The Impact of Car Seats: A New Prescription for Prevention?

A new proposal aims to offer child car seats in the same way as vaccinations.

Jan. 24, 2008— -- As a pediatrician, I am quite aware of the power of the prescription pad. I have written countless prescriptions for everything from diaper creams to inhalers to antibiotics, all in the name of improving the health and lives of children.

Last week, however, a highly regarded pediatric journal reported on a study for a new type of prescription that instantly caught my attention. Researchers at the Center for Injury Research and Prevention at the Children's Hospital of Philadelphia concluded that we, as a country, could significantly affect the leading cause of death and acquired disability in childhood by simply writing a prescription -- one that I was certain few pediatricians have ever written.

The prescribed preventive measure? A car seat.

Now that's not to say that just about every pediatrician I know doesn't actively advocate for appropriate child restraint systems. Nor have the lifesaving benefits of child restraint systems been overlooked. We know well that car safety seats, which have been around for decades, reduce the likelihood of infant death by as much as 71 percent.

Nevertheless, vehicle crashes remain the No. 1 killer of kids and continue to cause lifelong, disabling injuries.

Worse yet, children from lower income families in the United States are disproportionately at risk, in part because of lack of access to car seats and to education regarding basic principles of child passenger safety. Before the results of this eye-opening new research were released, I could see no way for my pen and prescription pad to make a difference in this arena, no matter how poised and ready.

Small Cost, Big Returns

The solution? What the researchers at Children's Hospital proposed was a Medicaid prevention initiative, or Prescription for Car Seats.

This proposed plan would literally provide access to child restraints, accompanied by education, for Medicaid-eligible children at the stroke of a physician's pen. The net cost per child? An estimated $4 per year, or a cumulative $32 over the eight years it takes to effectively restrain a child.

This really piqued my interest. You see, I spend most of my time outside the four walls of the pediatric office -- focusing my professional efforts on early literacy promotion, early education and child care, proper nutrition, parent education and health communication. And while I am in no way an expert on the ins and outs of Medicaid or health care policy, I am also trained as a child passenger safety technician and instructor.

Not to be swayed by my excitement at the prospect of saving thousands of lives over the next decade that I wouldn't look at the study with a critical eye, I followed along as the authors described the economic benefits, the cost-effectiveness and the fact that their proposed reimbursement strategy -- based on a well-proven and highly effective model program (Medicaid's Vaccines for Children) -- would pay for itself in a mere three years.

So where do we (and I) go from here? We're not ready just yet to write prescriptions, and the researchers are not suggesting they've found all the answers to child passenger safety. But their innovative research should certainly be a call to action for all of us as we look toward setting new policies that focus on prevention, help close the gap in health disparities and hold great promise not only in their cost-effectiveness but also in their ability to improve the lives of children.

I say, Let's give it a try -- and in the meantime, I certainly hope everyone looks at the power of a car seat or booster seat in a new light!

Dr. Laura Jana is a pediatrician in Omaha, Neb. She is a certified child passenger safety technician and serves on the Nebraska Child Passenger Safety Board. She also owns and operates an educational child care center and is the author of two parenting books -- "Heading Home With Your Newborn: From Birth to Reality" and "Food Fights: Winning the Nutritional Challenges of Parenthood Armed with Insight, Humor and a Bottle of Ketchup". Check out her Web site at