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Rural
Youth Pedestrian-Motor Vehicle Traffic
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July 2001
Background
Injuries resulting
from pedestrian-motor vehicle crashes on public roadways are termed pedestrian-motor
vehicle traffic (PMVT) injuries. In 1999, youth under age 15 accounted for 30%
of all PMVT fatalities nationwide.1 Per mile
traveled, pedestrians experience a 36 times higher fatality rate than motor
vehicle occupants.2
National and
State Injury Experience
Rural-Specific
- Nationally in
1999, 180 youth under age 14 were killed in PMVT collisions in rural* areas.3
- From 1996-98,
South Carolina, Mississippi, Georgia, Utah, Louisiana, and Arizona experienced
the highest average youth PMVT fatality rates.4
- From 1995-1999,
nationwide, youth PMVT fatalities in rural and urban areas declined. Youth
fatalities in urban areas decreased at nearly twice the rate of youth fatalities
in rural areas.3
- A 1988 Washington
state study reported that urban youth under age 14 were more frequently injured
in PMVT crashes. However, rural youth experienced a 4-5 times higher fatality
rate.6
General
- Decreases in
youth PMVT fatalities may be due to youth walking less.5
- Common youth
PMVT injuries requiring hospitalizations included fractures (especially femur),
closed head trauma, and lacerations.7,10
- Etiology of
youth pedestrian-motor vehicle injury varies developmentally. Children 1-4
years are typically injured in driveway runovers, 5-9 years in mid-block dartouts
on residential streets, and 10-14 years while crossing busy streets.9
Youth PMVT Fatalities
in Rural Areas*
1995-1999 national data reveal the following about youth PMVT fatalities
on rural roadways:
| Youth |
61% male
74% 5-14 years |
| Driver |
estimated
11% struck by impaired driver |
| Lighting |
60% occurred
from 3-9 p.m. |
| Vehicle |
49% cars
26% pickup trucks
3% school bus
|
| Roadway |
97% paved
roads
75% local roads and secondary roads in between small towns
50% mid-block locations
42% roads with posted speeds > 50 MPH** |
Selected factors
believed to be more problematic in rural areas include:
- Lack of road
shoulders, medians, traffic signals, over and underpasses, sidewalks 12
- Concentration
of roads with higher speed limits 13
- Poor or no street
lighting 12,14
- Longer pre-hospital
transport times 6
- Limited access
to trauma centers 6
* Unincorporated
area or an incorporated area of less than 5,000 people.
** Though posted speed is a proxy for actual speed traveled, a pedestrian
hit at 20 MPH has a 95% chance of survival compared to virtually no chance if
hit at 50 MPH or greater. 11
General Risk Factors
for Youth PMVTs:
- The most significant
risk factors, in order, for youth PMVT injuries are high traffic volume, lower
income status, younger age, and environmental characteristics such as high
speed limits and no available play areas.15
- In general,
young children are not physically, mentally, and emotionally capable of being
safe pedestrians. Adults often overestimate a child's ability to walk in or
near traffic. 21
Prevention Recommendations
Rural-Specific
- No effective
interventions to reduce youth PMVT injuries in rural environments were identified
in the literature.
- Research is
needed to understand the rural youth PMVT injury experience (especially non-fatal
injuries) and identify priorities for intervention.
General
- Literature suggests
the following strategies reduce pedestrian injuries:
- Engineering
modifications to slow traffic speed (e.g. speed bumps) and separate pedestrians
from traffic (e.g. sidewalks) 16
- community
wide campaigns involving education ( e.g. pamphlets, and media press),
enforcement (e.g. police warnings for failure to yield), and engineering
interventions (e.g. advanced stop lines before crosswalks) 16
- vehicle
modifications (e.g. smooth front ends) 16
- lengthening
daylight savings time in the fall 16
- wearing
retro-reflective clothing at night 17
- Literature suggests
the following interventions offer limited effectiveness:
- skill building
programs targeting pre-school or young elementary school students.
19,20
- anticipatory
guidance by healthcare providers 18
Selected Resources*
Rural-Specific
- TASK II Pedestrian
Safety Curricula: Developed the Teaching Agricultural Safety to Kids (TASK)
Program, this curricula provides a lesson plan to teach pedestrian safety
to children in 4th to 6th grade. Availability: http://www.iesstask.com/
General Pedestrian
- Walkinginfo.org:
Includes state, regional, and local pedestrian safety planning resources.
Availability: www.walkinginfo.org
- National
Center for Bicycling and Walking Resource Center Website: Website offers
pedestrian information, training, technical assistance, and resources. Availability:
www.bikefed.org
- Pedestrian
and Bicycle Planning: A Guide to Best Practices: Describes how to design,
implement, and evaluate pedestrian and bicycle plans at the local level. Availability:
www.vtpi.org/0_nmt.htm
- Panel to
Prevent Pedestrian Injury (PAPPI): National expert panel will be releasing
recommendations on addressing child pedestrian injuries in late 2001. Availability:
www.cdc.gov/ncipc
- Reviews of
youth risk factors for PMVT injuries
- A Review
Of Risk Factors For Child Pedestrian Injuries: Are They Modifiable? 15
- Developmental
Risk Factors For Childhood Pedestrian Injuries. 20
* These
resources are provided as general information. In some cases, studies examining
their effectiveness in reducing youth injury have not been conducted.
Citations
- National Center
for Statistics and Analysis. Traffic Safety Facts 1999: Children. Washington,
DC: National Highway Traffic Safety Administration; 2000.
- McCann B, Delille
B. Mean Streets 2000: Pedestrian Safety, Health, and Federal Transportation
Spending. Washington DC: Surface Transportation Policy Project; 2000. Downloaded
January 5, 2001 at http://www.transact.org/Reports/ms2000/ms2000.pdf.
- Unpublished
FARS data. Washington, DC: National Highway Traffic Safety Administration;
1995-1999.
- Unpublished
WISQARS data: National Center for Injury Prevention and Control; 1996-1998.
- Roberts I, Norton
R, Taua B. Child pedestrian injury rates: the importance of exposure to risk
relating to socioeconomic and ethnic differences, in Auckland, New Zealand.
J Epidemiol Community Health. 1996;50:162-5.
- Mueller BA,
Rivara FP, Bergman AB. Urban-rural location and the risk of dying in a pedestrian-vehicle
collision. J Trauma. 1988;28:91-4.
- Calhoun AD,
McGwin G, Jr., King WD, Rousculp MD. Pediatric pedestrian injuries: A community
assessment using a hospital surveillance system. Acad Emerg Med. 1998;5:685-90.
- Highway Loss
Data Institute. Q & A: Pedestrians. Arlington, VA: Insurance Institute for
Highway Safety; 2000. Downloaded August 17, 2000 at: www.highwaysafety.org/safety_facts/qanda.peds.htm.
- SafeUSA. Walking
Safety Factsheet. Silver Springs, MD; 2000 Downloaded September 21, 2000 at:
www.cdc.gov/safeusa/walk/walking.htm.
- Kong LB, Lekawa
M, Navarro RA, et al. Pedestrian-motor vehicle trauma: an analysis of injury
profiles by age. J Am Coll Surg. 1996;182:17-23.
- Pasanen E. Driving
speeds and pedestrian Safety: A mathematical model. Copenhagen: Nordisk Kabel-
og Traadfabriker; 1992:41.
- Smith S, Opiela
K, Impett L. Planning and implementing pedestrian facilities in suburban and
developing rural areas: Research report. Washington DC: National Research
Council; 1987:92.
- Leaf W, Preusser
D. Literature review on vehicle travel speeds and pedestrian injuries. Trumbull,
CT 06611: Preusser Research Group, Inc.; 1999:67.
- Miles-Doan R,
Kelly S. Inequities in health care and survival after injury among pedestrians:
Explaining the urban/rural differential. J Rural Health. 1995;11:177-84.
- Wazana A, Krueger
P, Raina P, Chambers L. A review of risk factors for child pedestrian injuries:
Are they modifiable? [see comments]. Inj Prev. 1997;3:295-304.
- Harborview Injury
Prevention and Research Center. Child Pedestrians: Scope of Problem. Seattle,
WA: Harborview Injury Prevention and Research Center, 1997. Downloaded January
5, 2001 at http://depts.washington.edu/hiprc/childinjury/.
- Muttart J. Effects
of Retroreflective Material Upon Pedestrian Identification at Night. ASTM
Subcommittee Meeting on the establishment of Standards for Safety Clothing,
1998. Downloaded June 14, 2001 at http://docs.vircomnet.com/mobility/traffic_vc/pedestrian_identification.html.
- Guyer B, Talbot
AM, Pless IB. Pedestrian injuries to children and youth. Pediatr Clin North
Am 1985; 32:163-74.
- lassen TP,
Morag MacKay J, Moher D, Walker A, Jones AL. Community-Based Injury Prevention
Interventions. The Future of Children: Unintentional Injures in Childhood.
2000:10 (1):83-110.
- Schieber RA,
Thompson NJ. Developmental risk factors for childhood pedestrian injuries.
Inj Prev. 1996;2:228-36.
- Dunne RG, Asher
KN, Rivara FP. Behavior and parental expectations of child pedestrians. Pediatrics
1992; 89:486-90.
For more
information:
National Children's
Center for Rural and Agricultural Health and Safety, a site of the Children’s
Safety Network
National Farm
Medicine Center
1000 North Oak Avenue
Marshfield, WI 54449
% 888-924-SAFE (7233)
Fax: 715-389-4996
Email: nccrahs@mmrf.mfldclin.edu
(updated: 7/24/02)
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