Are Booster Seats Actually Safer Than Just Seatbelts

If you are like many parents watching your children’s booster seats slide around while they hop into the vehicle and otherwise wonder what precisely is the way you’re supposed to incorporate the seatbelt around the bits so it’s properly positioned on the kids (we’ll get into how to always do this one correctly later in this video), or lord help you if you have your kids buckle themselves and watch as they somehow find a completely different way to position things each and every time, you may have found yourself wondering if this more complicated and expensive way to get children safely secured in the car is, in fact, actually any safer than just using a seatbelt alone.

Well, it turns out, because universe is gonna universe, the answer is kind of complicated, ranging from no, not at all, to yes, boosters are safer, to also it doesn’t actually matter either way because it would be much better if we all stopped using booster seats once kids graduate from infant car seats.

Confused? Well, we’re really glad because we spent a ton of time researching and writing the rest of this piece and it would make us a very sad Panda if nobody bothered to continue to watch and learn from the fruits of our efforts… Plus, we’re going to tell you later how to make sure you are always using the booster seats correctly. So everybody wins!

To begin with, let’s first note that the recommended child safety seats for littles before they’re big enough for booster seats, aka infant seats, are unequivocally safer than both booster seats and seatbelts for this especially young age group. ESPECIALLY when these infant safety seats are rear facing. And, in fact, you should keep these things rear facing as absolutely long as possible, with many Scandinavian countries even requiring up through the age of 4 years old for rear facing child safety seats. This fact is thought to be why, for example, Sweden has the lowest percentage of this age group of kids killed in auto accidents in the world.

As a brief aside, it is extremely likely that everyone, adults included, should be rear facing, except, for practical reasons, the driver. But for reasons that simply come down to “people don’t like facing the opposite direction of their motion”, nobody advocates for this outside of with babies and toddlers, not even on airliners where such a switch would be trivially easy via simply slotting the seats the other way in their tracks. In cars, the switch would be less trivial, but completely doable if people actually cared for maximum safety over the apparent universal and oh so powerful, “But I don’t wanna” line of reasoning.

Going back to the topic at hand, doing this may even supersede most of the reason for a seatbelt at all, which is to distribute the force of the crash over a wide area of a particularly durable part of your body instead of, for example, your head smacking against something in front of you and that being the first thing that starts to slow you down. This, by the way, is why school buses don’t typically have seatbelts and also, in part, why crash safety data indicates pretty strongly they don’t seem to need them. The seats in front of the kids are specifically designed both in structure and height to provide a nice, somewhat padded surface for the littles’ tiny bodies to impact against, and this works exceptionally well.

But we’re not here to talk about rear vs forward facing seats in moving transportation. We’re here to talk about why the governments of the world may or may not be being controlled by the real scourge of the universe. No, not our Lizard overlords, who are nothing but kind and accommodating in our experience. No, the Lizard People are not the problem, and should be welcomed with open arms by all of us for their benevolent nature, and for how dedicating ourselves to serving their greatness provides much needed purpose, structure, and calm to our otherwise chaotic lives, so infected with needless freedoms. No, the Lizard People are not the problem. The real issue is Big Booster, lining those political pockets with those sweet, sweet, cupholders.

On that note, let’s start with the “yes” part of our previous “it’s complicated” answer to whether booster seats are safer than just seatbelts.

For this, one of the best studies to date potentially in support of boosters is the 2006 masterfully titled study, Effectiveness of Child Safety Seats vs Seat Belts in Reducing Risk for Death in Children in Passenger Vehicle Crashes, by Dr. Michael R. Elliott et al, looking at 2-6 year olds involved in crashes that included fatalities occurring between 1998 and 2003.

The results? Children from 2-6 years old, when properly secured in child safety seats, had about a 28% reduction in risk of dying vs straight seatbelt use. When including known cases of misused child safety seats, this percentage dropped to 21%, but still a significant net benefit.

So, case closed, right?

Well, not so much. While the researchers do take a number of steps to overcome the limitations on the data they had to work with, some limitations remain. For example, the fact that drivers who use such child restraint systems are already statistically less likely to be involved in fatal crashes in the first place. Thus, to quote the researchers, “use of the NASS CDS population [one of their two main data sources] may overstate the effectiveness of child restraint systems vs seat belts by confounding child restraint use with safer driving behavior…”

Perhaps even more important to point out here is that while this study, and many others like it, are often pretty widely used in support of booster seat usage, the study itself does not distinguish between booster seats and five point harness style infant car seats. Thus, even if working with a perfect dataset, the results don’t really necessarily apply to the question of booster seats vs just seatbelts.

The reason this study and many others do not make this distinction is simply that up until relatively recently the U.S. Department of Transportation Fatality Analysis Reporting System (FARS) database this study used, along with the aforementioned National Automotive Sampling System data, did not distinguish between the two in accident reporting.

So how about a study that does isolate booster seats? Enter Kristy Arbogast et al in their 2009 paper, Effectiveness of Belt Positioning Booster Seats: an Updated Assessment. In this one they look at 7,151 children involved in 6,591 crashes ages 4-8 years old from 1998-2007, about 70% of which were wearing seatbelts only, and the rest in a booster seat. Noteworthy on this one, they also aren’t just looking at fatalities like so many other studies on the matter, but injuries in general.

The results? They found that children using a booster seat were 45% less likely to be injured in car accidents vs children in seatbelts alone. Interestingly, contrary to what some other studies seem to indicate, they also found there was no statistically significant difference between injury rates in booster seats that had backs vs ones that were backless. As they state, this is an important point if accurate given children, particularly as they get older, are usually less resistant to using backless booster seats compared to ones with backs. And since their data indicates neither provides noticeable benefit to the other, going with backless is perfectly fine in their recommendation.

So, case closed for sure this time, right?!?

Well, no. There are some issues here. This is not because the researchers in any of these studies are dumb. Most of them literally have PhD’s and everything and, while it may come as a shock, so I hope you’re all sitting down- these people literally do this for a living. Just sit around contemplating the problem and gathering and analyzing the data and everything. In fact, they invariably point out the issues in their respective studies for people who actually bother to read them instead of just the few sentence summation of results, which tend to make for much more compelling social media headlines than actually delving into the complex details.

So if the issue is not a lack of brain power or attention to detail, what is it? The problem is that the perfect dataset for this issue simply doesn’t exist owing to the number of variables involved from accident scenario, to car type and safety features built in, to safety seat design (which is likewise constantly evolving), to the child’s size and exact belt and seat positioning at the time of the accident, and a number of other factors, many of which are extremely poorly or inaccurately documented, or sometimes not at all, in automobile accidents.

So what’s the problem with this specific one? Among other potential issues, noteworthy is that the data used here was collected by insurance claims records, validated by phone surveys. As one skeptic of the usefulness of such a dataset, economist Dr. Steven Levitt, speculates,“If you were a parent involved in a crash in which your child was injured, and a researcher with your insurance company called you, what would you say if your child was not restrained (i.e., wasn’t even wearing a seat belt)?… You tell the person the kid was using an adult seat belt.”

If that hypothesis is correct, this would then skew things in favor of booster seat safety over straight seat belts in any study using data collected this way.

That said, supporters of the use of booster seats have a bit of a trump card up their sleeve in that regardless of what the real world accident data seems to say either way, biometric data and injury types in accidents pretty clearly show proper belt positioning which distributes the impact load over our most robust bits possible, rather than more easily injured areas, is better at reducing injuries and fatalities in all humans, not just the littles. Thus, given booster seats in theory help do exactly this if used correctly, we should all just kind of go with that they probably are decreasing the risk of injury and fatalities at least somewhat, even if proving this hypothesis is obscenely difficult…

Well, outside of if anyone wants to throw out the crash test dummies and instead start strapping our little human parasites up in scientifically observed crashes. And then just go to town on testing… I mean, we can just make new crib lizards. They are literally a renewable resource! …And it’s pretty fun making them as well! At least, initially… The solution is so simple people! And it’s FOR SCIENCE!!!! There’s really no downside here…

In any event, so that’s a sampling of among the best of the data and arguments in support for “yes booster seats are safer than just seatbelts”. What about the evidence that booster seats aren’t actually safer?

To begin with, as noted, while it is absolutely true that in theory child safety seats *should* be much safer than just seatbelts thanks to better positioning of the seatbelt on our miniatures, as alluded to, data pretty strongly indicates that the majority of kids are not being secured in their booster seats properly. For example, according to the U.S. CDC, approximately 46% of child safety seats aren’t being used correctly in the United States, and when looking at just booster seats, this number rises to a whopping 59%, just shy of 2 out of 3 nose pickers!

This is both because people often don’t really understand the point of a booster seat, thus not positioning the seatbelt properly with them (we’ll get to this in a bit), and in part because the variants of booster seat design out there are about as numerous as “The Sperminator” Simon Watson’s offspring. On this one, the mid-40s British man to date has allegedly sired around 1,000 babies, including supposedly impregnating 13 different women in just 26 days in 2019… If you’re wondering how this is possible given sperm donor rules in most areas, Mr. Watson simply bypasses such with the ladies coming directly to him. And by a happy coincidence, him coming directly after… Charging the women 50 pounds for a first dose of his baby-daddy juice and 25 pounds for each additional cream filling in a given menstrual cycle. Given all this, we can only assume Mr. Watson also works for Big Booster, helping to increase sales one crotch goblin at a time.

What were we talking about again?

Oh yes, the insane number of booster seat varieties and the issues this causes. Thus, even adults get confused at times about the best way to buckle up their sex trophies in them, let alone when the semen demons do it themselves. And even when buckled up correctly initially, because our little hump dumplings can’t sit still to save their lives- perhaps literally in this case- this further potentially causes seat belt positioning issues, thereby completely negating the main potential safety benefit of the booster seat! Not only that, the littles often have a tendency to very intentionally move their shoulder strap under their arms or behind their backs without parents necessarily noticing during a drive.

This all, perhaps, contributes to the fact that while in theory booster seats should probably be safer in general than just seatbelts for those who are particularly vertically challenged, real world datasets are seemingly not so generous.

This brings us to the studies that indicate booster seats are pointless… Not just because pointy bits on a crash safety device aren’t a great idea, but also in the figurative sense of not serving a useful purpose in their very existence, much like you, David.

Enter the aforementioned economist Dr. Steven Levitt who a couple decades ago also found himself wondering if booster seats were actually safer than just seatbelts, particularly when he observed that the previous studies demonstrating they were safer in real world scenarios had some major issues with the data they were using.

To try to improve on the situation, in Levitt’s 2005 work, Evidence that Seat Belts are as Effective as Child Safety Seats in Preventing Death for Children aged Two and Up, he used the aforementioned FARS data, in this case from 1975 to 2003. From here, he then proceeded to try in every way possible to overcome the limits of the data and sample used here to get around the myriad of issues previously alluded to.

The result? Before doing such filtering on the data, there was about a 1% difference in expected fatality between child safety seat users vs lap and shoulder belt users for this age group of children 2 and older. And after? Well, the data did not become any more generous to child safety seats, at least when talking fatalities. He summed up very aptly that based on real world data, “There is no evidence that car seats do a better job than seat belts in saving the lives of children older than 2.”

Now, he does note in the paper two important things to consider. First, there is some evidence that when moving from discussing deaths to just injuries, that child safety seats offer extra protection. And second, that the overall results even when discussing fatalities may be being skewed via the fact that, as he notes, the “NHTSA (1996) estimates that more than 80 percent of all child safety seats are incorrectly installed.”

That said, he goes on to say, “I conducted my own crash tests at an independent lab using lap and shoulder belts on dummies corresponding to children aged 3 and 6, the seat belts performed well within the guidelines the federal government has established for child safety seats, and just about as well as the (properly installed) child safety seats that I tested. While far from definitive, the crash tests I conducted suggest that even with proper installation, there may not be clear advantages of car seats over seat belts.”

Also of note on this one we feel once again is important to point out when discussing the question of booster seats vs just seatbelts, owing to the limitations of the dataset being used here, Levitt, like so many before him, does not distinguish between booster seats and other car safety seats, which may or may not change the conclusion reached.

As a brief aside, another interesting thing about the results Levitt observed in the data is that adults are more likely to be injured in a front seat accident than children riding in the front seat are for a variety of reasons. Thus, if all seats in the car are filled and one were to optimally reduce the risk of injury overall to occupants in said car, any passenger adult should sit in the back and the ankle-biters in the front. That said, the data here and in basically every study out there on the issue pretty clearly shows everyone of any age is generally going to be safer in a car accident sitting in the back seat than the front, and particularly when talking about the center of the back, which is the safest place to sit in a car accident. For example, when discussing kids 3 and under, in one study looking at 4790 accidents from 1998 to 2006, those littles sitting in the center of the back seat were 43% less likely to suffer an injury than those sitting on the sides.

So, note to self, favorite child goes in the middle, children who maybe would be best served to be “voted off the family island,” so to speak, from being a terrible disappointment to their parents, much like you, David… should sit on the sides.

Going back to Levitt’s study, while his paper is perhaps superior in several ways from many previous studies, there are still issues. This, once again, is not because Levitt is an idiot. Very clearly far from it. Simply that there is no perfect dataset available here. For example, this data is only from accidents in which at least one person was killed, so likely in many cases of the extremely severe crash variety, which may or may not be representative of a more typical car crash. For example, fatal crashes tend to skew towards people who drive older cars with fewer safety features. Thus, the results here may or may not be as applicable to, say, a fender bender in a brand new Tesla Model Y with all the safety bells and whistles.

Also interesting to note, while not necessarily affecting Levitt’s results, it’s somewhat fascinating nonetheless that people who drive older cars are also disproportionately inclined to not just not have booster seats for their kids, but also not have their children utilize any safety device, even seatbelts. This group also is statistically more likely to get into accidents in the first place, receive more traffic citations, and otherwise drive more recklessly.

And speaking of older cars and advancements over the years, if you were paying attention, you might have noticed Levitt’s paper was published all the way back in 2005, and used data only up to 2003.

A lot has changed in the years since 2003, most notably me losing my virginity… Which isn’t relevant to the booster seat discussion, I just wanted everyone to know…

Enter Mark Anderson and Sina Sandholt from Montana State University… For a study concerning booster seats. Nothing to do with my status as having been with a woman in the Biblical sense. Which totally is a thing that has happened, by the way. I’m still pretty stoked about it.

In their paper, Are Booster Seats More Effective than Child Safety Seats or Seat Belts at Reducing Traffic Fatalities among Children? published in 2017, Anderson and Sandholt note, much like Levitt had previously observed, “In an effort to increase booster seat use among children, the National Highway Traffic Safety Administration is encouraging state legislators to promote stricter booster seat laws, yet there is a paucity of information on booster seat efficacy relative to other forms of restraint.”

They further go on, “what is surprising is that most studies evaluate the effectiveness of these devices relative to riding unrestrained, as opposed to riding in a standard seat belt. Moreover, they do not take into account the sample selection problem associated with analyzing data on fatal motor vehicle crashes. Specifically, if restraint use influences the likelihood of dying, then a data set on fatal motor vehicle crashes is not representative of all crashes in the United States. The exception to the literature is Levitt… However, due to data limitations, Levitt… was unable to distinguish between different types of child restraint devices.”

Given all this, they sought to do a bit of an update on Levitt’s study using the FARS system, applying many of the same filters on the data he used, but this time using a more modern dataset of 2008-2016, along with some extra data that wasn’t available to Levitt. Most pertinent to the topic at hand, in the updated FARS, from 2008 on, one is finally able to distinguish between booster seats and other child safety seats.

So what did they find? To quote them, “For the older children in our sample (6 to 9 year-olds), our results suggest that booster seats, child safety seats, and seat belts alone are equally effective at decreasing the probability of fatality.”

Fascinatingly, however, when you adjust down to the ages of 2-5, booster seats actually lost out to both child safety seats and seatbelts alone in the whole kids dying rate we all seem to want to reduce for some reason despite growing overpopulation issues, how expensive they are, and the fact that they never let us sleep in. This potentially suggests that in this age group, you’d be better off skipping the booster and going right to seatbelts. At least if you want your kids to live for some reason.

As to why, this may simply be due to imprecision in the data. For example, one possibility is once again going back to improper booster seat usage. With, for example, a 2 year old perhaps not being buckled correctly in the booster seat, or not remaining that way, vs, for example, an 8 year old, or that same 2 year old buckled with just a seatbelt. It’s also always possible booster seats are simply not optimized for children of that age group given more robust 5 point child safety seats usually are used in this case instead. Whatever is going on here, as the authors note, “These results are consistent with the notion that putting a child in a booster seat too soon, may be especially unsafe.”

So, FINALLY, case closed, right? Booster seats are pointless? … Except, once again we should explicitly point out in this one, while this is arguably one of the best studies done to date covering the issue of boosters vs seatbelts, it is only dealing in fatalities, not injuries in general. As mentioned, other studies seem to indicate on the whole boosters have an overall net benefit at reducing injuries overall…

Except, actually… well… Enter the 2013 study Effectiveness of Booster Seats Compared With No Restraint or Seat Belt Alone for Crash Injury Prevention, which looked at children from 0-10, and found that children in booster seats suffered approximately the same number of injuries as those in seatbelts alone, just the injury type was a bit different in that booster seat kids had a higher risk of neck and thorax injuries while reducing certain other injury type instances. These researchers also once again note that the majority of the previous studies that showed reduction in injury with booster seats had issues like relying on somewhat questionable insurance phone survey data and the like as already mentioned…

Going back to the neck and thorax injury increase, perhaps key in all of this, again, is simply the rampant misuse of boosters, with it hypothesized by some it’s not unreasonable to think that if everyone would just start using them correctly, the data may well skew more in favor of boosters instead of right now where results are rather lackluster.

Of course, despite widespread efforts to educate people on proper booster usage for many years now, things on this front don’t seem to have really improved much, or perhaps ever will, because kids are gonna kids, and even if initially secured properly, they won’t necessarily stay that way, particularly when very young. And when older, they are just going to argue constantly to not have to use a booster until parents give in and switch to belts alone.

This brings us around to the argument some, such as Dr. Levitt, have put forth- that regardless of what the data says, and indeed ESPECIALLY if boosters really are safer than just seatbelts, it might actually be better if we all stopped using the boosters.

Why?

As Levitt’s et al point out, “The problems are… being addressed by solutions that are often not the best solutions. If safety is the primary concern, there are better options.”

On this note, let’s briefly talk a little about the cost of booster seats and what it actually accomplishes if used perfectly to see what might be a much better solution to protect our adorable ladybit destroyers.

As alluded to, a booster seat’s main purpose is to provide essential and ultra critical extra cupholders for the backseat disaster artists. A lesser known side benefit is to get the seatbelt approximately where it needs to be for maximum safety for the vertically challenged. This is only needed because seatbelt designs in cars are meant to be approximately correctly positioned for the average sized adult passenger. Because of this, parents world-wide spend well over $1 billion per year on booster seats alone, with that figure rising incredibly rapidly in recent years.

For reference here, in 2015, the entire global sales of all child safety seats was only $1.4 billion. By 2020 that had risen to $8 billion. And by 2025, this is expected to reach well over $11 billion with no slowing in sight. All of this is primarily driven by laws passed requiring such child safety seats, as well as government sponsored advertisements and the like advocating for the life saving benefits of these devices, despite the data not exactly backing these notions up when it comes to boosters, at least in practice.

And if you’re curious here with the preceding numbers, infant car seats represent about 1/3 of these current approximately $9 billion in annual sales, designated boosters about 1/6, and the rest being convertible or combination seats that can do both.

Opponents of the booster seat push also note that for those who treat the vagina like a clown car, popping out adorable little tax shelters left and right, they even sometimes have to upgrade to bigger vehicles just to accommodate the fact that putting, for example, three booster seats side by side by side is at best impractical and difficult to buckle everyone in, and in many cases simply not possible given many car widths available, with this having to be dealt with for legal reasons in many regions these days all the way to the point when the sex trophies become teenagers.

Thus when factoring in the massive sums various safety agencies spend to push these specialty seats, funds that perhaps could be used to push for other safety measures elsewhere, the even more massive amounts parents have to spend every year on the booster seats, and the impracticality in some cases, all combined with the rather lackluster support for much of this in the underlying data when it comes to boosters, as Levitt suggests, perhaps it’s time to look at other solutions to the problem.

Most obviously, instead of passing laws to require boosters that the majority of the time aren’t used correctly anyway, governments may well be better served passing laws requiring car manufacturers to come up with better seatbelt systems designed to be adjustable to people of all sizes.

This would not only benefit parents and their littles, but also adult humans of the particularly vertically challenged persuasion, as well as those whom God, in his glorious wisdom, gifted with especially large built in airbags, with said chesticles, particularly in conjunction with otherwise small stature, in some cases making the shoulder strap less than ideally placed in the stock position.

In all cases, such a required adjustable seatbelt system would then give added safety for those whose lives I think we all want preserved the most- our lovely lady friends and the human parasites they enjoy creating with us for some weird reason.

With such systems being fairly universal in design across vehicle models, similar to current seatbelt systems, this would not only see the end to seatbelts cutting into necks, but also see the end to confusion in the proper way to buckle a given kid up. Thus ensuring relative consistency from buckle to buckle and vehicle to vehicle, likely improving overall safety over our current booster seat requirement model, and saving parents the world over a bit of booster seat cash to then instead spend in much more important ways, like on our sponsors here at TodayIFoundOut.

And while we are at it, let’s all start thinking long and hard about rear-facing seat designs for all passengers, and the massive number of lives that would save and reduction in injuries every year, shall we?

…Just joking, from basically the moment we are first able to talk, it’s clear we pretty much all would rather die than face backwards while going forwards.

But, seriously, rear facing seats people, for all of us. We have the technology, and we’ll all get used to it. Because all joking aside, nobody likes dead people… I mean, ok, maybe if you get lonely enough and have some hot water bottles handy to warm things up a bit… But otherwise! Best to keep our fellow humans alive as long as possible… Except for you, David. You can just F- right off to hell where you belong.

Bonus Fact:

As promised way back at the beginning of this video which was in no way an attempt to get you to keep watching to the end to appease the fickle Algorithm Gods, let’s now talk about how you can always make sure regardless of booster seat design, your mom-bod makers are secured correctly in their boosters.

It’s quite simple actually if you, once again, understand that the entire point of the booster seat is to provide extra cupholders… And, like, to make sure the seatbelt is positioned properly on the body.

As for this position, the belt strap should be across their hips, not higher in their abdomen area. Thereby distributing force across their skeletal structures and not, for example, their liver, spleen, and bowels. This one is usually a given by the very nature of the booster. If it’s firmly planted against the back of the seat and sitting flush on top, you can’t really screw the lower belt up, unless, we suppose, if it has arm rests and you decide for some reason to run the strap above the armrests instead of below I guess…

Second, the shoulder strap should be positioned across their collar bone (approximately the middle between the edge of the shoulder and the neck), and then down diagonally across the middle of the trunk. Most of all, the straps definitely shouldn’t be positioned on their neck. And definitely not under their armpit or behind their back. as so many kids and adult females that have been especially blessed in the funbag department or otherwise are just adorably short like to do. If no armrests on your booster, this will probably naturally happen, but in some cases the booster, for example, is designed to have the shoulder strap run under one of the armrests to get this strap approximately in that position.

So, to conclude, if you’ve buckled your child or funsized partner in a booster seat and the positioning of the belt is over their collar bone and diagonal down across the middle of the chest, and the lap portion is centered as low as possible on their hips, then you’ve in all likelihood done things right, regardless of booster seat design.

Expand for References

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