cocktail“What’s Your Strategy?” she asked. And although she wasn’t asking me directly, I must admit I was a bit startled by the question. What really is my strategy for keeping my kids alive in the car? Although I’m strict about boosters, about buckling, about ensuring the booster seats travel with my kids, and I repel when I hear parents joke about not using car seats perfectly, I’m unsure I’ve ironed out the strategy to ensure my kids never die at the hands of a drunk driver. I mean we make smart choices, but smart enough? “What’s Your Strategy?”

Dr Beth Ebel, Director of the Harborview Injury Prevention & Research Center, is a pediatrician and researcher who spends her days working to improve safety for children in the car. She studies the use of car seats, the effects of distraction on driving, and health disparities. In my experience, she’s an optimist. During our conversation she stated a couple of times that the last decade housed great success: there has been a 41% reduction in child passengers deaths involving alcohol-impaired drivers and a 44% reduction in death in child passenger deaths over all. In addition she reminds me that 97% of drivers and passengers wear their seat belts! Even though she’s proud of the declines in death and the huge number of seat-belt-wearers, she does account for the ongoing deaths and how that 3% of the population who is unrestrained account for a huge proportion of the near-fatal and fatal injuries in car accidents.

New numbers out today provide a chilling lens into the realities of how young children in the US die in the car. Car accidents remain the number one killer of children over age 4. Today’s report focuses on children under age 15 who died in the last decade as a result of a car accident. I’d suggest this is uncomfortable data and somewhat uninteresting to most people. It does seem like this is just going to happen to someone else’s kid, right? My concern is some of us may be wrong and while looking around we better look closely at those we know well who drive our children around.

Tips For Picking A Safe, Affordable Car Seat

New research in Pediatrics out today details the numbers of the last decade. Two facts jumped off the page for me:

  • 65% of children who died in car accidents involving alcohol in the last decade died in the car with the drunk driver. That means those sweet little kids got in the car with a driver they likely trusted and died as a result of the driver’s poor choice.
  • 61% of the children who died were unrestrained (out of car seat, booster, or seat belt) at the time of the crash.

Two Reasons Drunk Drivers Kill Children:

  1. People drive with children when they are drunk.
  2. People forget to get children into their car seats or boosters when they are drunk.

The great news is that over the past decade the nation has seen a 40% decrease in deaths of children secondary to drunk driving. That’s a huge deal. Researchers suggest this is because of improved child restraint laws, and primary enforcement for seat belt use. When drunk drivers crash or crash into a car with children they are clearly much more likely to survive if they’re restrained. We should be thankful that the cops can pull people over for not donning a seat belt — this may have saved many lives. Over the decade child restraint notably improved: the National Highway Traffic Safety Administration found that >34% of children who died in accidents in 2001 were unrestrained, but by 2010, only 20% of children who died were outside the car or booster seat.

12% of all children who die in a car accident die in a car with the drunk driver

Building a strategy to protect your family may be the most important thing you do to continue to change these numbers.

Building A Strategy To Protect Kids From Drunk Drivers:

  • Mr Zero: Like every list, I can’t fail to mention that you need a zero tolerance policy around alcohol and driving in your home. If you’re going out for dinner, a party, picnic, etc with alcohol make sure you get a back-up driver (cab, Uber, friend) or have one designated driver. It can be inconvenient and uncomfortable but clearly essential.
  • Look Around: Nearly all of us have alcoholism in our family and groups of friends. If you’re concerned about the drinking in an adult who drives children in your house or in your life that you know about don’t wait to speak up. Dr Ebel said, “many people don’t feel they have a ton of choice when they are dependent on someone helping them transport their children.” Can you make changes when there is concern? In minimum, ensure your child always has their booster for carpool and transport, and teach children (around age 4) to always have their buckles on no matter what. Give them the skill independently to protect themselves. Why wait?
  • Protect Young Drivers. Somewhere around 30-40% of the drunk drivers involved in fatal accidents are young, new, and unexperienced drivers between age 16 and 24 years of age. Although the above study looked at the deaths of younger children, this group cannot go unmentioned. Have a strategy for your teen and college-age drivers. Help establish “safe autonomy” for your teens by establishing hard and fast rules and by using the “no questions asked” rule (below).
  • No Questions Asked Rule: for teens in your home, always let them know if they need a ride home you will come and get them anywhere, at anytime, and no questions will be asked and NO LECTURES given. Dr Ebel provided this script, “I may not be happy and I may be in my bathrobe but I promise I won’t ask a single question and I’ll always bring you home safely.”
  • Always Use Car Seats and Boosters: Duh. But really, the profound improvement in the last decade is likely due to better use of child restraints. Keep children rear-facing until they are at least 2 or 3 years of age, keep young children in booster seats until they are 4 foot 9 inches tall and keep kids in the back seat until at least age 13. Always having every child restrained properly will save lives.