title: Seat belt use among American Indians/Alaska Natives and non-Hispanic whites.
abstract: BACKGROUND
  Accidents (including motor vehicle injuries) are a leading cause of death among American Indians/Alaskan Natives (AI/AN). The purpose of this study was to examine geographic variation and the existence of a seat belt law on seat belt use among AI/AN and non-Hispanic whites (NHW).
  
  
  METHODS
  Self-reported seat belt behavior data from the 1997 and 2002 Behavioral Risk Factor Surveillance System were analyzed in 2006-2007 and were restricted to AI/AN (n=4,310 for 2002, and n=1,758 for 1997) and NHW (n=193,617 for 2002, and n=108,551 for 1997) aged 18 years and older.
  
  
  RESULTS
  Seat belt non-use varied significantly across geographic regions for both AI/AN and NHW. For example, AI/AN living in the Northern Plains (odds ratio [OR]=12.4, 95% confidence interval [CI]=6.5-23.7) and Alaska (OR=10.3, 95%CI=5.3-19.9) had significantly higher seat belt non-use compared to AI/AN living in the West. In addition, compared to those residing in urban areas, those living in rural areas were 60% more likely in NHW and 2.6 times more likely in AI/AN not to wear a seat belt. Both AI/AN and NHW living in states without primary seat belt laws were approximately twice as likely to report seat belt non-use in 2002 as those living in states with primary laws. In states with primary laws enacted between 1997 and 2002, AI/AN experienced greater decline in seat belt non-use than NHW.
  
  
  CONCLUSIONS
  Seat belt use among AI/AN and NHW varied significantly by region and urban-rural residency in 2002. Primary seat belt laws appear to help reduce regional and racial disparities in seat belt non-use.
authors.affiliation: Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, Maryland 20892-9205, USA.
authors.forename: Andrea N
authors.initials: AN
authors.lastname: Garcia
authors.forename: Kushang V
authors.initials: KV
authors.lastname: Patel
authors.forename: Jack M
authors.initials: JM
authors.lastname: Guralnik
mesh_terms: D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D000368:Aged; D000413:Alaska; D040343:Behavioral Risk Factor Surveillance System; D015982:Bias; D005260:Female; D005843:Geography; D006801:Humans; D007198:Indians, North American / Q000208:ethnology*; D008297:Male; D008875:Middle Aged; D012309:Risk-Taking; D012622:Seat Belts / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D012650:Self Disclosure; D014481:United States; D044465:White People / Q000208:ethnology