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Racing down a rural highway, siren blaring, paramedic Brian Pollock couldn't help but give his short lecture to the middle-aged woman in the back of his ambulance recently.
"You're lucky you didn't go through the windshield and get killed," he recalled saying as she lay strapped to a back board.
Whenever Pollock sees someone in a crash who wasn't wearing a seat belt, his mind flashes to an October night four years ago when authorities pulled an SUV from a country roadside ditch. His 15-year-old daughter lay underneath.
"My daughter was in a car accident and did not have her seat belt on," Pollock said he told the woman in the ambulance, tears forming in her eyes. "My daughter was killed."
Pollock, who lives and works in rural Minnesota, sees a higher percentage of unbelted motorists -- and a higher percentage of vehicle crash deaths -- than his counterparts in the Twin Cities.
Although seat belt use has reached an all-time high of nearly 93 percent in Minnesota, according to results of an annual state survey to be released Thursday, other state data shows motorists outstate are using seat belts at far lower rates.
Authorities in rural areas say it's a combination of factors: Some oppose government legislation of seat belt use; they rarely see law enforcement and don't think they'll get caught; there's so little traffic on the roads, they have a false sense of safety.
People think "it's never going to happen to me. I'm only going three miles to farmer Joe's place and I'm going to meet three cars, so why do I have to buckle up?" said State Patrol Captain Dick Wittenberg, who works in the northwest region of the state, which had the lowest seat belt use at 65.8 percent, according to a recent count. Other regional counts included northeastern Minnesota at 80.3 percent and southwestern Minnesota at 81.1 percent.
With two-lane roads, high speeds, narrow shoulders and little roadway lighting, country roads are considered more dangerous than those in urban areas. Some 80 percent of the state's unbelted traffic deaths occur outside the seven-county metro area.
"If people saw what we saw," said Beltrami County Sheriff Phil Hodapp, "they wouldn't get in a car without wearing a seat belt."
Law enforcement has been ramping up seat belt enforcement across the state the last several years with Click It or Ticket campaigns, which include federally funded overtime for extra enforcement.
Last year, officers wrote nearly 20,000 citations during the campaigns. This year, they wrote another 7,765 in a May campaign. Another campaign ends Oct. 27.
In sprawling rural areas, where there aren't enough officers to make a strong presence on less-traveled roads, it will be difficult to pose much of a citation threat, some say.
"There's no way we can enforce our way to compliance here," Hodapp said. "We have to get people to voluntarily do this ... because it's the smart thing to do, not because it's the government telling you to do it."
New Hampshire is the only state without a seat belt law for adults in the front seat, according to the Insurance Institute for Highway Safety. Thirty states, including Minnesota, allow officers to pull motorists over specifically for failing to wear a seat belt.
When lap and shoulder belts are used, front-seat passengers in cars have a 45 percent reduced risk of being killed in a crash and a 50 percent reduced risk of moderate to critical injury, according to the institute.
For motorists who argue that they're only hurting themselves, Polk County Sheriff's Sgt. Phil Juve said he's seen some unbelted passengers who had been bounced around "like a pinball" in crashes, sometimes slamming into others inside the car.
"If you've got a passenger that's not wearing their seat belt, it's just as dangerous," Juve said.
And it's costly.
"When you have someone that's seriously injured, perhaps disabled for the rest of their lives, that's a huge burden," Wittenberg said.
A $103 fine
Wednesday afternoon, in the midst of the state's latest Click It or Ticket campaign, Bloomington police officer Warren Jones pulled his squad car into a left turn lane on busy American Boulevard and trained his eyes on approaching motorists, looking for a small triangle formed by the belt and driver's shoulder.
Within minutes, he spotted a violator and turned on his emergency lights.
Driver Vincent Sliva wasn't happy to be getting a ticket for $103 -- he said he was wearing his lap belt -- but said he didn't plan to fight it.
"Why do they try to legislate my own personal safety?" he asked in an interview, noting that helmets aren't required on motorcycles, and taxi passengers often don't buckle up. "This is just a way to get revenue. This is baloney. That's my personal opinion."
Next year, state officials will use $100,000 in federal grant funding to focus on 10 rural counties that have had the highest number of unbelted deaths and serious injuries over three years.
They plan a campaign that includes over-time enforcement, public service announcements, school visits, videos and advertising in those counties.
Pollock, the paramedic, is convinced that his daughter, Alyssa, probably would have survived the crash four years ago near Willmar if she had been belted.
The SUV's interior was intact, but Alyssa was ejected through a window.
Now working in Wadena, he can't help but talk to every unbelted patient he sees.
"I do this job for Alyssa," Pollock said. "If I can save one person's life, I've done my job."
Pam Louwagie • 612-673-7102