Child Pedestrian Accidents

The Effect of Interventions

Over a 6 Year Period

Thomas S. Renshaw, M.D.

Professor of Orthopaedic Surgery

Yale University

Pediatric trauma in the USA

• Kills more children than all diseases combined

• Each year

22,000 deaths

Ten Most Common Causes

• Pedestrian accidents• Drowning

• Bicycle accidents

• Falls from heights

• Scald burns

• Flame burns

• Suicides

• Assaults

• Choking

• Smoke inhalation

Why? Young Children:

• Think that if they can see a driver, the driver can see them.

• They think that cars can stop instantly

Young Children:

• They can’t tell where sounds come from

• They can’t judge how fast traffic is moving

Young Children:• They have a field of vision 1/3

that of adults

• They don’t recognize danger or react to it

• They think of cars as friendly, living creatures

Child Pedestrian Injuries

• The 2nd leading cause of death in ages 5-9, behind cancer

• Account for 30-50% of all trauma hospitalizations

Child Pedestrian Injuries

• 18,000 annual hospital admissions

• Fatality rate is 4%

Child pedestrian injuries in New Haven, CT have been reduced by 61% over a six year period.

•From 223 in 1992-93

•To 87 in 1998-99

Data Collection New Haven, CT

• Two 18 month periods

• 1992-93 and 1998-99

Data Collection

• Hospital records

• School bus company information

• City departments of:Police Traffic and ParkingPlanning Public Housing Economic Development School Districts

Collision Mapping

• 26 census districts in New Haven

• Each collision was mapped

• Correlated with season of year, day of week, time of day

• Correlated with demographics

Demographics

• Population density

• Race, gender, age

• Income

• Persons per household

• Housing units per acre

Comparable for Both Periods

Population Traffic volume up 3%

Speed limits Right turn on red laws

Parking status Public parks

One-way streets Cross walks

Walk signals Crossing guards

High Risk Factors Both Times

• Non-white population

• Households with >1 person per room

• More children per acre

High Risk Factors Both Times

• Occupied units per acre

• Families below poverty line

• Lower median incomes

Five Interventions Occurred

• Educating the children

• Increased school bussing

• Educating the motorists

• Decentralized public housing

• Increased traffic tickets and warnings

Education for children

• Traffic safety programs in all elementary school grades twice a year (from zero/year)

Increased school bussing

• From 35% of children to 73%

• More door to door pick-ups

• Fewer streets to cross

• 30-45 minutes on the bus = fewer daylight hours to play outside

Educating the Motorists

• Public safe driving campaign• Flyers in public areas

• Billboards

• Mailings

Decentralized public housing

• Largest complex demolished

• Transfers to smaller projects

• Vouchers for subsidized private housing

• A nationwide trend to decrease crime and poverty

Increased traffic tickets and warnings by 22%

• In high risk areas

• At high risk times

Never underestimate the power of the Police

Results

1992-93 223 injuries

1998-99 87 injuries

a 61% reduction

Other Intervention Options for High Risk Areas

• Post crossing guards at high risk times

Other Intervention Options for High Risk Areas

• Install highly visible warning signs for motorists

Other Intervention Options for High Risk Areas

• Crosswalks should be well-lit and painted in bright colors• Bright yellow with zebra design

• Embed rows of small lightsor reflectors in the asphalt

• Install flashing signs over themiddle of crosswalks

• Self-flagging crosswalksNot like thisNot like this

Other Intervention Options for High Risk Areas

• Sidewalks added and fenced or barrier curbed

Other Intervention Options for High Risk Areas

• Traffic lights reset to give children more time to cross busy intersections

Other Intervention Options for High Risk Areas

• Playgrounds should be safe and clean

Other Intervention Options for High Risk Areas**

• One-way streets

• One side parking bans

• Speed bumps

Other Intervention Options for High Risk Areas**

• Pedestrian overpasses

• Ban cell phone use by drivers

** very difficult to accomplish politically

Child pedestrian injuries and deaths can

be reduced without political battles and

without changing the intractable

problems of poverty and overpopulation.

You can do this in your community!

“Never doubt that a small group

of people can change the world,

in fact it’s the only thing that

ever has.”

…… Margaret Mead

Thank you!

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