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Motor vehicle crashes are one of the leading causes of death in the United States (US) and the world [1-4]. Global data reveals that over one million deaths annually are attributable to traffic accidents, which is comparable to tuberculosis, an infectious disease, and diabetes, a chronic disease [5]. In the US, more than 33,700 people died from motor vehicle crashes in 2014 alone and more than 2.5 million people were injured and treated in emergency departments as a result of motor vehicle crashes [4, 6]. A substantial fraction of these motor vehicle accidents were a direct results of not always using seatbelts while the vehicles were moving [7-9]. It is well-established in the literature that seatbelt use remains a highly effective method to prevent motor vehicle injuries and fatalities in motor vehicle crashes [3, 10]. Studies have shown that seatbelt use reduces the risk of death by 45 percent and the risk of moderate to critical injury in crashes by 50% [6, 10].Projections from 1975-2008, indicated that seatbelts saved approximately255,000 lives in the U.S.[11]. More than half of teens and adults who died in crashes in 2015 were not wearing seat belts at the time of the crash and 2,814 deaths could have been prevented if all passenger-vehicle occupants had been restrained using a seatbelt [6]. Abstract

Predictors of not always Using Seatbelts among Adults in the United States: Findings from the 2016 Behavioral Risk Factor Surveillance System