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All passenger cars have been built with some sort of seat belt restraint since 1964. These systems began with lap belts and graduated to include a shoulder strap. In 2022, the Insurance Institute for Highway Safety (IIHS) reported that before the adoption of seat belt laws, national use was only 14%. 

The law, kicked off by New York in the 1980s, was enacted for good reason; modern seat belts can reduce the risk of front occupant injury by up to 65%, according to the National Highway Traffic Safety Association (NHTSA).

Today, seat belts are widely utilized by drivers and passengers in the U.S. In 2021, individual U.S. state population use averaged over 90%. However, two states stick out for their lack of buckling up. The NHTSA delivered the 11th edition of its annual report, “Countermeasures That Work,” back in December 2023. The report highlights ways governing bodies might select or adjust policies to increase highway safety.

States that buckle up the least

In 2021, seat belt use in Massachusetts was only 77.5%. New Hampshire had the lowest reported belt usage, at only 75.5%. The U.S. Virgin Islands deserves an honorable mention here, as its reported usage was only 72.3%.

An unbuckled seat belt assembly is shown in a black leather car interior
Car seat belt buckle | afishman64 via iStock

These percentages are the same as the national average back around 2002, or more than twenty years ago.

The reasons for these lower-than-average statistics are two-fold. The first seems to be a clear direct link: New Hampshire does not require adults driving or riding in cars to wear seat belts.

Second, the report mentions that, in general, demographic differences are clear between high-use and low-use areas. For instance, more rural areas report lower usage. They also report less support for initiatives and legislation, plus fewer resources for media campaigns, safety research, and community outreach.

California, the state with the highest population, has seat belt usage of 97.2%. Massachusetts is estimated to be the 16th most populated state, while New Hampshire is 42nd.

Other important national takeaways from the report differentiate daytime and nighttime driving. Daytime seat belt use is higher than nighttime. In 2021, 57% of vehicle occupants killed in car accidents at night were unrestrained. A previously reported takeaway revealed COVID saw rising instances of drunk driving than in previous years, with 2020 and 2021 returning to 2005 levels.