Neighborhood-level factors affecting seat belt use.

Despite the well-known safety benefits of seat belt use, some vehicle occupants still do not use them. This is a challenge in Tennessee, which has a lower seat belt use rate compared to the United States national average. Roadside observations and interviews are the two main sources for estimating seat belt use rate and have several limitations (e.g., small sample size, social desirability bias). To address these limitations, we attributed seat belt use of individuals who were involved in traffic crashes (N = 542,776) to their corresponding home-addresses. Home-addresses were retrieved from police crash reports and were geocoded, and assigned to their corresponding census tract revealing added information about the spatial distribution of seat belt use and socioeconomics of the areas surrounding the crash victim's home. The average seat belt use rate in the metropolitan area was 88% and for the non-metropolitan area was 87%. A Tobit model was used to evaluate the relationship between the seat belt use rate for both drivers and passengers over 16 years old, with neighborhood sociodemographic variables. Population, age cohorts, race, household vehicles' ownership, household size, and education were among the predictors of the seat belt use rate. Results of this analysis could be used in safety campaign design to reach specific geographic areas and groups with a lower seat belt use rate.