Mandating seats for children on airplanes could cause more deaths

If you flew with a baby this past holiday season, you might one day consider yourself lucky. If Canada’s Transport Safety Board has it their way, in the future, children under two won’t be able to fly for free. But it would be a big mistake if the federal government were to follow the new recommendation of mandatory restraints for children under two.

This may be a surprising point to hear coming from a doctor. After all, the Transport Safety Board is calling for restraints in hopes of bringing the safety standard for children to the same level as the standards in place for adults. The recommendation was set in motion after an airplane crashed outside of Sanikiluaq, Nunavut in 2012. All the passengers survived except a six-month old child who had been sitting on his mother’s lap. In its review of the accident released this June, the Transportation Safety Board issued a recommendation for “the mandatory use of child restraint systems [for] infants and young children travelling on commercial aircraft.” Transport Canada confirmed in October it will begin monitoring numbers of children on airplanes and will review this policy in 2016.

So what’s the issue? The impact of imposing seat restraints on children – and purchasing extra tickets for them – is almost certain to cause more deaths than it will prevent.

The reason involves thinking outside of the airplane. The additional fee will cause many parents to reconsider travel plans, say from Toronto to Montreal. The extra $400 to pay for an infant’s flight will for many make it far more economical to drive instead of fly. And driving – statistically speaking – is exponentially more dangerous than flying (104 times more dangerous per mile travelled). Increased numbers of drivers on the 401 that would otherwise have flown will almost certainly result in more traffic accidents – and more harm to children.

There is plenty of research to back this up, generated in the United States where this debate erupted and was largely quelled a decade ago. A 2003 study from University of California at San Francisco estimated that even if only five percent of parents decided to drive instead of fly, the result would be four more deaths of children each year than would be saved by seat restraints. Meanwhile, the cost of buying an airplane ticket for all under-twos in the United States would be close to $1.3 billion.

Policy makers need to use sound evidence when suggesting changes, and must be cognizant of the wider impact of their ideas. The child’s airplane seat is a stark example of how policy making can be driven inappropriately by events and not by data. But the importance of thinking about wider, downstream implications applies to countless health policy decisions, from strengthening regulation of pharmaceuticals to decisions about which diseases research dollars should go toward. A child’s death is of course a tragedy. But it would be greater tragedy if it resulted in self-defeating policy.