Objective To assess the impact of a booster seat law in Wisconsin on booster seat use in relation to race, ethnicity and socioeconomic status.
Methods A longitudinal study in Milwaukee County, Wisconsin, involving repeated direct observational assessments of booster seat use rates by child passengers aged 4–7 years over five time periods, before and after legislation mandating booster seat use.
Results Overall, booster seat use increased from 24% to 43%, whereas proper restraint use increased pre to post-legislation from 21% to 28%. Proper use increased after legislation in white, but not in black or Latino children. White individuals had a proper booster use increase from 48% to 68% over the time period of the study. Black children's proper use dropped from 18% to 7% over the study period and Latino children's proper use rates were stable at 10%. Driver-reported household income had a significant impact on overall use, but not on proper use.
Conclusions Racial/ethnic minority groups and those of lower socioeconomic status have significantly lower use and proper use of booster seats. Legislation may increase the total use of booster seats but not necessarily the correct use of the restraint, particularly in racial/ethnic minorities.
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Funding This work was funded in part by the Medical College of Wisconsin Injury Research Center (CDC grants R49/CE001175 and R49/CCR519614) and in part by the Healthier Wisconsin Partnership Program, a component of the Advancing a Healthier Wisconsin Endowment at the Medical College of Wisconsin.
Competing interests None.
Patient consent Obtained.
Ethics approval Ethics committee approval was obtained from the Children's Hospital of Wisconsin Institutional Review Board.
Provenance and peer review Not commissioned; externally peer reviewed.
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