Background The police-reported recent decrease in pedestrian fatality was questionable in terms of the serious under-reporting of police-reported data.

Aims/Objectives/Purpose To examine changes in pedestrian fatality between 2006 and 2010 in China using Non-police-reported data.

Methods A longitudinal study was conducted based on the mortality data during 2006–2010 from the Disease Surveillance Points data of China. Multivariate Poisson regression was used to control the effects of sex, age, and urban/rural. Mortality rate ratio (MRR) was used to quantify the increase in pedestrian fatality. ‘p<0.05’was selected as the statistically significant level.

Results/Outcomes Between 2006 and 2010, the crude pedestrian fatality increased from 7.0 to 10.5 per 100 000 population. After controlling sex, age and urban/rural, the fatality increased by 44% in the research time period (adjusted MRR=1.11, 95% CI 1.10 to 1.11). Males had higher fatality rate than females (adjusted MRR=2.54, 95% CI 2.48 to 2.61); rural residents were 1.42 times urban residents dying as pedestrians (adjusted MRR=1.42, 95% CI 1.39 to 1.45). Selecting children less than 5 years as the reference, persons ages 5–14 years, 15–24 years, 25–59 years, and 60+ ages had the MRRs as 0.64, 1.42, 2.56, 5.52, respectively.

Significance/Contribution to the Field The recent police-reported decrease in pedestrian fatality may not be true. Non-police-reported data should be applied to improve the quality of pedestrian injury data in China. The high-risk groups of pedestrian fatality—men, rural residents, old age groups, should be addressed in China's injury prevention action.