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Calculating the Cost of Saving Lives

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The Centers for Disease Control and Prevention has recently released a new version of a tool to help people (legislators, law enforcement officials, advocates, etc.) determine what kind of impact various motor vehicle laws and enforcement practices would have on saving lives, and what the overall cost/savings would be.  The tool is called the Motor Vehicle Prioritizing Interventions and Cost Calculator for States—but you can call it MV PICCS (pronounced “picks”) for short.

When you first open the calculator, you see a map of the United States with each state color-coded according to its 2015 vehicle death rate. You can then select a state and select various laws/fines/enforcement options that might reduce motor vehicle fatalities and injuries. You can enter a specific budget, and you can also determine whether to have fees and fines from those interventions rolled back into the cost of implementation.

Then the calculator will show an estimate of how many lives will be saved, how many injuries will be prevented, the cost of enforcement, the fees/fines produced, and the overall cost to the state.

I decided to play around with the calculator a bit. First, I selected my current home: Illinois. Illinois already has a very low vehicle death rate (7.8 per 100,000 people). One thing that really bugs me about Illinois, though, is the lack of a motorcycle helmet law. Of the motorcycles I see on the road, I’d say around 25% have riders with helmets. My small community alone has a few motorcycle deaths each year, and I often wonder how many of those could be prevented with helmets.

So on MV PICCS, I checked the option for motorcycle helmets and the option to use fees and fines to offset costs. I then hit the “run model” button, but I got a message saying that it couldn’t select any interventions given a budget of $0. So I entered a budget of $1,000,000, and it said it couldn’t select any interventions given a budget of $1,000,000.

I decided to keep my $1 million budget, but, in addition to the motorcycle helmet law, I checked “Increased Seat Belt Fine” and “In Person Renewal” (for drivers license renewals of those aged 70 or older). This time it did calculate, and it showed 102 lives saved (42 from helmets, 47 from increased seatbelt fines, and 13 from in-person renewal). The overall cost to the state would be $-3.85 million, meaning the fines and fees would greatly outweigh the implementation costs.

Then I decided to play with Wyoming, the state with the highest vehicle death rate: 24.7 per 100,000 people. For Wyoming, I selected seven interventions (Motorcycle Helmet, License Plate Impoundment, In Person Renewal, Increased Seat Belt Fine, Primary Enforcement Seat Belt Law, Seat Belt Enforcement Campaign, and Sobriety Checkpoints.) I also entered a budget of $1,000,000.

MV PICC calculated 40 lives saved and 2,535 injuries prevented. The overall cost to the state would be $840,000.

(It’s also important to remember that laws and driving practices aren’t the only contributors to vehicle deaths. As we’ve reported before, fatality rates are often higher in rural areas, due in part to increased response time for emergency services. States like Wyoming and Montana could certainly reduce their fatality levels with the enforcement of certain laws, but that won’t change issues like terrain and response times.)

While the calculator was kind of interesting to play around with, and while it might provide a decent cost-benefit analysis for some scenarios, I felt like it was a bit too simplistic. I finally figured out that its estimated cost to Illinois to implement a motorcycle helmet law would be $3.5 million. There would be some additional costs in the first year for sure (to update driver’s handbooks, update websites, publicize the law, update law enforcement), but surely the long-term costs wouldn’t be anywhere near that high. It would be nice to see a 5- or 10-year cost estimate.

I also felt the calculator lacked a lot of important options that play huge roles in motor vehicle deaths. There are no options for enhanced child restraint laws or enforcement. There is no option to lower speed limits. There is no option for implementing/enhancing graduated driver’s license programs for teens. And, perhaps most glaringly, there is no option for enhanced laws or enforcement surrounding distracted driving.

The MV PICCS is a decent starting point, but it’s not all-encompassing. Without having a more comprehensive list of interventions and a longer-term view of costs, I’m not sure how useful the calculator will actually be. For finding quick statistics and getting a general overview, though, I can see how it could be a handy tool.

Consumer Reports Releases New Booster Ratings

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Consumer Reports has just released ratings of 51 boosters, including high-back, backless and models that convert from high-back to backless.  In their article, CR gives some great advice for parents:

First, they recommend not moving your child to a booster until she or he has reached the height or weight limits of the forward-facing 5-point-harness system in the current car seat.  CarseatBlog recommends the industry standard advice for a minimum of 4 years and 40 pounds before kids begin to use a booster.  Some organizations now recommend 5 years, especially for squirmy kids that cannot remain seated properly.

Next, CR also advises that laws for booster use can vary from state to state, so be sure to find out what the law says in the state where you are using the booster. They also warn that state laws don’t always reflect best practice, or might be based on weight rather than age/height. CR and the American Academy of Pediatrics (AAP) recommend that kids use boosters until they are at least 4 feet 9 inches tall and 8 to 12 years old.  We agree!  Depending on vehicle and child, some kids will not fit correctly without a booster until well beyond 8 years old.  How can you tell if your child still needs a booster?  Have them take the 5-Step Test.

The full ratings for boosters from Consumer Reports are available to subscribers.  CR’s top ranked high-back to backless boosters are the Evenflo Big Kid models starting around $30.  The Chicco KidFit and KidFit Zip are top performing models in all CR’s testing as well.  A CarseatBlog Editors’ Pick, the Graco Affix, is also among the higher rated models in CR’s evaluations.  Among high-back only models, the top performer in their testing is the Cybex Solution, though these are currently difficult to find at retail and among the most expensive on the market.  For backless models, the Harmony Youth Booster was the top pick.  It’s also a CarseatBlog Editors’ Pick and a bargain for under $11 at Walmart.

Most models did well in Consumer Reports evaluations.  We note that Consumer Reports had low ratings for some compact/budget backless boosters.  Notably, the Mifold booster had the lowest score in their ratings.  CR stated, “… kids using the Mifold may still be tempted to slouch because it lacks a cushion for their knees to bend comfortably over.”

In addition to CarseatBlog’s expert staff picks for Recommended Boosters, we also advise parents to check out the IIHS Booster Evaluations as well.  Even models highly rated by CarseatBlog, Consumer Reports and the IIHS may not work well for you, with your child, in your vehicle.  So, as always, we recommend purchasing from a store with an easy, free returns policy just in case it doesn’t work well for any reason!

2017 IIHS Booster Seat Ratings Bonanza: Where Does Your Booster Seat Rank?

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Does your booster rate as a Best Bet?

It’s that time of year again: fall has arrived, the air is crisp, turkey day is around the corner, thoughts are on naughty and nice lists, and the Insurance Institute of Highway Safety (IIHS) released their annual fit ratings of belt-positioning booster seats. Because proper seat belt fit on children is so important to their safety in a crash, having a booster seat that adjusts the seat belt easily for both parent and child is paramount. Fortunately, since the IIHS has released their ratings for years and given access to their testing protocol to manufacturers, we have many more excellent choices than ever before. This year IIHS evaluated 16 booster models and 13 earned their highest ranking of Best Bet. We now have an overall total of 118 Best Bet boosters available in the retail market from which to choose!

Beginning this year, IIHS used a new dummy designed specifically for these tests called Jasper (Juvenile Anthropomorphic Seat-belt Position Evaluation Rig). IIHS worked with Humanetics, the dummy’s manufacturer to design Jasper, which represents a 45 pound 6 yr old.

What makes a “Best Bet” booster seat? The booster should correctly position the seat belt on a typical 4-8 year old child in most vehicles. A correctly positioned seat belt will fit low on the lap, touching the thighs, and cross the shoulders about half-way over the collarbone. The shoulder belt should move freely through the belt guide if you have a highback booster.

But remember, your vehicle may not be “most” vehicles and may have a different belt geometry. Always try before you buy, if you can, and hold onto the box and receipt in case you need to return the booster.

“Good Bet” means that the belt fit will be acceptable in most vehicles and these boosters shouldn’t be automatically shunned because they aren’t “top tier.”

“Check Fit” means just that: it may fit a larger child better than a smaller child in some vehicles or vice versa. I’ve used “Check Fit” boosters quite successfully before with my kids in my cars—it definitely doesn’t mean you should chuck the seat out with the bathwater.

What Does Good Belt Fit Look Like?

Most kids need boosters until ages 10-12. Seat belts are designed to fit adult bodies and until children reach adult size, they need a restraint that helps the seat belt fit them or they are at risk of severe injury or death in a crash. The 5-Step Test was designed to help parents determine when their kids fit safely in a seat belt without needing a booster seat.

Sometimes it can be confusing and not at all clear as to whether the seat belt is sitting on the child correctly or not. When evaluating belt fit, it’s always best to dress the child in tight-fitting clothes that don’t bunch; the worst outfit to choose is jeans and a sweatshirt.

Highback boosters with headwings generally have the shoulder belt guides attached and adjust in height. Please check your instruction manual on how to raise the headwings to adjust the shoulder belt position on your child’s shoulder.

New Best Bet Boosters Tested in 2017

This is not an all-inclusive list – many boosters were rated in previous years. You can search all the booster ratings, current and previous years, by manufacturer HERE.

IIHS-BEST-BET-BOOSTER-color
Manufacturer and Model Can Use LATCH CarseatBlog Review CarseatBlog Recommended Seat
Chicco GoFit (backless)
Cosco Finale (highback) Review
Cosco Finale DX (highback) Review
Diono Monterey XT (backless)
Diono Monterey XT (highback) Yes
Evenflo Spectrum (backless) Review
Evenflo Spectrum (highback) Review Yes
Graco Wayz (backless) Review
Graco Wayz (highback) Yes Review
Maxi-Cosi RodiFix (highback) Yes Review Yes
Nuna AACE (backless) Yes
Nuna AACE (highback) Yes
Peg Perego Viaggio Shuttle (backless) Yes

Check Fit Boosters
Manufacturer and Model Can Use LATCH CarseatBlog Review CarseatBlog Recommended Seat
Harmony Folding Travel Booster (highback)
Kiddy USA Cruiser 3 (highback) Yes
Ride Safer Delighter Booster (backless) Review

Not Recommended Boosters

For the first time in years, there are no new boosters on the “Not Recommended” lists; however, that doesn’t mean there aren’t still Not Recommended boosters from past years still being used or for sale as leftover stock. One seat, the Safety 1st Summit 65, is still being manufactured. It is worth looking at the list to make sure a booster you’re using or considering isn’t on this list. These boosters have demonstrated consistently poor belt fit.

For the complete 2017 IIHS Status Report with listing of all previously ranked boosters, visit the IIHS website: http://www.iihs.org/iihs/ratings/child-boosters

Given the number of Best Bet boosters available, chances are high that your booster kid is using one. However, if you’re using a booster that doesn’t garner that coveted Best Bet label, remember to do a fit check yourself in every vehicle you use the booster in since seat belt geometry varies so much. If you have a booster on the Not Recommended list, we do suggest that you find a dedicated belt-positioning booster from the Best Bet list and it need not break the bank.

If you’d like more guidance on which booster to choose, we have our own list of Recommended Carseats with a section on booster seats.

HOT CARS Act Passes U.S. House

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Language from a bill known as the Helping Overcome Trauma for Children Alone in Rear Seats Act (or HOT CARS Act) has been approved by the United States House of Representatives. The HOT CARS Act requires auto manufacturers to include an alarm reminding drivers to check the back seat of their vehicles, ideally leading to a decrease in the number of deaths caused by inadvertently leaving children in the back seat.

The HOT CARS Act was initially introduced in the Energy and Commerce Committee in June, but language from the bill was passed on September 6 as an amendment to the DECAL Act, which seeks to inform consumers about the capabilities and limitations of self-driving cars.

The amendment concerning children left in hot cars says that within two years of the bill becoming law, the National Highway Traffic Safety Administration must issue a rule requiring automakers to include an alarm that will alert drivers to check the rear seat when they turn off the engine. Auto manufacturers would then have two years to comply with the rule.

Children dying in hot cars is a serious issue, and one that has been getting more attention lately. Some vehicle manufacturers, like General Motors, are already putting safeguards in place (as are some car seat companies, like Evenflo). This regulation would force other auto manufacturers to follow suit.

While this bill is a step in the right direction for protecting children from accidental deaths, there’s still a long way to go. First, the bill will need to pass the U.S. Senate. If it does, it will then need to be signed into law by a president who has signaled a resistance to new regulations.

If the bill does become law, the regulation will need to actually be enacted–a process that is often met with challenges, changes, and delays.

We have questions about how these proposed alarms will work. If an alarm chimes each time the car is turned off (as is suggested in the language of the bill), people are more likely to ignore it or otherwise tune it out, especially once they get used to hearing it. Falling into a routine is exactly the problem these alarms should be trying to solve; they shouldn’t be contributing to it. A system like GM’s, where the alarm sounds only if the back door had been opened and shut prior to the car moving, seems more likely to be effective since it has a better chance of catching people specifically when they have a child onboard.

Even under the best scenarios, this regulation is still years away from becoming reality. 

There are benefits and downfalls to relying on technology or gadgets to help keep caregivers from forgetting children in the car. People can always take precautions on their own, though. We recommend that people put an item they’ll need at their destination (like a phone, a purse, or a shoe) in the back seat so they’ll need to open that back door and see the child inside.

Legislation might eventually help, but it’s a long road.