you’re seriously injured, it can be more difficult to get out.

Myth: I don’t want to wear a seat belt because it can cause me to get injured in a crash.

Fact: Not wearing a seat belt causes a greater risk of injury.

It’s true that seat belts themselves can be associated with injuries in the event of a crash. But if you’re unrestrained, it makes it much more likely to get propelled forward — which puts you in much more danger.

Myth: Larger vehicles are safer, so seat belts are less essential.

Fact: Seat belts are just as essential in vans, trucks, and SUVs as they are in cars.

Seat belts greatly reduce the risk of death and serious injury in pickup trucks, vans, and SUVs. According to a 2015 study of more than 50 years’ worth of car crashes, seat belts reduce the risk of fatality in those types of vehicles by 60% for people in the front seat and 73% for people in the back seat.

How to Properly Wear a Seat Belt

Just as important as wearing a seat belt is wearing it the right way. Wearing it the wrong way also can put you at risk of injury or death in the event of a crash.

The proper way to wear a seat belt:

• The lap and shoulder belts should be across your pelvis and rib cage.
• The shoulder belt should be across the middle of your chest, away from your neck.
• The lap belt should rest over your hips, not your stomach.
• If you are pregnant, wearing a seat belt is the best way of protecting yourself and your unborn child. The shoulder belt should be secured on your shoulder — away from your neck — and across your chest. You should never put the lap belt on top of your stomach; it should be below your stomach, across your hips and pelvic bone.
• You should never put the shoulder belt under an arm or behind your back.

If your seat belts do not fit properly, you can adjust them yourself or purchase seat belt adjusters.

Children and Seat Belts

Just as adults should wear seat belts at all times to ensure safety, so should children. The NHTSA says children can begin to transition to regular seat belts between the ages of 8 to 12 years old. Before that, you should keep them in a car seat or booster seat appropriate for their age and size.

Pennsylvania law requires children under 2 to be in a rear-facing car seat until they outgrow the manufacturer’s weight and height limits. Children under 4 must be in an approved child safety seat, and children ages 4 to 8 must be in an appropriate booster seat.

NHTSA has guidelines for car seats and booster seats that can help you find the right one for your child.

“All of those devices should be the appropriate size for the age of the child,” Dr. Martin-Gill says. “And make sure that they’re secured appropriately, just as the manufacturer specifies. When used correctly, having a child in a safety restraint system, particularly an approved child seat, provides substantial protection to that child if the vehicle is involved in a collision.”

Your child is old enough for an adult seat belt, according to NHTSA, if they are tall enough to:

• Sit up straight without slouching.
• Keep their back against the vehicle seat.
• Keep their knees bent naturally over the edge of the seat.
• Keep their feet flat on the vehicle floor.

Like adults, children should wear the seat belt with the shoulder belt snug over their shoulder and chest, away from their neck. The lap belt should be over the top of their thighs, not over their stomach. NHTSA says children should ride in the back seat of the vehicle until they are 12 years old.

It’s best to set a good example for your child by wearing a seat belt yourself. NHTSA data says children’s seat belt usage drops significantly when adults don’t wear seat belts.

Why Wearing a Seat Belt Matters

When you wear a seat belt and wear it correctly, it can save lives. It’s a simple action that has enormous benefits.

“It’s important for us to do the simple things,” Dr. Martin-Gill says. “Not only to be driving mindfully, but to use our seat belt and to make sure that we’re doing things to protect ourselves, to protect other occupants in the vehicle, and to protect those around us.”