Determinants of Health Related to Primary Health Care

Encouraging Seatbelt Usage as Part of Primary Care

Unintentional injuries resulting from motor vehicle accidents represent one of the leading causes of death among adolescents in Western nations today (Jones & Schultz, 2009). Despite legislation requiring their use in many countries, adolescents and young adults are among those with the lowest rates of seat belt usage with the highest risk of being injured in a motor vehicle accident (Cross, 1999). To determine what role nurses can play in encouraging self belt use and reducing the current levels of morbidity and mortality associated in the future, this paper provides a review of the relevant literature followed by a summary of the research and important findings in the conclusion.

Review and Discussion

More young people aged 13 to 19 years die from unintentional injuries received in traffic-related collisions on U.S. public roads than any other cause (Jones & Schultz, 2009). In fact, more than 5,000 young people in this age range died from motor vehicle crashes in the United States in 2005 alone, and more than a half million incurred nonfatal injuries that were sufficiently serious to warrant treatment in an emergency department (Jones & Schultz, 2009). Males in this age range are more than twice as likely as their female counterparts to die or become injured in a motor vehicle accident, while the nonfatal injury rate was slightly higher for females in this age group (Jones & Schultz, 2009). According to Cross (1999), "The effectiveness of seat belts in reducing transportation-related fatalities and injuries is widely accepted. Seat belts reduce the risk of death and serious injuries in motor vehicle crashes by 45-60%. Increasing seat belt use among adolescents is a priority because they have among the lowest rates of belt use and the highest risk of fatal crashes per mile driven of any age group" (p. 268). The effectiveness of seat belts in reducing injuries and deaths from motor vehicle accidents has been proven through exhaustive testing including study designs involving laboratory experiments (using human volunteers, cadavers, and anthropomorphic crash dummies), postcrash comparisons of injuries sustained by restrained and unrestrained occupants, and post-crash judgments by crash analysts regarding the probable effects of restraints had they been used (McGlynn & Damberg, 2000). Furthermore, the research to date confirms that even when young people are injured in motor vehicles accidents, victims who were wearing their seat belts at the time of the accident have less severe injuries, are less likely to require admission, and have lower hospital charges (McGlynn & Damberg, 2000).

Seat belts have been installed in all American cars and trucks for nearly a half century, but most drivers have only been wearing seat belts routinely since the practice was required by law in their individual state, in most cases within the past few years (Seat belts, 2013). As a result, clinicians were largely unaware of the importance of seat belt usage, especially by young people (Jones & Schultz, 2009). By contrast, today, the importance of wearing a seat belt is well documented and primary care nurses are in an excellent position to intervene in this area by educating young people concerning the imperative to wear a seat belt at all time when operating or riding in motor vehicle. According to the Canadian Nurses Association, the focus of primary health care is "on preventing illness and promoting health. It means being attentive to, and addressing, the many issues in people's lives that make them sick" (Primary health care -- the time has come, 2003, p. 1). The primary health care approach is also congruent with Kendall (2008) observation that, "Central to the WHO notion of Primary Health Care is the concept of bringing health care much closer to the homes and workplaces of the people and communities who most need it" (p. 5). More research is needed, though, concerning the most efficacious way primary health care nurses can intervene to promote increased seat belt usage by young people who use seat belts less often than any other subgroup of drivers (Seat belts, 2013).