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Running head: NONFATAL PEDESTRIAN INJURIES 1

Nonfatal Pedestrian Injuries in Young Adults in Ages 18 to 24

Jenna Fransen

Brigham Young University-Idaho

NONFATAL PEDESTRIAN INJURIES AGES 18-24 2

Nonfatal Pedestrian Injuries in Young Adults aged 18 to 24

PART 1: Defining the Population

The Health Issue

In 2010, the national percentage of nonfatal pedestrian injuries for ages 18-24 years old

was 30.2 percent, and as of 2015, this percentage increased to 38.2 percent (ODPHP, 2017).

Unfortunately, the statistics for the state of Idaho are not any better. According to the Idaho

Office of Highway Safety (n.d.), a report that included people ages 15-19, showed 29 pedestrians

were killed or injured. In the same report, pedestrians ages 20-24 showed 26 pedestrians killed or

injured in Idaho. Most surprisingly, “Of all pedestrians involved in crashes in 2015, 96%

received some degree of injury” (Idaho Office of Highway Safety, n.d., p. 60). Therefore, these

statistics indicate a problem throughout the nation, as well as in the state of Idaho, of a

significant number of pedestrian injuries. In other words, there is a problem with pedestrian

safety resulting in injuries.


(ODPHP, 2017).

(ODPHP, 2017).

Healthy People 2020 Objective

Given the facts stated above, Healthy People 2020 has set an objective for the next

decade. The 2020 national baseline from 2008 for the total population was 22.6 (ODPHP, 2017).

For the total population, a decrease in nonfatal pedestrian injuries with a target of 20.3 is the

2020 objective (ODPHP, 2017). Healthy People 2020 states that its objective is labeled IVP-19 is

to, “Reduce nonfatal pedestrian injuries on public roads” (ODPHP, 2017).

As the data is broken down further from the total population average, the age group from

18-24 has an average of 38.2 percent of nonfatal pedestrian injuries, which is the highest average

among all age groups (ODPHP, 2017). Interestingly, a significant drop follows in the national

average for ages 25-44 year olds at only 20.4 (ODPHP, 2017). The question to ask becomes,

“Why do young adults, ages 18-24, have the highest average for nonfatal pedestrian injuries?”


Specific community factors of Madison County will be looked at and compared to state and

national levels. Some factors may include the Brigham Young University-Idaho campus, traffic

on public roads, parking lots, crosswalks, lack of knowledge, and distractions by pedestrians and

drivers. These are all possible reasons why this topic is important for this specific population.

Further research of this population and community is necessary to figure determinant factors.

Population Demographics

The population to be assessed is 18-24 year-old males and females in Madison County,

Idaho. Six dimensions will be addressed in this section: the total population of Madison County,

the average age in Madison County, the enrollment status at Brigham Young University-Idaho

for fall 2016, the average age at Brigham Young University-Idaho for fall 2016, male verses

female graduates in Madison County, and car ownership in Madison County.

The total population for Madison County is about 37, 916. Residents between the ages of

18-24 are fairly common in Madison county as the average, native age is 23.2 years old

(“Madison County, ID,” Data USA, n.d.). Located in Rexburg is Brigham Young University-

Idaho, which will be discussed later, under the “Community” section. Enrollment for the

university was 21,530 full and part-time campus students attending in fall of 2016 (“Enrollment

Summary—Fall 2016 Degree-Seeking Students,” 2016). Of these campus students, 18,199 were

between ages 18-24 (“Age of BYU-Idaho Degree-Seeking Students,” 2016). In addition to BYU-

Idaho, two other school institutions are located in Madison County. Between these institutions,

Data USA found in 2015, there were more female graduates than male graduates in Madison

County (n.d.). Lastly, the number of cars owned in Madison County is an average of two cars per

household, followed by a second highest average of 3 cars per household (“Madison County,

ID,” Data USA, n.d.).


The Community

Rexburg is located in Madison County in Southeastern Idaho. As mentioned previously, a

large part of the Madison County population comes from the students enrolled at Brigham

Young University-Idaho. This is a private university under the ownership of the Church of Jesus

Christ of Latter-day Saints (LDS), therefore making the LDS faith very prominent among the

people in the area. Centered on the hill of Rexburg is the LDS temple. Rexburg is very much a

younger-aged, college town based on the fact that the average age is 23.2 years old (“Madison

County, ID,” Data USA, n.d.). The university largely influences the age group and culture of

Madison County. Given the university aspect of Madison County, individuals in the community,

especially those aged 18-24, are likely to frequently take on the pedestrian or driver role in a

frequent manner.

(Arkyan, 2007).


(Pavili, 2009).

(Brigham Young University-Idaho, 2016).




(Eustress, 2008).

Resources

In order to generate quality, primary data, the following will be completed: a key

informant interview with the Brigham Young University-Idaho (BYU-Idaho) Public Safety

Office and perform a windshield survey throughout Madison County, along with the BYU-Idaho

campus. For secondary data, the Healthy People 2020 website, the 2015 Idaho Traffic Crashes

Report, Data USA, and Brigham Young University-Idaho statistical reports will be used.


PART 2: Assessment

Primary Data

Primary data for this section included a community assessment involving an interview

with a key informant, citizens of Madison County interviews, and windshield surveys. The

purpose of collecting this data was to assess the community and specific population.

Key Informant Interview

A personal interview completed with BYU-Idaho Patrol Administrator, Doug Barker

took place on September 28, 2017 in the Safety Office on campus. The questions and answers

during the personal interview included the following:

Interviewer: Jenna Fransen Interviewee: Doug Barker, Patrol Administrator at BYU-IdahoLocation: Kimball 150 Safety Office BYU-Idaho Campus

1. What is your biggest concern as far as the safety of campus?“A very common problem is sidewalk safety. People can get hit anytime by speeding, and, anywhere, I think it is pedestrian safety, not just on campus but around campus. You see it there all the time. We’re lucky people don’t get hit as much. The dynamics of the movement on campus are a big risk. One of the most dangerous/vulnerable time is movement on campus around class time.”

2. What are some reasons for why pedestrian safety is a problem at BYU-I? Can you pick out 3?“Lack of eye contact, distracted in vehicle or on the phone, at night, in dark clothing and can’t see them.”

“It really comes down to this: responsibility of personal safety.” “You can’t assume that they see you.” Being responsible for your own safety.

3. What is currently being done to help this issue?“Public service announcements with university with corny videos on social media, ‘sharing the road.’” “Even with big old flashing lights, you still can’t assume. Those lights still don’t make everything line up and make everything safe.” “…there’s not much unless we’re out stopping everything.”

4. Is it a problem with the pedestrians or the drivers?


“It’s a dance. Both parties have to work together Texting and driving is the same as texting while walking.” “It is so important to make that eye contact.”

“You are putting your life at risk literally by not making that eye contact. Too often we think pedestrians have that right of way, but seed, time, and velocity is going to kill you. We can’t assume the driver is doing what their supposed to be doing. It’s a guessing game.”

“Idaho law says they have to enter the crosswalk safely,” which means you have to look both ways there is law and responsibility on both parties.”

5. What has been done in the past to help this issue? What would you do differently? What would you keep doing?“In the past there weren’t crosswalks… I think every precaution is being taken.” “In my personal opinion, if you were to take the crosswalks as they are today and compare them to the past, now you have J-walking fines (keeps people in crosswalks). If crossing the street 7 years ago? There was J-walking, but (we) were more aware of our surroundings, were more attentive. Now, we assume because we’re in a cross walk, we’re safe.”

“I would hold pedestrians as responsible as crossing the crosswalk as I am for motorist. Motorists, simply are inherently at fault if there is an accident. They (pedestrians) need to be held to some standard of safety. I would be educating pedestrians as much as motorists do like stop and that crosswalk.”

6. What do you, personally, suggest as a plan to decrease the number of pedestrian injuries and to increase the safety of campus?“Educate, hold them accountable, have crosswalk guides.” “So much liability on you as a crosswalk guide,” and, “putting that responsibility of the pedestrian and putting it on someone else.”“For little kids its works,” but, “For this age group, (if you see college students with flags and signs) they’ve been busted for a J-walking fine.”

7. What other problems do you see with the safety of campus? “Personal property.” “Secure it, don’t assume that because you’re at BYU-I that no one steals anything.” Theft, is mainly opportunistic because, “they see something laying there so that have it in them to take it.”

8. Does season effect safety? Winter? “Definitely. Everything we’ve talked about times the fact that the road conditions are worse.” “Same normal situations, but now we slide or don’t have that control.” “Not just environmental, but mechanical.” “Tires from places no one has even seen snow.”

9. In looking at the specific population of people ages 18-24, what are the strengths


of this population? What are the weaknesses? What concerns do you have fort his population? Strengths: “you are in college, getting an education.” Students can say, “I’m learning life… (Including) the practical common sense stuff that goes on around being safe on campus.”Weaknesses: “being busy, stresses.” “Not even college students, but every person driving down the road, (finances, and relationships) can become mindless, that’s what gets us in trouble. We are so busy in life.”

10. What resources are available to the students?“Public service announcements, education, light cross walks, officers that can do 15-20 minute talks. Plus you have a whole world of social media google winter driving tips or vehicle maintenance.” “Having windshield clear.” There was a, “3 car crash where the windshield was not scraped with the sun glaring. Hit one car, which hit another and put it into the intersection.”

11. How do we motivate this age group to be safe, especially in regards to pedestrian safety?“You cannot make anyone accountable for their personal safety, that’s an internal thing. You learn to defend yourself or cower in a corner. You can teach me and educate me, but if I don’t care that I get squished by an 18 wheeler in an intersection?”

“They have to care and internalize it. If you don’t see anything you’re not going to text. You can plead with people, you’re not going to change anyone until they see it for themselves.” They have to gain, “their own internal testimony of why I should wear my seat belt, not text.”

(Barker, 2017).

Young Adult Population Interviews

Four additional, separate interviews were conducted amongst individuals meeting the

criteria of being aged 18-24 and living in/recently lived in Madison County. Two males and two

females were interviewed in regards to their personal opinions about pedestrian safety. The data

collected included the following:

Interviewee #1Gender: FemaleAge: 23

1. Why or why not do you feel safe as a pedestrian in Madison County?I don’t always feel safe as a pedestrian when it’s snowing out, especially when the cars have not driven in snow before are driving.” “Generally, yeah, I feel safe. I make eye contact with people when I cross the road. There are times when I’m


like, “are they paying attention? Do they see me?”

2. How do you feel about the current system in Madison County in regards to pedestrian safety?

“Don’t they put videos up on Facebook? I see that. I guess that makes us more aware of how should drive?” “I think it is. It’s not the system it’s the drivers.”3. Is it a problem with pedestrians or drivers?

“I feel like it can be both, I shouldn’t just conclude to the driver.” “Then there’s also pedestrians who don’t pay attention to the signals or making sure someone sees them, or cross when they’re not supposed to cross.”

“As a person you are better than a machine to tell you what to do.”

4. What do you suggest doing to help increase safety for both drivers and pedestrians in Madison County?“I feel people need to be more aware of traffic rules, and also driving experience, and common sense. Maybe classes for those who don’t know how to drive in the snow.”

Interviewee #2Gender: MaleAge: 24

1. Why or why not do you feel safe as a pedestrian in Madison County?“No because there’s a bunch of immature kids driving, and yes because it’s Rexburg. I feel safer when school is not in session. It can go both ways.”

2. How do you feel about the current system in Madison County in regards to pedestrian safety?“Sure, I’ve never been hit by a car or shot at. I think it’s working pretty okay. Anymore rules would be pretty over kill in my opinion. I think they regulate the crosswalks a little much in my opinion. Like if you J-walk you’re fined over a $100.”

3. Is it a problem with pedestrians or drivers?“The pedestrians because they’re the ones stupid enough to cross at dumb times. So it’s definitely the pedestrian’s fault.”

4. What do you suggest doing to help increase safety for both drivers and pedestrians in Madison County?“There definitely wouldn’t be a $100 fine. That’s definitely uncalled for. But if it’s for a dumb reason, fines are okay. Showing more mercy.”

Interviewee #3Gender: FemaleAge: 19


1. Why or why not do you feel safe as a pedestrian in Madison County?“No. Because people don’t pay attention…that’s really it.”

2. How do you feel about the current system in Madison County in regards to pedestrian safety?

“Yes, because at almost every cross way there’s a light. If there’s not it’s either a low traffic area or the flags.”3. Is it a problem with pedestrians or drivers?“As a driver, I think it’s a problem with other drivers because they aren’t paying attention when they’re driving. Pedestrians have the right of way.”

4. What do you suggest doing to help increase safety for both drivers and pedestrians in Madison County?“You can’t really change people’s perspective, because with all the laws in place, it should be “perfect.” Wouldn’t change anything.

Interviewee #4Gender: Male Age: 22

1. Why or why not do you feel safe as a pedestrian in Madison County?“I do feel safe because I’ve been in Orlando where it’s a lot more dangerous. I also don’t walk that often.”

2. How do you feel about the current system in Madison County in regards to pedestrian safety?“As far as the blinking lights, I do think that’s good. As a driver I sometimes feel unsafe. I feel like they do good. It’s just a matter of people putting to use what is in place.”

3. Is it a problem with pedestrians or drivers?“Both. When people don’t push the blinking buttons that is so stupid. A lot of college kids are pretty reckless. Today on my way to work I saw a guy swerve in front of another car and almost got T-boned.”

4. What do you suggest doing to help increase safety for both drivers and pedestrians in Madison County?“I don’t know what could be changed. I feel like adding the lights has helped. I don’t know what else you can do! There’s enough crosswalks.”

Windshield Survey

In addition to the interviews conducted, as explained above, a series of windshield

surveys were completed in 3 different locations throughout Madison County to add to the


primary data collection. The locations included a four-way stop between The Burg and the BYU-

Idaho Center, the Broulim’s parking lot, and a crosswalk perpendicular to the Snow building on

the BYU-Idaho campus. The data collected included the following:

The Burg and BYU-Idaho Center Four-Way Intersection

Date: October 4, 2017Start Time: 12:45Stop Time: 1:15

Lack of Eye Contact(lack of looking at cars or

pedestrians)

Vehicle Distraction(texting, talking on the phone, eating, talking to passenger in

car)

Pedestrian Distraction (headphones, looking at or

talking on the phone)

24 12 32

Notes: It appeared that the majority of students tended to listen to headphones and most vehicle distractions included talking on the phone or to a car passenger. Students here were likely to use their device, cross, then looking at it again. There was a specific instance involving a biker occurred who lacked to stop at all at this crosswalk.

Snow Building Crosswalk

Date: 10/6/17Start Time: 8:45amStop Time: 9:15am

Lack of Eye Contact23

Vehicle Distraction8

Pedestrian Distraction32

Notes: Mixed eye contact between pedestrians and vehicles was noted. People with headphones may or may not have looked, but is still considered a distraction. There is also a lack of an official crosswalk on South center street. It was also noted that if one person goes, then a crowd follows, and is less likely to make individual eye contact.

Broulim’s Parking Lot

Date: October 4, 2017Start Time: 5:45Stop Time: 6:15

Lack of Eye Contact20

Vehicle Distraction6

Pedestrian Distraction17


Notes: Pedestrians more likely to pull out device, then put it away when compared to pedestrians in the crosswalk. Lack of eye contact and pedestrian distractions were the highest counted observations.Lack of eye contact 67Vehicle Distraction 26Pedestrian Distraction 81

Notes: Highest totals included pedestrian distraction, followed by lack of eye contact.

Other Observations

When driving throughout Madison County, public, rural, and city streets are all part of

the variety of roads observed. Rural roads may involve places that drivers do not expect

pedestrians. Some streets do not have marked crosswalks. Geographical areas such as mountains,

hills, and bridges can all potentiate risks in safety. This will also be discussed further in part 3.

Secondary Data

As stated in part 1, four credible sources to be used include Health People 2020, Data

USA for Madison County and the state of Idaho, 2015 Idaho Traffic Crashes Report, and BYU-

Idaho Statistical reports. The data in each of these sources will be compared locally, state-wide,

and nationally.

Demographics

Madison County has a prevalence of students given 4 education facilities: Brigham

Young University-Idaho, Paul Mitchell Hair Academy, Evan’s Hairstyling College, and Rexburg

College of Massage Therapy (“Madison County, ID”, Data USA, n.d.). Students who are

affiliated with these various schools tend to be in the young adult population. A total of 21, 530

full and part-time students attended BYU-Idaho in fall of 2016 (“Enrollment Summary—Fall

2016 Degree-Seeking Students”, 2016). As mentioned previously, of these students, 18, 199 are


between ages 18-24 (“Age of BYU-Idaho Degree-Seeking Students”, 2016). Given that BYU-

Idaho is owned by the Church of Jesus Christ of Latter-day Saints, a strong set of values greatly

influences the community.

Information from Government Agencies

Madison County pedestrian data found that the top event location for fatal/nonfatal

injuries was in a crosswalk or a crossing intersection (Campbell, n.d.). In addition, “failing to

yield,” by vehicles was the top factor in accidents in 36 instances, followed by pedestrians

“failing to yield,” in 5 instances. From 6:00pm-8:59pm, 30 percent of pedestrian injuries or

accidents occurred in Madison County (Campbell, n.d.). Additionally, 15 nonfatal pedestrian

injuries occurred from 2011-2015 in Madison County, with nonfatal pedestrian injuries as the

highest total. Lastly, having pedestrian accidents and injuries during clear weather was also the

highest total at 21 incidences (Campbell, n.d.)

In the state of Idaho, 32 percent of serious injuries occurred in a cross walk or crossing

intersection and from 2011-2015, there were 266 pedestrians, “seriously injured,” in Idaho

(“Fatal and Serious Injury,” n.d.). A total of 15 percent of serious injuries were due to the

pedestrian lacking to yield, while almost 40 % of fatal injuries were due to pedestrian

impairment-drugs and alcohol (“Fatal and Serious Injury,” n.d.). The highest total for the time of

year in which fatal and serious crashes occurred was from October to December at 33 percent

(“Fatal and Serious Injury,” n.d.). The Idaho Office of Highway Safety lists that in 2015, “A

Pedestrian was injured in a traffic crash every 39.8 hours” (n.d., p. 5). The number of nonfatal

injuries in Idaho decreased from 2014-2015 (“Fatal and Serious Injury,” n.d.).

In 2012, there were 31.2 million individuals ages 18-24 in the United States, (Federal

Interagency Forum on Child and Family Statistics, 2014, p. 2). The total US population by the


end of 2012 was 315,219,776 (United States Census Bureau, 2017). Healthy People 2020 has

listed IVP-19 under injury and violence to, “reduce nonfatal pedestrian injuries on public roads”

(ODPHP, 2017). The 2020 baseline was 22.6 from 2008, the goal is 20.3, and the number for

injuries of ages 18-24 as of 2015 was 38.2, the highest of all age groups (ODPHP, 2017). The

number of nonfatal pedestrian injuries increased from 2014-2015 in the United States (ODPHP,

2017).

Other Data Resources

The Madison county average age for 2015 was 23.2 years old, with the highest ethnicity

for Madison County being white at 34, 054, followed by Hispanic at 2, 515, with a total

population of 37, 916 (“Madison County, ID,” Data USA, n.d.). Driving is the most common

mode of transportation, however more people walk in Madison County than compared to Idaho

and the United States (“Madison County,” Data USA, n.d.).

The average age of Idahoans for 2015 was 35.4, with the highest ethnicity as white with

1.37 million, followed by Hispanic at 199, 894 (“Idaho,” Data USA, n.d.). The total population

for Idaho was 1.65 million in 2015 (“Idaho,” Data USA, n.d.). Individuals aged 5-17 was the

highest age group in Idaho (“Idaho,” Data USA, n.d.). The highest, average number of cars own

is 2 per household in Idaho, and driving is the highest mode of transportation (“Idaho,” Data

USA, n.d.).

The total population of the United States was 321 million in 2015, with an average age of

36. (“United States,” Data USA, n.d.). The greatest population was ages 5-17 years old in 2015

in Idaho, however, the population of the US is aging (“Idaho,” Data USA, n.d.), (“United

States,” Data USA, n.d.). The typical car ownership is 2 cars per household, and white and

Hispanic ethnicities were the most prominent populations (“United States,” Data USA, n.d.).


Driving, carpooling and public transportation were the top modes of transportation in the US

(“United States,” Data USA, n.d.).

Comparison of Data

In comparing the secondary data locally, state-wide, and nationally, various similarities

and differences can be found. There is a much higher average of people ages 18-24 in Madison

County than there is throughout the state of Idaho (“Madison County, ID,” Data USA, n.d.) and

(“Idaho,” Data USA, n.d.). Given the lower average age for the entire state of Idaho, not all areas

of the state may be as populated with as many students. Both Idaho, Madison County, and the

US had the same average number of cars per household (“Madison County, ID,” Data USA,

n.d.), (“Idaho,” Data USA, n.d.), and (“United States,” Data USA, n.d.). The national average

may be higher due to the likelihood of different environmental factors throughout the nation,

which may increase or decrease pedestrian injury risks. For Idaho, a combination of ages 15-19

and 20-24 is the second highest age of pedestrians killed/injured, followed by ages zero to three

years old (Idaho Office of Highway Safety, n.d., p.60). Both the primary and secondary data

support the fact of a problem with pedestrian safety in ages 18-24 in Madison County, Idaho, and

the United States.

Five Validating Facts

Five facts from the primary and secondary data supporting the issue nonfatal pedestrian

injuries can be observed:

1. There is a much higher average of people ages 18-24 in Madison County than there is

throughout the state of Idaho (“Madison County, ID”, Data USA, n.d.) and (“Idaho”,

Data USA, n.d.).


2. The number of general pedestrian accidents has increased in the United States from 2014-

2015, while the number of general pedestrian accidents in Idaho decreased from 2014-

2015 (ODPHP, 2017) and (“Fatal and Serious Injury”, n.d.).

3. The average cars per house hold is two amongst Madison County, Idaho, and the United

States (“Madison County, ID”, Data USA, n.d.), (“Idaho”, Data USA, n.d.), and (“United

States,” Data USA, n.d.).

4. Driving is the top mode of transportation for Madison County, Idaho, and the United

States, however, walking as a form of transportation is greater in Madison County than

Idaho and the United States (“Madison County, ID”, Data USA, n.d.), (“Idaho”, Data

USA, n.d.), and (“United States,” Data USA, n.d.).

5. A crosswalk or crossing intersection was the top location for pedestrian accidents in both

Madison County and Idaho (Campbell, n.d.) and (“Fatal and Serious Injury”, n.d.).

(Fatal and Serious Injury 2011-2015 Pedestrian Crash Summary, n.d.).


(Idaho Office of Highway Safety, n.d.)


PART 3: Data Interpretation

Three Similarities of the Data

When observing the data locally, state-wide, and nationally, three similarities between

primary and secondary data:

1. Pedestrian distraction or lack of eye contact were the top two observations noted in the

windshield survey. Failing to yield by both vehicles and pedestrians were the highest

contributing factors for accidents in Madison County (Campbell, n.d.). In Idaho, failing

to yield by the pedestrian was the highest factor contributing to serious injury accidents

(“Fatal and Serious Injury,” n.d.).

2. A crosswalk or crossing intersection was the highest location for accidents in both

Madison County and the state of Idaho. 32 percent of nonfatal injuries occurred in

crosswalks in Idaho (“Fatal and Serious Injury,” n.d.). A total of 21 accidents also took

place in crosswalks/crossing intersection in Madison County (Campbell, n.d.).

3. Data from Madison County, Idaho, and the United States shows that pedestrian safety

with nonfatal and fatal injuries is a problem. (Healthy People 2020).

Three Differences of the Data

In comparing the data, three differences can be noticed. These included:

1. Madison County has a younger average age when compared to the rest state of Idaho,

with an average population of 23.2 years old in 2015 (“Madison County, ID,” Data USA,

n.d.). The average age in Idaho was 35.4 in 2015 (“Idaho,” Data USA, n.d.).

2. In Idaho, more pedestrian, fatal injuries were caused by impairment (defined as drug and

alcohol use), and more serious, pedestrian injuries were caused by failing to yield (“Fatal

and Serious Injury,” n.d.). There is no data regarding impaired driving in Madison


County (Campbell, n.d.). Therefore, impaired driving is as large of a problem compared

to Idaho.

3. The top three times of the day for pedestrian accidents and injuries in Madison County

occurred from noon to 8:59pm, with 6-8:59pm having the highest percentage of the data

(Campbell, n.d.). For the state, minimal variance in time of day for pedestrian accidents

was reported (“Fatal and Serious Injury,” n.d). The Madison County windshield survey

had more data was collected during the morning and midafternoon. Location differences

may also be an influencing factor in the windshield survey data.

Strengths of this Population

Strengths of this population (young adults ages 18-24 in Madison County) are innovative

and have a willingness to be open to new ideas. As mentioned before, Madison County is

younger because of BYU-Idaho and other universities. This population is energetic, active, and

has a desire to learn. Doug Barker, a Patrol Administrator at BYU-Idaho, spoke about strengths

in this population in an interview by stating: “You are in college, getting an education,”

combined with the fact that not only are students learning scholastically, but are also learning life

skills (2017).

In summary, three strengths of this population are:

1. A young, energetic population allows them to be innovative and open to ideas. This can

be beneficial in regards to pedestrian safety techniques.

2. Madison County, along with Brigham Young University-Idaho, brings with it a value-

based community. These values greatly influence the culture of this population as

students or nonstudents. These values of Madison County can help to support pedestrian

safety interventions throughout the community.


3. Being in this population generally puts the individual in a stage of development to learn

scholastically and practically. This kind of learning may help to increase decision making

ability and influence thought processes when it comes to pedestrian safety.

Challenges of this Population

People around the United States, Idaho, and even in Madison County may argue about the

strengths and challenges of this population. Today, there can be a stigma regarding young adults;

attitudes of laziness, selfishness, being spoon fed, and being too involved with technology are

described. In the same interview, Doug Barker stated that, “Being busy, [and having] stresses,”

were some of the weaknesses faced by this population (2017).

During the windshield surveys, it was noticed that pedestrians from this population did

not make eye contact with the driver. If the driver was distracted, if a snow storm hits, or if a

pedestrian is wearing headphones, there are likely to be negative safety outcomes.

In regards to more complex thinking, emotional regulation is another large part of development.

Simpson and Kettyle also state:

Critical to their safety, young adults acquire a significantly greater capacity for

integration of thought and emotion. With the ability to hold the present and the future on

their mental visor at the same time, they can weigh immediate rewards against future

consequences, for organizing abstract thoughts… (2008).

Because of a greater ability for decision making, young adults are able to see how decisions

affect themselves and others (Simpson & Kettyle, 2008). Continued growth and the perfecting of

judgement and decision making skills are continuing throughout adulthood. The whole brain

continues to develop into the twenties (State Adolescent Health Resource Center, 2013). In

summary, developmental factors play into this population in regards to pedestrian safety.


Three challenges of this population are:

1. Dealing with real or perceived negative attitudes regarding young adults, ages 18-24.

This can prevent cooperation of pedestrian safety techniques and laws.

2. Busyness or stresses of being a young adult. This prevents young adults from taking the

time to perform safety checks at crosswalks and increases the risk for speeding or risky

driving. Not being mentally present in the moment and focusing on other aspects of life

stresses can pose a threat to safety.

3. Continuing developmental stages of the brain. The ability to critically think and make

decisions is still developing or is finishing in this population. Therefore, responsibility for

safety can be compromised.

Young adult development. In late adolescence to early adulthood, abstract thinking

combined with, “philosophical and idealistic,” thinking increases (State Adolescent Health

Resource Center, 2013). The frontal cortex in the brain deals with reasoning, planning, and

evaluation. This development is either finishing, or has just finished during early adulthood

(State Adolescent Health Resource Center, 2013). This information is critical because it can be a

valid reason as to why young adults are the highest population for pedestrian nonfatal injuries,

according to Healthy People 2020 (ODPHP, 2017).

Validating Information

The validating information found to confirm this health issue include: first, nonfatal

pedestrian injuries are a problem on each level. This is validated in the data collection and

analysis, above in statistical data. Second, during the windshield surveys, various instances of

risks in safety were directly observed, proving the problem. In one of the locations, there was not

an official crosswalk in an area of high pedestrian and vehicle traffic, across from the Snow


Building and on South Center Street. Location and geography can influence the safety of cross

walks. For example, there are various hills in Rexburg, and right in the middle of them are

crosswalks (Google, Inc. Earth, 2017). This adds to vehicle speed and the probability of not

being able to slow down in time. Around Madison County are also various rural areas and

country roads. Many of these do not have crosswalks, and drivers may not be used to pedestrians

on these roads. Thirdly, if we live in such an advanced society, why do we deal with problems

such as pedestrian safety? Individuals cannot be completely controlled, even by more legislation,

regulation, or laws.

1. There is a much higher average of people ages 18-24 in Madison County than there are

throughout the state of Idaho (“Madison County, ID,” Data USA, n.d.) and (“Idaho,”

Data USA, n.d.).

2. The number of general pedestrian accidents has increased in the United States from 2014-

2015, while the number of general pedestrian accidents in Idaho decreased from 2014-

2015 (ODPHP, 2017) and (“Fatal and Serious Injury,” n.d.).

3. The average cars per house hold is 2 amongst Madison County, Idaho, and the United

States (“Madison County, ID,” Data USA, n.d.), (“Idaho,” Data USA, n.d.), and (“United

States,” Data USA, n.d.).

4. Driving is the top mode of transportation for Madison County, Idaho, and the United

States, however, walking as a form of transportation is greater in Madison County than in

the state and country (“Madison County, ID,” Data USA, n.d.), (“Idaho,” Data USA,

n.d.), and (“United States,” Data USA, n.d.).

5. A crosswalk or crossing intersection was the top location for pedestrian accidents in both

Madison County and Idaho (Campbell, n.d.) and (“Fatal and Serious Injury,” n.d.).


Above are five validating facts, also mentioned in part two. From these five facts we gain the

following validating information:

1. Nonfatal injuries occur in all levels of society, locally, state, and nationally. The risks

and factors for safety were directly observed through visualization, interviews, and

secondary data collection.

2. There is not just one reason as to why nonfatal pedestrian injuries occur. It is a

problem on both ends of the driver and pedestrian.

3. Individuals cannot be totally controlled, even with laws and regulations. People

choose their safety. This may be a factor as to why this is an ongoing problem.

Significant Themes

In collecting data, various themes were detected amongst windshield surveys and

interviews. Windshield surveys were completed at three locations in Madison County: a four-

way intersection between the BYU-Idaho Center and The Burg, crosswalks across from the

Snow Building, and in the Broulim’s Parking lot. Each location was observed at a different time

of day. The busiest times were in the morning and afternoon at the BYU-Idaho Center and Snow

Building crosswalks. However, location does effect the amount of data collected. If pedestrians

were distracted, it was either in the form of headphones, talking on the phone, or looking at the

phone. Pedestrians with these kinds of distractions had mixed results as far as making eye

contact. In all three locations, pedestrians would use their device, cross, then look at it again. It

was also noted that if a group of people was present, and one person started to cross, everyone

else would follow without making eye contact.

When interviewing four citizens of Madison County ages 18-24, two males and two

females, most participants felt unsafe. The fourth interviewee reflected on his experiences in


Florida and felt safer in the crosswalks in Madison County. Despite some difficulties, 100% of

interviewees felt that the current system was working. There were mixed opinions regarding who

was at fault, the pedestrian or the driver? One participant felt it was on the driver, one explained

it was on the pedestrian, and two described how both the pedestrian and driver were at fault.

Minimal suggestions or no changes regarding safety improvement were given.

Interviewee felt safe in Madison County. 3 out of 4 participants felt unsafe as a pedestrian in Madison County.

Interviewee felt current system is working. All 4 participants felt the current system is working, despite a few reservations.

Problem with pedestrians or drivers? Both=2Pedestrian=1Driver=1

Suggestions to increase safety. Increased awareness of rules, classes for winter driving, decreased fines, no change, nothing else can be done.

Doug Barker’s interview provided key insights into the data collection. His experience on

the BYU-Idaho campus and expertise regarding safety shed light on a variety of factors and how

safety is sought after. Themes from this key informant interview are included below:

Responsibility for safety. The first theme noticed from his interview was that an

emphasis on personal responsibility kept being brought up. Discussions about the factors

resulting in injuries and accidents brought up the crucial objective of making eye contact

between drivers and pedestrians. He stated, “It really comes down to this: responsibility of

personal safety,” and, “You can’t assume that they see you” (Barker, 2017). This personal

responsibility takes place on an individual basis. There are flashing lights at most crosswalks in

Rexburg, but even then, you still cannot always think you are seen as a pedestrian. The lights or

the fact of simply taking on the role as a pedestrian does not automatically make everyone safe

(Barker, 2017).


Give and take. The conflict between drivers and pedestrians is a two-way street. Neither

party can assume anything. The theme of making eye contact was, again, highlighted with the

following:

You are putting your life at risk literally by not making that eye contact. Too often we

think pedestrians have that right of way, but speed, time, and velocity is going to

kill you. We can’t assume the driver is doing what their supposed to be doing. It’s a

guessing game (Barker, 2017).

Often, it does appear a guessing game, for drivers and pedestrians. Should I cross? Can I

go? Do they see me? Safely entering a crosswalk is part of Idaho state law. In order to do this, it

is like, “a dance,” between the two parties (Barker, 2017).

Internalizing and caring. When asked about how to motivate this population to be safe,

especially in regards to pedestrian safety, Barker stated that you cannot make or force anyone to

be responsible. Education, discussions, laws, regulations, may help, but not all the way. The

individual must care about it. “They have to care and internalize it. You can plead with people,

you’re not going to change anyone until they see it for themselves” (Barker, 2017). This is where

change comes from. People have to demonstrate that they care and show that by internalizing it,

taking personal responsibility, and working as a whole to reduce nonfatal pedestrian injuries in

young adults.

PART 4: Population Health Plan

First Area of Improvement

Increased responsibility for personal safety: perhaps this is the largest area of

improvement. Young adults, ages 18-24, were observed to be careless in their actions as

pedestrians and drivers. Lack of eye contact, failing to yield, and distractions at the crosswalk


with either party were commonly seen. The large population of pedestrians, combined with the

culture indicated in Madison County, suggest a lackadaisical approach to pedestrian safety.

Various other factors on the state and national level add to the problem.

Recommendations for this problem:

It can be difficult to motivate this population to take responsibility for personal safety. It

is up to the young adult to make an individual choice to enter the crosswalk safely, make eye

contact, avoid distractions, and make oneself visible to the driver. This is the alternative to

walking across the street blindly and hoping for the best. Key recommendations are to:

Have direct, real time education of safety by having students, officers, or other

community members promoting pedestrian safety along the sidewalk as individuals

reach the crosswalk. Promotion would include verbal reminders or funny and eye-

catching t-shirts by the promoters to capture the culture of young adults.

Continued enforcement of current laws or resources such as flashing lights, flags, and

crossing only in crosswalks.

Free winterization of vehicle classes or providing resources with local tire shops

throughout Madison County, Idaho, and winter climate states in the US.

Second Area of Improvement:

Effective stress and time management: When Doug Barker, Patrol Administrator at BYU-

Idaho, was interviewed, he stated that stress and busyness were the main weaknesses of this

population (2017). Multitasking while crossing the street and driving, speeding, being late,

classes, homework, relationships, jobs, etc. cause daily stress. These daily stresses can prevent us

from being mindful of safety.



Although some stress is beneficial, overwhelming amounts of stress can potentiate

harmful effects on the individual. To decrease stress levels and promote better time management

in young adults ages 18-24, recommendations are:

Stress and anxiety screenings in this population to assess for how significant these levels

may be.

Promote stress relieving coping strategies such as exercise. “There is strong evidence

from animal studies that exercise and regular activity positively impacts the

pathophysiological processes of anxiety” (Anderson & Shivakumar, 2013). City

tournaments of basketball, ultimate Frisbee, or other sports, sponsored by the Madison

County Police Department and the Idaho Transportation Department, can get the

community exercising and decrease stress levels. Further education of coping

mechanisms can be discussed at these events.

Social media posts of time management tips through university, state and federal

organizations, or other agencies pages and websites.

Third Area of Improvement

An increase in understanding and acknowledging limitations due to young adulthood

brain development: brain development varies depending on age. For young adults, development

of specific parts of the brain (frontal cortex) have just finished developing or are continuing to

develop (State Adolescent Health Resource Center, 2013). This part of the brain involves

planning and reasoning, therefore, young adults may not have the full capacity of the brain when

making critical decisions, putting them more at risk for safety (State Adolescent Health Resource

Center, 2013).



There may be people in the community, state, and county who have an understanding of

the development of the brain. However, a focus on this and how it relates to pedestrian injuries is

needed. Therefore, recommendations for this area of improvement may include:

Educational seminars regarding young adult brain development, and how it relates to

pedestrian injuries. Young adults need to recognize they are at risk, yet be given the tools

to be empowered to make safe decisions.

Billboards and public service announcements explaining fast statistical information about

pedestrian injuries, decision making, and how the brain develops can promote education

of how these topics are related. People can see them on TV, the internet, or while driving.

Implement pedestrian safety skills into the state public education system while

individuals are young, to facilitate critical thinking and decision making skills into early

adulthood. Education could involve what street signs mean, lights, the importance of

making eye contact, etc.

Evaluation of Recommendations

Evaluation can ensure the stated recommendations have been effective. Education can be

evaluated by directly observing how pedestrians act during and after being taught from

crosswalk promoters, seminars, and classes. Views of public service announcements and social

media posts can infer how well the information is being spread to the public. Attendance to

classes and sponsored activities can also give information about how open citizens are to the

information. Results of screenings can infer anxiety levels of the community and if more

intervention is needed. Individuals can be surveyed about stress levels after participating in

physical activity. Further data collection and research after implementing the above


recommendations and be compared to previous data. For example, additional windshield

surveys, injury reports, and other relating data (such as injuries during the winter after promotion

of winterized vehicles) can conclude improvement in pedestrian safety.

Reflection

I can apply what I learned to be successful in the work force by constantly thinking of the

“why” behind things, how to improve practices, and how to solve problems. This project really

pushed me in involving myself in community issues, and I learned how to focus on specific

population needs. When I enter the workforce, I can focus on assessing certain populations to

know how to best help them. This project was also representative of the nursing process. We had

to assess a population, formulate plans and interventions (recommendations), and identify how to

evaluate them.

This project focuses on problems with certain populations. I can apply my learning to

improve the lives of others by recognizing that each individual belongs to a particular

population. I can assess various individuals and use this to then apply nursing interventions to

entire populations. This is how we can improve the lives of others on a wide scale. I think about

people around the world who suffer from various diseases, nutritional deficiencies, loss of homes

and personal property, family tragedies, violence, and crisis. I have a desire to help people and to

influence the world somehow. I now know how to assess at risk populations and how to come up

with ways to try and solve these problems. This is one way to influence the lives of others.

My thought process has changed as a result of working on this project by paying more

attention to the local, state, and national community health problems. I look problems with a

perspective of how we can solve it. I hypothesize and think of ways to gather data and complete


research through possible windshield surveys. I think about society more as a whole, and often

ponder possible situations and the impact they have on it.

(Reflection Word Count: 299).


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jennafransen.files.wordpress.com · web viewin 2010, the national percentage of nonfatal...

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