Motorists and passengers in California, Oregon and Washington state have the highest seat-belt use in the country, according to a new report by the U.S. Centers for Disease Control and Prevention.
Oregon -- where nearly 94% of people said they always wore a seat belt -- ranked No. 1, according to a CDC telephone survey. California was close behind in self-reported seat belt use at 93.2%, followed by Washington state at 92%.
All three states have strict enforcement of safety belt laws -- allowing police to pull a vehicle over solely because they see an occupant not wearing a seat belt.
The states where residents were least likely to say they wore a seat belt include New Hampshire, the only state without a mandatory seat belt law. Only 66.4% in the "Live Free or Die" state said they always buckled up.
Two states reported even lower rates: South Dakota at 59.7% and North Dakota at 59.2%. Both are among places where police are allowed to issue tickets for lack of safety belt use only if drivers are pulled over for another moving violation.
Safety belts are a relatively new thing, with the first mandatory safety belt law enacted in New York state in 1984. Motor vehicle crashes remain the leading cause of death in the United States among people ages 5 to 34 years old, but using seat belts has significantly reduced injuries, the CDC said.
In a study published in the CDC's Morbidity and Mortality Weekly Report on Tuesday, scientists found that the injury rate among motor vehicle occupants dropped 16% between 2001 and 2009. Over a similar period, 2002 to 2008, self- reported seat-belt use rose from 81% to 85%.
"Yet, about 1 in 7 adults do not wear a seat belt on every trip. If everyone in the vehicle buckled up every time, we could further reduce one of the leading causes of death," CDC Director Thomas Frieden said in a statement.
Still, the data showed a sea change in attitudes toward safety belts from a generation ago.
"Self-reported seat-belt use ... is now the social norm among residents of the United States," the CDC report said. "In contrast, in 1982, only 11% of U.S. residents reported seat-belt use."
California implemented its strict enforcement law in 1993. As of January 2011, 31 states had strict safety belt enforcement laws.
The report's authors said the strengthening of such laws over the last decade in more than a dozen states had played a major role in a drop in the rate of motor vehicle fatalities.
Chris Cochran, spokesman for the California Office of Traffic Safety, said that even with high seat-belt use, the deaths of 300 to 400 people on California roadways last year could have been prevented had they been wearing safety belts.
Another troubling CDC finding was that teenagers and young adults were less likely to buckle up compared with older people. Drivers between 16 and 24 years old have the highest rates of injury and death from auto crashes, the CDC said.
Men were less likely than women to report using seat belts, as were rural residents compared with urban residents. Whites, blacks and Native Americans were less likely to say they used seat belts than were Latinos and Asians.
But even populations resistant to seat belts were more likely to comply with the law in states with stronger enforcement, the CDC found.