designated drivers, responsible alcohol-serving practices and a decrease in per capita alcohol consumption. Young drivers and passengers: From 1975 to 1997, motor-vehicle-related fatality rates had decreased 27% for young motor-vehicle occupants (ages 16–20 years). However, in 1997 the death rate was 28.3 per 100,000 population—more than twice that of the U.S. population (13.3 per 100,000 population). Some teenagers are more likely than adult drivers to speed, run red lights, make illegal turns, ride with an intoxicated driver, and drive after drinking alcohol or using drugs. Strategies that had contributed to improved motor-vehicle safety among young drivers included laws restricting purchase of alcohol among underaged youths and some aspects of graduated licensing systems (e.g., restrictions related to nighttime driving). Pedestrians: From 1975 to 1997, pedestrian fatality rates decreased 41%, from 4 per 100,000 population in 1975 to 2.3 in 1997 but still account for 13% of motor-vehicle-related deaths. Factors that may have reduced pedestrian fatalities included more and better sidewalks, pedestrian paths, playgrounds away from streets, one-way traffic flow, and restricted on-street parking. Occupant-Protection Systems Safety belts: In response to legislation, highly visible law enforcement, and public education, rates of safety belt use nationwide had increased from approximately 11% in 1981 to 68% in 1997 (8). Safety belt use began to increase following enactment of the first state mandatory-use laws in 1984. In 1997, all states except New Hampshire had seat belt laws. Primary laws (which allow police to stop vehicles simply because occupants are not wearing safety belts) are more effective than secondary laws (which require that a vehicle be stopped for some other traffic violation). The prevalence of safety belt use after enactment of primary laws increased 1.5-4.3 times, and motor-vehicle-related fatality rates decreased 13%-46%. Child-safety and booster seats: All states had passed child passenger protection laws, but these varied widely in age and size requirements and the penalties imposed for noncompliance. Child-restraint used in 1996 was 85% for children aged less than 1 year and 60% for children aged 1–4 years. From 1975 to 1997, deaths among children aged less than 5 years had decreased 30% to 3.1 per 100,000 population, but rates for age groups 5–15 years had declined by only 11%-13%. Child seats were misused by as many as 80% of users In addition, parents failed to recognize the need for booster seats for children who were too large for child seats but not large enough