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The Hidden Link: How Obesity Affects Child Passenger Safety
A perspective from Clayton Ulm
Picture a typical American classroom. Kids are drawing, some are playing on the playground, and others are giggling over a shared secret. Children are learning to read, add and subtract, and how to make friends. One day, all the children attend class. However, the next day three chairs are left permanently empty. The next day, three more join them. And the next day, and the next day, and so on.
Day after day, families are forced to face the stark reality that rarely makes it to news headlines, a reality that traffic accidents cause the deaths of 3 children in the US every day (Traffic Safety Facts, 2021).
One proven way we have reduced child mortality from traffic accidents is through proper restraint. Legislators have required the widespread adoption of safety seats for infants and toddlers and booster seats for older children. And for the most part, this adoption has been successful. Between 1999 and 2008, after the introduction of child restraint laws and increased education on rear seating position and age-appropriate restraints, we saw a 45% decline in the number of US children who died in traffic accidents (National Highway Traffic Safety Administration, 2010). Yet, traffic accidents are still the leading cause of death for children over the age of four (CDC, 2023). Out of all States, North Carolina has the fourth-highest number of child traffic deaths with a 72% higher rate than the national average (Traffic Safety Facts, 2021).
Although we have made progress in child passenger safety, a hidden factor is emerging, childhood obesity. Not only does obesity predispose our children to health issues, but it also exacerbates the risk of traffic accident injury. It was once theorized that excess body fat provided a protective “cushion” when involved in a traffic accident. However, recent reviews, like those by Alattar et al. (2022), shed light on the concerning link between childhood obesity and increased severity of injuries in car accidents. For example, children aged 2 to 13 who were obese were at an increased risk of thoracic injury whereas children aged 2 to 5 had a higher likelihood of head, face, or neck injury during a car crash.
This underlying connection between childhood obesity and increased risk of injury and death in traffic accidents is becoming increasingly clear. A study by Durbin et al. (2018) found that as childhood obesity rates rise, so does the difficulty in finding appropriately fitting child safety seats and booster seats. Even though some manufacturers have adapted seats for larger children, the risk remains, especially since larger children face an increased risk of lower-extremity fractures during accidents. Similarly, once children move out of safety seats, obesity significantly reduces the effectiveness of seat belt fit (Reed et al., 2012). For obese individuals, the lap belt tends to sit higher and more forward. Higher lap belt positioning could lead to what’s known as ‘submarining,’ where the person slides under the belt, raising the risk of serious lower body and abdominal injuries.
Today, 1 in 5 US children are obese (CDC, 2022). Part of the problem is traffic density. Increasing traffic is not only involved in increased risk of death and injury but it is also implicated in this rising obesity crisis. For instance, as traffic flow and vehicle air pollution in neighborhoods increase over time, so does the rates of obesity in children (Jerrett et al., 2014; Wang et al., 2021). Further, traffic density and speed, are also associated with lower physical activity in children (Davison & Lawson, 2006). Would you want your children to play outside if cars are constantly speeding by? As traffic density continues to increase, so do factors that contribute to childhood obesity. Now that the problem has been identified, potential solutions are currently underway.
One way to fix this synergistic effect of traffic contributing to increasing bodily risk to children with obesity is simple: reduce childhood obesity. Research on ways to do this are currently underway. One method is enacting policies on sugary drink warning labels. Research at UNC shows that introducing a simple warning label on sugary drinks reduces parents’ purchases of these drinks for their children by 38% (Hall et al., 2022). Further, more UNC research shows that reducing the consumption of sugary drinks at this level would lead to large reductions in obesity prevalence. When researchers used a complex computer modeling program called microsimulation to estimate the impact of sugary drink warning labels on obesity, they projected that obesity would decrease by 3 out of 100 people or a 3.1% reduction (Grummon et al., 2019).
Whatever the solution is, one thing must be made clear. Childhood obesity increases the risk of injury during a traffic accident. Parents and policymakers alike should be made aware of this fact.
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