[MeetingsBrowser]

> We're very nearly paralyzed by insisting that everything must be maximally safe.

Are we? People saying "have a safe trip" is pretty weak evidence.

The counter evidence is just about everything else going on, at least in the US. Relaxed worker safety standards, weakened environmental protections, and generally moving as fast as possible.

[adamsb6]

My kids are going to be legally mandated to be in car seats until they’re about 12 years old.

[MeetingsBrowser]

Your implied frustration at a relatively easy change backed by experts and mountains of data is another point in favor of

> humans are so oblivious to safety

[enoch_r]

We have 4 kids. Before we had our 3rd, we needed to buy a new vehicle solely because we couldn't fit 3 car seats into the back of our old car. And when traveling with kids, carrying 4 gigantic car seats plus your other luggage is not exactly as easy as you might think! It essentially rules out solo parent travel with all 4 kids. Transferring car seats between two cars, or installing car seats in a taxi, is a serious pain.

Furthermore, the evidence that car seats actually benefit safety is significantly less robust than you might think. The "mountains of evidence" that do exist for things like 70% reductions in fatalities, bizarrely enough, generally compare the rate of fatalities for car seats vs completely unrestrained kids. When you compare the rate of fatalities in car seats to kids wearing adult seat belts, the bulk of the evidence suggests essentially no difference. Fatalities happen when the forces involved are catastrophic and sadly a car seat doesn't help much for kids over 2.

Even a back of the envelope comparison makes this extremely plausible: car crash fatalities for kids 9-12 have declined by 72% from 1978-2017. If car seats and car seat laws save significant numbers of lives, you'd expect that the fatality rate for kids 0-8, who are generally in car seats, to have decreased much more. But it hasn't, it declined by 73% over the same period.

Now, car seats and boosters do seem to moderately reduce non-fatal injuries - huge spread of estimates here, most clustering around 10-25%. It's reasonable for most people to use car seats or boosters most of the time based on this alone, IMO, especially for young kids. But do they justify a mandate? IMO: no. Absolutely not.

Worth mentioning that mandates probably do succeed in one thing: they reduce the number of children born at all by at least 57x more than they prevent child fatalities. Roughly 8,000 kids per year, 145,000 kids since 1980. That's with the (unlikely, as discussed above) assumption that car seats do in fact save significant numbers of lives. But it's also entirely possible that they've prevented hundreds of thousands of kids from being born, somewhat reduced the nonfatal injury rate, and saved essentially no lives.

Citations below:

Fatality reduction with car seats or boosters:

- https://pricetheory.uchicago.edu/levitt/Papers/seatbelts.pdf (found that seat belts as effective as car seats for children 2-6)

- https://onlinelibrary.wiley.com/doi/10.1002/jae.2449 (independent replication of above with different data set)

- https://pubmed.ncbi.nlm.nih.gov/19959729/ (no statistically significant difference between booster seats and seat belt alone for fatalities)

- https://pubmed.ncbi.nlm.nih.gov/16754824/ (the main counter-estimate to the above, with the 28% fatality reduction)

Non-fatal injury reductions:

- https://ideas.repec.org/a/bla/ecinqu/v48y2010i3p521-536.html (no difference in serious injuries, ~25% reduction in least serious injury category)

- https://crashstats.nhtsa.dot.gov/Api/Public/ViewPublication/... (14% reduction in likelihood of injury for boosters)

- https://pubmed.ncbi.nlm.nih.gov/19841126/ (45% estimate)

- https://pubmed.ncbi.nlm.nih.gov/12783914/ (59% estimate)

Reduction in birth rate from car seat mandates:

- https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3665046 (car seat mandates "led to a permanent reduction of approximately 8,000 births in the same year, and 145,000 fewer births since 1980, with 90% of this decline being since 2000")

Note that both the 45% and 59% estimate for injury reduction and the 28% estimate for fatality reduction all come from one research group using a proprietary data set. Everything that's independently reproducible points towards small or zero effect on fatalities and modest effects on injuries.

[laughing_man]

Yep. As I understand it, there's no statistical difference between a car seat and a seat belt over age two. We've known this for a very long time, too. But it's easy to make an emotional appeal to do something to make the world safer for children, even if what you're doing doesn't make any difference.

[MeetingsBrowser]

I don’t think your analysis is fair, but pointing out details I disagree with misses the forest for the trees.

Look at what lengths you went to in order to justify and defend what is, by your own arguments, the demonstrably less safe option.

[enoch_r]

Do you think that car seat mandates (up to age 12 in my state) are good policy if the net effect is:

- a small reduction in minor injuries,

- worse childhoods and parenting experiences (difficult to quantify, but real),

- and a few hundred thousand fewer children being born in the first place,

- very few, if any, lives saved?

If yes, then cool - but I strongly disagree.

If no - then I think the evidence and details very much matter, and that's why I was happy to invest my time in them.

[MeetingsBrowser]

In the hypothetical scenario where car seats have only downsides, then of course I’m against a mandate.

There is a difference between cherry picking studies that back up your view point and how medical experts set policy though.

Experts review all of the data, and ignore outliers like a paper published in a law journal that suggests car seats are the primary reason families have shrunk from having three to two kids since the 80’s

[sfn42]

Oh wow what a tragedy. You think maybe there's reasons for that mandate? Like maybe it saves children's lives?

But sure everything would be better if any moron was allowed to decide how to keep their own kids safe.

[enoch_r]

The evidence that car seats save lives is significantly weaker that you probably believe, as I detailed in another comment in this thread. But look: even if car seats make sense for a typical 5 year old on a typical drive in their typical car (which is a higher evidentiary burden than you might think), a mandate imposes a huge logistical tax that makes many normal things completely infeasible or impractical:

- travel with many kids (nope, physically can't carry 4 car seats plus luggage)

- using a taxi, e.g. to go see a movie (nope, can't carry a car seat into the theater)

- carpooling with other families (I'll drive them, you pick up? Nope, we'd have to shuffle car seats around.)

- rides with grandparents or other family members (sorry, we'd have to deliver the car seat to them first)

- splitting kids between two vehicles for errands (let's spend 10m wrestling car seats from one car to the other first)

The whole texture of independent childhood is altered by car seat mandates! Everything gets filtered through "is there a car seat available?". If you haven't experienced this, it's hard to describe - and I think it's absolutely a case where tradeoffs like "how will this affect quality of life?" are completely overridden because "well, if it just saves one life..."

[sfn42]

Here's what I found doing a basic Google search:

> Car seats and booster seats significantly reduce the risk of fatal injury in crashes by 71% for infants and 54% for toddlers (1-4 years old), saving over 11,000 lives in the US since 1975

> Booster seats reduce the risk of serious injury for children aged 4-8 by 45% compared to seatbelts alone.

It's from the AI summary because it was the most quotable but the articles I found say pretty much the same thing. Seems pretty solid to me.

> If you haven't experienced this, it's hard to describe - and I think it's absolutely a case where tradeoffs like "how will this affect quality of life?" are completely overridden because "well, if it just saves one life..."

If you haven't experienced your children dying unnecessarily because it was inconvenient to make them safe it's hard to describe..

[enoch_r]

See my comment summarizing the evidence as I understand it here: https://news.ycombinator.com/item?id=47590700

What articles did you find, exactly? What primary evidence are they basing their claims on? Many of the numbers you'll find with a google search are unclear about what they're comparing to - I believe both of the fatality numbers above (71% and 54%) are relative to completely unrestrained kids, which is not the relevant comparison.

The 45% number I specifically discuss in the other comment, but every independently reproducible study using publicly available data has found much smaller effects, around 10-25% for minor injuries and no statistically significant difference in severe injuries.

To be clear, I'm not saying "don't use car seats," I'm saying that the evidence doesn't support mandating them through age 8 (or 12!).

Our kids would be much safer if we drove everywhere at 15mph - less convenient, but it would prevent many unnecessary deaths. Unfortunately, it is impossible to do anything in the world without risk. So we're forced to balance convenience against safety every day, whether we want to admit it to ourselves or not.

[sfn42]

I think this was one of the ones I looked at: https://www.trafficsafetymarketing.gov/safety-topics/child-s...

It notes this, which might be pertinent to your comment regarding how the overall statistics don't show the trends you expect:

> A NHTSA study found that while most parents and caregivers believe they know how to correctly install their car seats, about half (46%) have installed their child’s car seat incorrectly.

Here's a more quotable one that directly addresses your claim that it's compared with unrestrained: https://www.cdc.gov/child-passenger-safety/prevention/index....

> Car seat use reduces the risk for injury in a crash by 71–82% for children, when *compared with seat belt use alone*.

Here's another one specifically concerning booster seats: https://www.childrenshospitals.org/news/childrens-hospitals-...

> Children in booster seats in the back seat are 45% less likely to be injured in a crash than children *using a seat belt alone*.

That's about as much effort as I'm willing to put into this conversation. I'll finish off by saying I'm not American and these rules exist outside the US as well - I have a hard time believing so many countries would separately implement this (or similar) mandate if it was as unfounded as you claim.

[CWuestefeld]

But sure everything would be better if any moron was allowed to decide how to keep their own kids safe.

Yes, I think that we'd all be better off if every person was allowed to have their own personal values, deciding what's more important to themSELVES, rather than piling on and trying to force every one into a one-size-fits-all solution.

For my part, I'd much rather have people wishing me "have a rich and fulfilling life" rather than "be timid and careful to maximize your time even if it's boring and unrewarding".

Sure, you can disagree with my priorities, but that's the whole point. We should each be able to have our own priorities.

[sfn42]

I don't think you should be allowed to recklessly endanger your children.

You can endanger yourself all you like, I couldn't care less but you don't get to endanger others even if you made them.

[kortilla]

Do you think it’s okay for people to indoctrinate their own children with religion and other political views?

Far more harm comes from that than tail risk elimination mandating car seats between 8 and 12 years.

Would you be willing to make all new parents submit to frequent breathalyzers during pregnancy and after birth? Drinking is a massive factor in infant mortality at birth and SIDS.

[sfn42]

I don't see a reasonable way to avoid parents imposing their beliefs on their kids so this point you're trying to make is pretty weak man. You're comparing a problem with a very clear solution vs a problem with no clear solution. You wanna take the kids away from all religious people and all people with differing political views? Good luck with that.

Should all parents submit to frequent breathalyzers? Tell me, how many parents, as a fraction of all parents, drink irresponsibly to the point where it significantly endangers their children?

Now compare that number to the fraction of parents who drive their kids around in cars. You're grasping at straws comparing apples and oranges.

[anon291]

The evidence on car seats is extremely weak and they prevent only a handful of injuries. You'd be better off redesigning roads or having more collision protection systems in cars. As self-driving cars get better to the point where they can communicate and eliminate many human errors, there's probably no need for car seats at all. In many situations they make things more dangerous, not less.

[doubled112]

If I'm simplifying, your argument is that car seats are useless if we'd just stop crashing?

Isn't this true for every safety measure?

I don't need a guard on my table saw if I don't stick my thumb in it. Don't need a helmet if I don't fall off of my bike.

[InitialLastName]

> Isn't this true for every safety measure?

Every safety measure faces a question of whether the resources allocated to it are an efficient means of achieving that reduction in risk.

To GP's point, we probably can't prevent people from crashing altogether, but we currently have a road system designed to sacrifice safety on the altar of throughput [0]. How many more or fewer kids (or just people) would die if governments allocated the resources to making roads safer that they currently mandate their citizens use on car seats?

> I don't need a guard on my table saw if I don't stick my thumb in it. Don't need a helmet if I don't fall off of my bike.

Do you think the guard on your table saw makes you safer than training and experience using the saw safely? There are always limited resources and multiple routes to safety, so we shouldn't assume any given safety measure is the best use of those resources (especially in consideration of second-order effects).

[0] https://www.strongtowns.org/journal/2018-3-1-whats-a-stroad-...

[anon291]

Yes simply slowing down, arresting people, revoking licenses, smaller roads, etc would probably do more for road safety

[sfn42]

Seems strong to me, can you support this claim?

[fuzzfactor]

>allowed to decide how to keep their own kids safe.

This was not the major factor, but when things were still like that, it was not only NASA that made more forward progress than later times.

[array_key_first]

Considering cars are one of the top causes of death for kids (the top?), this just feels obvious.

[InitialLastName]

Thanks to risk compensation, making things "safer" doesn't necessarily improve safety. What are the odds that people drive their kids around more (increasing their risk) because having kids in car-seats reduces the perceived risk? How many of those people do you think can point at what the reduction in risk due to car seat use is [0], such that they compensate that risk "rationally"?

[0] Hint: As our sibling conversation shows, that's a non-trivial question.

[hoppyhoppy2]

>Relaxed worker safety standards, weakened environmental protections, and generally moving as fast as possible.

These sorts of collective values (or lack thereof) make it more important that individuals focus on their own safety in day-to-day life, no?

[MeetingsBrowser]

Yes, why don't individuals who live near industrial facilities simply find their own clean air to breathe.

And workers should refuse to do unsafe work, and simply take one of the many safe jobs instead.

We don't need a childhood vaccine schedule. We just need parents to keep their kids from getting sick.

Kind of silly that we as a society even bothered with all of the dangerous safety standards to start with.