TABLE 2. Self-reported seat belt use among adults aged ≥18 years, by rural-urban designation, census region, and type of state seat belt enforcement — Behavioral Risk Factor Surveillance System, United States, 2014.
| Rural-urban designation and census region | Seat belt use (always wears) |
||||
|---|---|---|---|---|---|
| Total |
Primary seat belt enforcement |
Secondary seat belt enforcement* |
Primary-secondary RR (95% CI) | ||
| No. | Weighted % (95% CI) | Weighted % (95% CI) | Weighted % (95% CI) | ||
|
United States
|
429,058
|
86.9 (86.6–87.1)
|
88.7 (88.5–89.0)
|
80.7 (80.3–81.1)
|
1.10 (1.09–1.11)§
|
|
Rural-urban designation†
| |||||
| Metropolitan counties, overall |
298,677
|
88.1 (87.9–88.3)
|
89.7 (89.5–90.0) |
82.5 (82.1–83.0) |
1.09 (1.08–1.09)§ |
| In metropolitan area with ≥1,000,000 population |
150,796
|
88.8 (88.5–89.1)
|
90.2 (89.8–90.6) |
83.9 (83.3–84.5) |
1.08 (1.07–1.08)§ |
| In metropolitan area with 250,000–999,999 population |
89,056
|
87.6 (87.1–88.0)
|
89.5 (89.0–89.9) |
81.2 (80.3–82.0) |
1.10 (1.09–1.12)§ |
| In metropolitan area with <250,000 population |
58,825
|
85.3 (84.7–85.9)
|
87.5 (86.8–88.2) |
78.5 (77.4–79.6) |
1.11 (1.10–1.13)§ |
| Nonmetropolitan counties, overall |
130,324
|
80.6 (80.1–81.0)
|
83.5 (82.9–84.0) |
72.5 (71.7–73.3) |
1.15 (1.14–1.17)§ |
| Urban population of ≥20,000 |
42,775
|
83.2 (82.4–83.9)
|
86.9 (86.0–87.7) |
74.2 (72.7–75.5) |
1.17 (1.15–1.20)§ |
| Urban population of 2,500–19,999 |
64,047
|
80.0 (79.3–80.7)
|
82.0 (81.2–82.8) |
73.3 (72.1–74.5) |
1.12 (1.10–1.14)§ |
| Completely rural or <2,500 urban population |
23,502
|
74.7 (73.4–76.0)
|
79.1 (77.3–80.7) |
64.7 (62.8–66.6) |
1.22 (1.18–1.27)§ |
|
Census region
¶
| |||||
| Northeast |
76,968
|
84.0 (83.4–84.5)
|
87.7 (87.0–88.4) |
78.1 (77.3–78.9) |
1.12 (1.11–1.14)§ |
| South |
128,702
|
88.2 (87.9–88.6)
|
88.3 (88.0–88.7) |
87.2 (86.1–88.1) |
1.01 (1.00–1.03)§ |
| Midwest |
120,363
|
83.7 (83.3–84.1)
|
86.2 (85.7–86.7) |
78.3 (77.5–79.1) |
1.10 (1.09–1.11)§ |
| West | 103,025 | 90.1 (89.6–90.5) | 93.1 (92.5–93.7) | 83.2 (82.7–83.7) | 1.12 (1.11–1.13)§ |
Abbreviations: CI = confidence interval; RR = rate ratio.
* In 2014, a total of 33 states and the District of Columbia (DC) had primary enforcement, 16 states had secondary enforcement, and one state (New Hampshire) had no requirement for seat belt use by adults. States with primary enforcement in 2014 included Alabama, Alaska, Arkansas, California, Connecticut, Delaware, DC, Florida, Georgia, Hawaii, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Michigan, Minnesota, Mississippi, New Jersey, New Mexico, New York, North Carolina, Oklahoma, Oregon, Rhode Island, South Carolina, Tennessee, Texas, Washington, West Virginia, and Wisconsin. States with secondary enforcement in 2014 included Arizona, Colorado, Idaho, Massachusetts, Missouri, Montana, Nebraska, Nevada, North Dakota, Ohio, Pennsylvania, South Dakota, Utah, Vermont, Virginia, and Wyoming. New Hampshire was grouped with secondary enforcement states for analysis purposes.
† Rural and urban designations were determined using the U.S. Department of Agriculture’s 2013 rural-urban continuum codes (https://www.ers.usda.gov/data-products/rural-urban-continuum-codes). Metropolitan counties include counties in metropolitan areas of ≥1,000,000 population, counties in metropolitan areas of 250,000–999,999 population, and counties in metropolitan areas of <250,000 population, Nonmetropolitan counties include counties in nonmetropolitan areas with an urban population of ≥20,000, counties in nonmetropolitan areas with an urban population of 2,500–19,999, and counties that are completely rural or with <2,500 urban population.
§ RRs comparing seat belt use in primary enforcement states to seat belt use in secondary enforcement states are significantly different from 1 (p<0.05).
¶ Census regions were determined using the U.S. Census Bureau definition (https://www2.census.gov/geo/pdfs/maps-data/maps/reference/us_regdiv.pdf).