What’s the Real Deal on Booster Seats?
Friday, December 5th, 2008 By Marc KilmerMy post from a couple days ago on efforts to change Ohio’s booster seat laws has engendered some comments that I want to address. One, from “Tim” dismisses respected economist Steven Levitt by essentially saying his work is fiction. A more useful pair of comments come from “Lisa” which a few articles to refute Levitt’s work (which I recommended) that says booster seats for older kids aren’t all that useful.
Unfortunately, I can’t find an ungated version of the study recommended by “Lisa,” so I’m unable to evaluate its claims. I will freely admit that there are studies which support the idea that older kids need to use booster seats. There is evidence that these seats do very little, too. While some blithely dismiss the work of Steven Levitt, he’s a respected economist who actually looks at the data underlying these studies. And his partner, Stephen Dubner, posts here about other failings of car seats.
This really isn’t the place to get into a thorough analysis of the validity of car seat studies. It is the place to note that the evidence is far from overwhelming and, in my reading, pretty inconclusive. I’ll admit I could be wrong about the facts here, though. It doesn’t really matter if I am wrong, however. I’m not passing laws that affect the lives of every Ohioan. The place to have this full discussion and sort out who is wrong and who is right is in the General Assembly, specifically the Senate Highways & Transportation Committee, which is considering the legislation to tighten Ohio’s booster seat regulations. From the coverage I read, this type of discussion is not happening. Everyone, even those skeptical of this bill, seems to be operating under the assumption that these booster seats are effective for older kids. The General Assembly should probe this question a lot more thoroughly before it imposes any new mandates.
Tags: General Assembly, safety
December 5th, 2008 at 6:04 pm
Marc,
Here’s a simple source for why booster seats are effective. It also happens to be from experts–in safety, not economics. The Centers for Disease Control and Prevention.
http://www.cdc.gov/ncipc/duip/research/boosterseat.htm
Here’s a simple source for why booster seats are better than seat belts for children 4-8. While it doesn’t source its information, the paragraph “Why use a booster seat instead of a safety belt?” sums it up: seat belts are designed for adults, not children.
http://pediatrics.about.com/library/car_seats/blbooster_seats.htm
Simply put, the authors of Freakonomics are statisticians, not public health researchers. Their argument makes some valid points, but only chose from sources where children died in crashes (unrestrained, restrained-seat belt only, restrained-booster seat). This ignores the fact that children 4-8 who only wear a seat belt are 3.5 times as likely to suffer significant injury and 4 times more likely to suffer significant brain/head injury (http://www.saferoads.org/issues/fs-boosterseat.htm; source: Children’s Hospital of Philadelphia, 2003). These types of injury cost an incredible amount of money to treat, very often over the lifetime of the victim. And we’re paying for it through our insurance premiums (automobile and medical).
There is no debate among health professionals. Booster seats save children 4-8 from death and significant injury. The only ones debating are economists and bloggers outside their comfort zone.
December 5th, 2008 at 6:59 pm
“The place to have this full discussion…is in the General Assembly, specifically the Senate Highways & Transportation Committee…From the coverage I read, this type of discussion is not happening.”
Unfortunately Marc, you read a really abbreviated synopsis of what the Committee heard (I read the same Gongwer Report). What did you think Drs. Crow and Cotton were saying in their testimony? Dr. Crow is not an economist, he’s a pediatric trauma surgeon. Dr. Cotton is also not an economist but rather he is a pediatric emergency medicine physician. They have performed a lot of scientific research into pediatric illness and injury. They have read with a critical eye extensive amounts of scientific research that has passed peer-review. They are true experts in injury causes and control. It was from this extensive experience that they gave their testimony. What is generating the frustrated responses to your initial post is that the testimony of true experts in the field of injury prevention is being IGNORED.
If you want to find all the scientific literature on this topic to bring yourself up-to-speed, go to http://www.ncbi.nlm.nih.gov/ and search the PubMed database for “booster seat”. Disregard the returns that are studies of booster seat implementation plans and what you will find is that there is, contrary to your assertions, a lot of peer-reviewed, scientific evidence supporting the efficacy of booster seats. These are studies performed by respected automotive safety engineers, respected physicians and respected epidemiologists, not respected economists.
Let me end with this perspective: I have read the science, almost all of it, and I have read Freakonomics. It appears that Lisa and Jo have, as well. We do not view the booster seat issue as an issue of economics; We view it as an issue of dead children.
December 5th, 2008 at 7:43 pm
Thanks for the link, Tim. I’ll make sure and check it out. Physicians aren’t researchers, though. I respect what they say but just because they are skilled at healing bodies does not necessarily mean they are experts about the relative merits of booster seats versus simple seat belts.
Jo, the idea that there is some difference between the type of research done by Levitt and the type of research done by those who disagree with them seems erroneous. Public health researchers look at statistics (although there is research that relies on booster seat tests; Levitt has done some of this, too, however).
Furthermore, to say that Levitt only looks at data dealing with fatalities is false. As he says (http://freakonomics.blogs.nytimes.com/2005/07/24/levitt-replies-to-the-critical-letter-published-in-ny-times-today/): “I have looked at three other data sets (one with all reported crashes in New Jersey, another with all reported crashes in Wisconsin, and one that is a nationally representative sample of all crashes in the United States). All three of these data sets cover a full set of accidents, not just crashes with fatalities. And in all three data sets the results obtained are virtually identical to the results using the fatal crashes.”
In that same link, Levitt raises some serious questions about the methodology of the data touted by the Children’s Hospital of Philadelphia, upon which much of the pro-booster seat agenda is based.
And the questions raised by Levitt is not about economics vs. dead children. It’s about whether or not the research done in support of booster seat usage for older children actually says what advocates claim. To try and say that since he’s an economist or a statitician that his research is invalid is ridiculous. He evaluates data. Dismissing him because you think economic methodology doesn’t apply in this instance won’t do anything to convince me he’s wrong.
December 6th, 2008 at 12:31 am
Do a simple test yourself. Take a five-year-old and put him in the back seat of your car with a seat belt on. Then watch for about 5-10 minutes. Wanna know what you’ll see? A kid who slides forward, because he’s too short for his legs to hang off the edge of the seat. Check where the belt ends up. The lap belt is on his stomach, the shoulder belt is across his neck, or behind him. Now close your eyes and imagine the video you’ve seen of crash testing. What slows the child down? The belt. But with it on his abdomen, it practically cuts him in half, even at low speed impacts.
Now try it with a booster. The lap belt fits, oddly enough, across the lap. The shoulder belt (with an adjustment) fits, again, oddly enough, across the shoulder. This is how it works for adults, and why seat belts are safe…for adults. The belts fit across some of the strongest bones in the body, not across soft tissue.
December 8th, 2008 at 7:49 am
Ah, “dead children.” Now there’s an honest intellectual argument for you, because of course anyone who disagrees with you or even asks a question is in favor of dead children. What are you from, the George Voinovich school of politics? “Vote for me, because I’m a nice guy, and you’re not.”
Perhaps you could show us all the letters to the editor and legislation you’ve proposed that outlaws cars or even leaving the house, since all those things result in dead children. Of course, you’d have to outlaw staying in the house, too, because that results in dead children also.
Sheesh. What a clown.
January 21st, 2009 at 8:08 pm
Mike, what kind of mean pills have you taken lately? I am a Democrat and my entire family has been democrats since I can remember. I happen to know George Voinovich from his days in Grovewood, a neighborhood on the NE edge of Cleveland. George Voinovich and his wife lost a child to a drunk driver in approx 1979! I have to tell you, we all knew how hurt the voinovich family was over this terrible accident and many of his later actions were to protect children. This man did a great deal for those in our neighborhood. My aunt greatly respected George Voinovich, she was a short, lovable Italian woman who never looked at politics as a key to guide her in seeing the good in people. Since she was then the head of our extended family, she insisted that we should all support George voinovich in his political career. I like George voinovich and would vote for him every chance I got, but then again I know without any doubt that George voinovich is and has always been a good and caring man and that goes for his family as well.