Chapter 4

The Fix is In—And It’s Cheap and Simple


The dangers of childbirth . . . Ignatz Semmelweis to the rescue . . . How the Endangered Species Act endangered species . . . Creative ways to keep from paying for your trash . . . Forceps hoarding . . . The famine that wasn’t . . . Three hundred thousand dead whales . . . The mysteries of polio . . . What really prevented your heart attack? . . . The killer car . . . The strange story of Robert McNamara . . . Let’s drop some skulls down the stairwell! . . . Hurray for seat belts . . . What’s wrong with riding shotgun? . . . How much good do car seats do? . . . Crash-test dummies tell no lies . . . Why hurricanes kill, and what can be done about it.

Sometimes it pays to be low status. When a family of four goes for a drive, the kids usually get shunted to the backseat while the mom or dad rides shotgun. The kids are luckier than they know: in the event of a crash, the backseat is far safer than the front. This is even truer for adults, who are larger and therefore more likely to smack into something hard when they sit up front. Unfortunately, while it’s okay to consign the low-status kids to the rear seat, if the parents go out for a drive alone, it’s a bit awkward for one of them to ride in the back while leaving the other up front in the martyr’s seat.

Seat belts are now standard issue in the rear seat of all cars. But they were designed to fit grown-ups, not kids. If you try to strap in your three-year-old darling, the lap belt will be too loose and the shoulder belt will come across his neck or nose or eyebrows instead of his shoulder.

Fortunately, we live in a world that cherishes and protects children, and a solution was found: the child safety seat, commonly known as a car seat. Introduced in the 1960s, it was first embraced by only the most vigilant parents. Thanks to the advocacy of doctors, traffic-safety experts, and — surprise! — car-seat manufacturers, it came into wider use, and the government eventually joined the party. Between 1978 and 1985, every state in the United States made it illegal for children to ride in a car unless they were buckled into a safety seat that met federal crash-test standards.

Motor-vehicle accidents were the leading cause of death for U.S. children back then, and they still are today, but the rate of death has been falling dramatically. Most of the credit has gone to the car seat.

Safety isn’t free, of course. Americans spend more than $300 million a year buying 4 million car seats. A single kid will typically inhabit three different seats over time: a rear-facing seat for infants; a larger, front-facing seat for toddlers; and a booster seat for older children. Moreover, if that kid has a sibling or two, his parents may have to buy an SUV or minivan to accommodate the width of the car seats.

Nor is the car-seat solution as simple as most people might like. Any given seat is a tangle of straps, tethers, and harnesses, built by one of dozens of manufacturers, and it must be anchored in place by a car’s existing seat belt— whose configuration varies depending on its manufacturer, as does the shape and contour of the rear seat itself. Furthermore, those seat belts were designed to batten down a large human being, not a small, inanimate hunk of plastic. According to the National Highway Traffic Safety Administration (NHTSA), more than 80 percent of car seats are improperly installed. That’s why so many parents trek to the local police station or fire house for help with the seats. And that’s why NHTSA runs a four-day National Standardized Child Passenger Safety Training Program for public-safety personnel, using a 345-page manual to teach proper installation.

But who cares if car seats aren’t so simple or cheap? Not every solution can be as elegant as we might like. Isn’t it worth a police officer sacrificing four days of work to master such a valuable safety device? What matters is that car seats are effective, that they save children’s lives. And according to NHTSA, they do, reducing the risk of fatality by a whopping 54 percent for children ages one to four.

Curious parents may have a question: a 54 percent reduction compared with what?